You can tell when an election is approaching, because that small angry group in Richland, who apparently believe that freedom of the press extends only to their own point of view and agenda, revives their absurd complaints about my columns, using anonymous emails, blogs, and letters. If you wonder who creates this stuff, just look back at my writing, and consider exactly who would benefit from muzzling the media. And who would suffer if there was no voice for the community.
Who would have believed that the April 22 PA primary would actually be meaningful? Or that the Democratic presidential nomination might go all the way to the convention floor for the first time in 30 years? Or that the battle would be between two candidates who are so similar, rather than so different?
Hillary is the high-profile woman, an experienced senator from New York. Married to a guy named Bill. Barack is the 46-year old junior senator from Illinois, a virtual unknown on the national scene until his address to the Democratic convention four years ago. Oh, yeah, he's also black. Both trumpet "change". But despite the campaign rhetoric, Dems have a choice of two similar products, just with different wrappers.
Clinton talks substance and seems better on the issues. Obama embraces the bigger picture, and relies on a more general, hopeful outlook. But aside from the blather about who has been more opposed to the war, the two have very similar approaches to the key issues of abortion, climate change, immigration, and education. Both would phase out our involvement in Iraq, support Roe v Wade, appoint judges with similar views, fight pollution worldwide, attempt to control illegal immigration, and devote more resources to education. Everything that our current president has not done.
The only field where they really differ is health care. But beware. Campaign proposals are easy to make, but this one will be particularly difficult-to-impossible to keep. Clinton and Obama both advocate a far more ambitious overhaul than Republican John McCain, who actually has the more realistic plan to use tax changes to encourage consumers to take a more active role. Basically, Clinton would require everyone to obtain insurance, subsidized by employers and the government. Obama would only require that all children have health insurance. Both would pay for it by rolling back President Bush's tax cuts for people earning over $250,000.
But the devil is in the details, and neither candidate has actually told us how insurance would either be more available, or more affordable. Or how they would assure compliance. Right now we "require" many things from our citizens, and millions still violate the law. How will we force health care on those who just don't cooperate?
And - even more important - what if universal health care coverage costs way more than Clinton or Obama are leading us to believe? Insurance on this scale is uncharted territory, and test runs on the state level have been disastrous. Massachusetts is now saying that the cost of subsidizing the poor has doubled to $1.35 billion in just two years. California recently abandoned its plans for universal coverage when the estimated costs soared. No one should be surprised. Have you ever heard of a government project that didn't end up costing far more than the original sell-it-to-the-public price tag?
And even if they were able to accurately assess the initial costs, and actually find a way of financing them by rolling back tax cuts, it still would not solve the problem! Anyone who has health coverage today knows the real issue - a total lack of cost containment. Rates are soaring. You can blame the legal system, with ambulance-chasing attorneys on contingent fees, and juries handing out "free money" verdicts. Or you can blame profit-driven insurance companies, who have replaced doctors as medical decision-makers.
Or you can blame the millions of people who are using you as their health insurer by just not having any of their own. Their unpaid bills are passed on to you by every care provider.
The problem will never be solved until there are actual incentives for both the health care industry, and consumers, to economize. When is the last time you shopped for medical services by price, like you do for everything else? Probably never, because someone else is footing most of the bill. You check the competition when you finance your house, buy your car, your clothes, your food, TV, furniture, and phone service. Even attorneys are obligated to reveal their rates in writing. But we never, ever, know how much our medical providers are being paid. And we would never, ever, dream of complaining.
Meanwhile, there are no restrictions, or cost controls, on most of the devices and medicines that health care providers use to treat you. Pharmaceutical companies can charge whatever they want for their drugs, and spend hundreds of millions of dollars on convincing doctors and hospitals to prescribe their products. We have all heard about people who go to Canada, Mexico, or even Europe to get the same medicines for a fraction of the cost.
Imagine the profits available to an insurance company, or a drug manufacturer, that could deal with tens of millions of clients at once, rather than one patient, or one doctor, or one hospital, at a time, like now. Merely insuring more people under the current conditions is a recipe for the worst federal boondoggle ever. No national health care system is going to work unless we first have a system to control costs. So until Hillary, or Barack, or John give us the details, and show us numbers that make some sense, don't get too caught up in idealistic phrases and promises.
Sadly, many - dare we say most - voters in this election are less knowledgeable about issues, and more focused on personalities. The Dem candidates attract and repel based on factors that have little to do with qualifications for office. Gender. Race. Husband. Hillary has been a target for years, but if she was a man with a different last name, would she have the same public interest? Would Obama have the same appeal if he was white? He is an articulate, charismatic, fresh face, who symbolizes hope for those who have felt politically disenfranchised. But he has virtually no experience. Remember Jimmy Carter.
Voting solely on the basis of race or gender is foolish. But blindly believing campaign promises, without exploring the realities, is even worse.