Centerfield

I can give you a hell yeah on the quote, but not on the policy of declaring that medical care is a "basic right". That sounds well and good in principle, but when something like that is put into a state constitution, it winds up generally letting the courts decide whether the legislature has adequately funded that guarantee. To me, "basic rights" should be reserved to those which I actually have regardless of government funding. If it requires an appropriation, it is not a "basic right".

As a quibble, Mathew, I wouldn't characterize "the right" as being at odds with "civil unions". The right in general is against "gay marriage", but recall that President Bush voiced support for civil unions in one of the presidential debates against Senator Kerry. Thus, I would link opposition to "civil unions" to the far right rather than merely the entire "right".

I should note that I don't technically agree with the wording "basic right" either, although I do believe it is a basic right that we should be better at allocating. I was reporting the facts.

but recall that President Bush voiced support for civil unions in one of the presidential debates against Senator Kerry. Thus, I would link opposition to "civil unions" to the far right rather than merely the entire "right".

I don't call what he did voicing support exactly. He did so quietly, in an election year, with strong protest from Conservatives in his party. My view is that the average conservative is opposed to extending rights to homosexuals, civil unions being one of them. Yes, more business minded, libertarian Republicans would more than likely be in favor of civil unions. Again, I don't fully agree with Westlund on this. This Republican supports gay marriage, period.

I meant disagree with the wording "basic right", not agree with it...

I'm not so sure, Mathew. He voiced his support for civil unions at a very visible place in the campaign, and I'm pretty certain that support cost him more votes from the religious right than it gained him from swing voters and moderate Democrats.

Some of the original anti-gay-marriage amendments to state constitutions were directly aimed just at gay "marriage", and failed pretty overwhelmingly, even in states like Oregon. Some of the more recent such amendments ban gay marriage and anything which looks like gay marriage under another name. I don't know if those are faring as well. Have you seen anything on this?

No, but that is a good question, and one worth looking into. I would vote for a civil rights law, but to me, there isn't a difference and not calling it marriage is a bit demeaning.

MA is currently looking at multimillionaire Christy Mihos running as an independent, too. But it's not clear he's doing this as anything other than a vanity run driven by his being miffed at being offered the pointless lt. gov. slot on the GOP's fall ticket.

This tells me that we are going to have to be wary of non-party candidates eager to pick up a centrist banner. "Hey. Look what I found! Votes!"

I think some medical care, like say emergency medicial care to prevent death or mitigate substantial pain or treat serious physical should be a basic right. And I think most people believe this as well, and would vote to approve this notion.

The conundrum, of course is that, as economists will tell you, people pursue high-risk strategies when they are protected against the consequences of failure. So we probably should not interpret the notion of medical care as a basic right to mean that it should therefore be provided absolutely free to everyone by the government. Maybe the right is a right to access, and a willingness of the people to help pay for it if you can't. But not for all treatments, and no regardles of your ability to pay for some portion of the cost.

We're not ready to let people start dying in the streets of course. But I'm not ready to be taxed to pay for everyone to get the same treatment regardless of the choices each of us makes, either.

The ballot measure to ban gay marriages in Oregon did pass with comfortable margins in 2004. The difference between that effort and previous efforts was that the earlier efforts encompassed far more than just gay marriage. They were shot down convincingly. But, recouched as just banning gay marriage the issue finally passed.

Westlund caught hell from the right for advocating civil unions. This just one year after he'd publically opposed gay "marriage."

An interesting factoid about Westlund: In his 2004 election to the state senate (he was in the state house until 2003 when he was appointed to the state senate), Westlund won the nominations of both the GOP and the Democrats. How many elected officials can make a similar claim?

The ballot measure to ban gay marriages in Oregon did pass with comfortable margins in 2004. The difference between that effort and previous efforts was that the earlier efforts encompassed far more than just gay marriage. They were shot down convincingly. But, recouched as just banning gay marriage the issue finally passed.

Westlund caught hell from the right for advocating civil unions. This just one year after he'd publically opposed gay "marriage."

An interesting factoid about Westlund: In his 2004 election to the state senate (he was in the state house until 2003 when he was appointed to the state senate), Westlund won the nominations of both the GOP and the Democrats. How many elected officials can make a similar claim?

Very interesting factoid, Kevin. I doubt very many politicians anywhere can make that claim.

Most states won't let you accept multiple party nominations. New York is one of the few states that I know of that allow for that.

Unless there's a lot of Democratic dissatisfaction with Gov. K, I see this Westlund run merely insuring his relection, since I don't see him weaning off too many Democratic voters with a libertatian platform.

If your "basic right" requires the forced taking of the resources of others to fulfill, it's not really a "right." It's a social entitlement. Big basic difference there.

(Remember I'm the guy who advocates universal single-payer basic health care--I'm just not under any illusions at all about what I'm advocating.)

As long as your an honest socialist, Tully! ;)

I like this guy from Oregon. Sounds like my kinda politician: socially liberal, fiscally conseravtive but moderate center-left on budget priorities.

As for healthcare, I've always been of the opinion that some form of universal access would greatly help all Americans, both those who pay and those who do not. Our system is broken and very expensive. It also weighs down small business and bankrupts many unfortunate people who cannot afford what insurance fails to cover with a chronic illness. We spend more on healthcare as a percentage of GDP than any other country BY FAR. Something is wrong here. I see no reason why we can't come up with a system that combines the best of systems like that in France (which is very very good) and like ours as well.

I like the idea that I've heard of somehow expanding medicare to cover everyone. Medicare's strength is that it runs inexpensively in terms of adminstration. which saves A LOT of money compared to private health care which is redundant and costly in its administration. Where is runs into problems is that it only takes on the eldery meaning its patients cost more to care for. Top expand this to cover everyone would use the power of economies of scale and spread out the burden over the entire population. Bulk bargaining would also be useful. All the while, people should be able to purchase additional top level coverage, which would in turn be significantly less since it's only supplemental.

Besides, allowing everyone access to general healthcare will keep the general population healthier and lead to earlier detections of problems which will save even more money.

It's broad and general...but it's a start.

John, I'm not sure you've been around for our previous bouts on the topic of healthcare, so here's my position in a nutshell.

What we have now is what I call privatized socialized medicine. HMOs combine all the bad parts of capitalism and socialism in one... unfeeling, unthinking bureaucracies coupled with a strong profit motive. Not good. Most around here seem to advocate a more government-involved system. I think we should have one which is far more free-market oriented than what we have now.

There are a few key factors in the increasing costs of health care. Each probably requires different principles to solve. First is the expense of taking care of really old people who are living longer than ever. Second is people who don't get health care until a minor problem has escalated into a major, expensive problem (lack of adequate maintenance of diabetes, etc.). Third is the administrative expense of record-keeping requirements imposed by all payers of health services, government and private HMOs.

I'd like to see more responsibility kicked down to the individuals and families themselves. Use a combination of Medical Savings Accounts and a tax credit for the poor, and decouple health insurance from employers all together. Let individuals deduct their health insurance premiums and choose top-of-the-line coverage or bare-bones coverage. Rather than having insurance/HMOs pay the bill for most routine doctors visits, let the patients decide whether a given illness is worth the expense and the tests. There's a lot of expense buried in unnecessary, defensive-medicine tests today which would be cut if patients were more cost-conscious. Structure the insurance regulations so that all insurers (and doctors) would have a strong incentive to develop and fund, for example, diabetes maintenance programs, rather than just paying for the complicated costs incurred if the maintenance program is not followed.

This would all address the second two problems, but cutting costs of caring for the infirm elderly is a much bigger and more difficult problem.

Use a combination of Medical Savings Accounts and a tax credit for the poor

What about the unemployed or the severely underemployed who have neither the money to sock away nor income on which to have a tax credit?

and decouple health insurance from employers all together.

Thing is, employer-paid health insurance is a direct form of compensation. If it were decoupled then that would be tantamount to a decrease in wages. How would you deal with that in the transition phase? Afterwards it would be the same basic marketplace of employers dangling compensation packages and prospective employees deciding which are the most attractive like we have presently. But it seems to me that the transition would be ripe for employers taking advantage while employees get the short end of the bargain.

I must say that while I opposed it vociferously when Hillary brought it up, I am increasingly partial to Tully's suggestion of a single-payer system. Especially since my own compensation at my job has effectively gone down over the last 4 years with the wage freezes but ever spiraling health insurance costs coming out of my pocket and my paycheck.

I must say that while I opposed it vociferously when Hillary brought it up, I am increasingly partial to Tully's suggestion of a single-payer system.

Maybe you were paying attention to the details of HillaryCare, Kevin. :-) I was against it myself. It wasn't really a single-payer system at all, it was a government-controlled political takeover of the current system.

Kevin, I meant a tax credit like the EITC, where if you don't have enough income, you get cash back from the government.

There would certainly be adjustments to be made during an interim, but the primary reason that health insurance, unlike life insurance or car insurance or home/renters insurance, is primarily employer-provided is because years ago the federal government made health insurance a deductible expense for businesses, but not for individuals. The employer's share of the insurance is not even treated as income to the employee for tax purposes. Those are powerful, powerful tax incentives which led to the system we have now.

The result is often employees tied to jobs which they dislike because of the health insurance. For example, I know several people whose children have severe disabilities. They are now more or less permanently tied to government employment. If they moved to a private employer, the increased premiums for that business because of this one person would be far too high (except for really large corporations), and the child might lose insurance for the first 6 to 12 months for the "pre-existing condition".

That needs to change. As I say, I think changing to give more power to individuals and make the system more market-oriented would be better.

Mathew, I seem to have unintentionally thread-jacked your post onto a health care topic. Sorry about that.

Thanks, Pat. Don't wanna highjack this thread any further than necessary.

Sorry Mathew.

A discussion on healthcare? How damaging! :)

No problem here, it's related after all.

Open random thread above. Have at!

Senator Ben Westlund certainly wouldn't mind that a thread on his candidacy sparked a conversation on healthcare reform- that's the whole point.

To clarify- The Hope Initiative does not mandate any particular solution, it just states that "every Oregon resident has access effective and affordable health care as a fundamental right" and creates a mandate for the legislature to start expanding access by 2009. It's not about providing everything, Oregon already has a model of a priortized managed care system for our most vulnerable. But, that leaves over 600,000 uninsured- 117,000 of them children.

Westlund believes that to lower health care costs for those who have it, we need to provide it to those who don't. Currently, in Oregon 10% of every insurance premium is covering the unpaid costs from the uninsured.

To help with short-term immediate needs, he is chief petitioner on an initiative to extend the Oregon Health Plan to cover all of the uninsured children and thousands more of our most vulnerable adults with a 60 cent cigarette tax.

Regarding his support for civil rights, Ben was from a rural area and a republican and he was way out there in front on adding sexual orientation to Oregon's nondiscrimination law and for getting civil unions becuase marriage was prevented by the passage of BM 36. He believes that getting equality for gay and lesbian families is the civil rights struggle of our generation. His floor speech is available on his website

Stacey, thanks for dropping by. I'm delighted to see that actual politicians are reading our website, and they and their staffs are always welcome to join in our discussions (with appropriate disclaimers, such as yours, of course!)

My concern, based on 13 years as a lawyer in the government sector, is that if the state constitution declares a fundamental right to "access effective and affordable health care", without some strict language to limit the ability of the courts to interpret and apply that provision, there is a major risk that health care policy will be made by judges, not legislators. If the legislature decides, for example, to fund new education programs at the expense of health care programs, I think it would be inappropriate to give judges an opportunity to overrule that decision based on the judges' own believes of what constitutes "effective and affordable" access to health care.

Best of luck to your candidate, though!