Despite a series of recent missteps on social issues, Rudy continues to hit the right notes on fiscal issues and the war. Here’s Rudy on health care:
Republican presidential candidate Rudy Giuliani on Friday accused his Democratic rivals of embracing health care plans that would amount to socialized medicine.
The former New York City mayor, responding to comments in the first Democratic primary debate Thursday night, claimed Democrats favor “mandatory” universal health care and the plans would only exacerbate the cost of care by putting the system in the hands of bureaucrats.
“They’re moving toward socialized medicine so fast, it’ll make your head spin,” Giuliani said, adding that private solutions could help bring down the cost of care. “When we want to cover poor people, as we should, we give them vouchers.”
Democratic candidates renewed their calls for universal health care during a debate in South Carolina, saying that a new system would help streamline costs and cover the nation’s 45 million uninsured.
Among the top-tier Democratic candidates, John Edwards has offered a specific health care plan that would require everyone to have health insurance.
Sen. Barack Obama, D-Ill., used the debate to describe a health care plan that would increase coverage by allowing the uninsured to buy into a plan similar to the one for federal employees, improve technology to cut costs and provide government-funded catastrophic insurance to prevent business from going bankrupt when they offer health insurance.
Sen. Hillary Rodham Clinton of New York has not offered a specific proposal, saying she is still listening to voters on the issue.
“I’ll be darned if I’m going to concede that Democrats care more about poor people than we do,” Giuliani told an audience of the North Carolina Conservative Leadership Conference during a brief trip to the home state of Edwards, who has made fighting poverty a signature issue.
In response to Giuliani’s criticism, Edwards issued a statement, saying, “Rudy Giuliani needs to put an end to his campaign to divide America and concentrate on offering solutions to the big challenges we face.”
Earlier this week, Giuliani, who was mayor during the Sept. 11 terrorist attacks, drew a sharp rebuke from the Democratic candidates for suggesting that the United States could face another major attack if a Democrat is elected in 2008. He didn’t back down from the comments.
He stood by those remarks Friday and said Democratic presidential candidates, most of whom want to begin timed troop withdrawals from Iraq, are “retreating in the face of this terrorist threat.”
“When, in the history of war, has a nation that decides to retreat, printed up a schedule of that retreat and handed it to its enemies?” Giuliani said at the event, hosted by the Civitas Institute, a Raleigh-based conservative think tank.
I agree completely with Rudy’s commentary that the way to deal with uninsured Americans is to give them vouchers to purchase private health insurance. This strikes me as quite similar to the way we’ve ensured that working-class and lower-middle-class young people can acquire a college education without yielding a massive state takeover of our nation’s colleges and universities. State-subsidized student loans have worked wonders for social mobility in this country without compromising the quality or autonomy of American higher education. Why couldn’t the same thing be done with health care? Why does every solution to the problem of the uninsured involve creating an American version of the NHS? Rudy seems to be on the right track regarding this issue.
All of this serves as a reminder that Rudy can be very, very good on fiscal issues, the war, and party loyalty. His problems seem to be the result of a very tricky dance on social issues, where Rudy is trying to do something that hasn’t been accomplished since 1976: win the GOP presidential nomination as a candidate who doesn’t support criminalizing abortion. I do wish that Rudy would have taken the free advice that the Editors here at R4’08 have given him on these issues, and I believe that there’s still time for Team Rudy to craft a platform on social issues that makes sense. But it will have to be one that involves agreeing with social conservatives in areas where lots of secular conservatives and moderates agree with them (partial-birth abortion, abortion funding) while standing his ground on issues that divide social and secular conservatives, such as civil unions or gays in the military.
April 28th, 2007 at 4:39 pm
Let’s be honest, Rudy has problems with personal issues as well as social issues. Having affairs with staff as a high-ranking government official and recommending someone for positions of responsibility like Bernie Kerik, who he either knew or should have known to have a questionable background, does not speak well for his character and judgment. Wait until tried-and-true Republicans hear about the folks Giuliani has relied on over the years as an inner circle to make all the important decisions – Democrats and folks who became nominal Republicans only because the Mayor was running for office on the GOP ticket.
Let’s see if his perceived strength on fiscal and international issues (which could erode because, after all, this is the guy who fought to keep the New York City commuter tax and whose management left New York City less than optimally prepared for 9/11 – so his record is often over-glamorized) can make up for these other clear weaknesses.
And his party loyalty wasn’t so great when he endorsed Mario Cuomo for governor over George Pataki.
April 28th, 2007 at 4:45 pm
or when he said he wasn’t much different than Bill Clinton, or when he tried to appeal to the NY libs by saying he wasn’t a conservative.
April 28th, 2007 at 4:50 pm
Gee, what was the war he was leading in NYC? was that against the NYC conservative establishment? Hmmm.
April 28th, 2007 at 4:51 pm
And… hmm… what have we here? Rudy the farthest to the right on one of our biggest domestic issues?
April 28th, 2007 at 5:13 pm
Dave, if I had any strings to pull at Rudy HQ, I’d try to get you hired.
April 28th, 2007 at 5:20 pm
Is it even the federal government’s job to support vouchers for healthcare?
I mean, let’s be honest, the only reason anyone supports vouchers for education is because we’re already too deep into public education. Isn’t the voucher system just a step towards socialized medicine?
Just a thought.
April 28th, 2007 at 5:25 pm
Nusrat,
It could be, but I would say, if the federal government is going to do anything additional regarding health care, which I agree is a big “if,” vouchers would probably be the least harmful alternative.
April 28th, 2007 at 5:36 pm
Yes, I see that..
I just think we are giving the Democrats too much room in this debate. We are pandering to their rules, their story, where if we showed why it is not the fed. government’s job, and why it would be a bad idea to go in that direction, we could absolutely win this debate.
I don’t think socialized medicine is inevitable, but if we keep acting like it is, then it will be.
April 28th, 2007 at 6:02 pm
Nusrat, I don’t understand what you’re saying. Vouchers are, in short, the ability to use public money towards private means. Vouchers in education mean taking money that is otherwise allocated to public schools, and allow individuals to spend it on private school tuition. Just so with healthcare: use money that otherwise goes into socialized medicine and spend it with private insurers and hospitals. What conservative could oppose vouchers? It’s the ultimate expression of individual responsibility and efficiency.
April 28th, 2007 at 6:05 pm
“All of this serves as a reminder that Rudy can be very, very good on fiscal issues, the war, and party loyalty.”
Um, except for the fact that Rudy’s never balanced a budget – he borrowed bonds and left NYC billions of dollars in debt when he left office.
And except for the fact that he endorsed Cuomo, he said he would like to run on the liberal party ticket for Mayor, never could get the endorsement of the conservative party in NYC, was a Democrat for most of his life, was a Dem party committeeman, and said he could have easily endorsed Clinton over Dole in ’96.
And I’m still really curious how running crisis management on 9/11 makes him any better on “The War” than any other GOP candidate (besides Brownback or Paul anyhow).
“…a candidate who doesn’t support criminalizing abortion.
This statement right here sums up in a nutshell why I will never, ever be voting for Rudy Giuliani – or any pro-choice candidate for President for that matter. It’s a complete flipping of abortion arguments on their head for the sake of making Rudy look good. How long and how hard have we fought to be called pro-life, not anti-abortion? How long have we fought not make people see we are not for making women criminals, but rather to protect innocent life? This statement should have read, “a candidate who doesn’t support killing unborn babies,” but already we’re seeing fellow Republicans use pro-choice language. If Rudy becomes the standard-bearer of the GOP, the pro-life movement takes ten steps backwards – not only because of his potential actions as POTUS, but because of his rhetoric and the rhetoric of his supporters.
April 28th, 2007 at 6:31 pm
I don’t oppose vouchers per-se, as a last-resort measure. I just think the federal government should stay out of medicine entirely, as it is extra spending that I, as a taxpayer, do not want to take on.
April 28th, 2007 at 6:31 pm
Rudy sets back the pro-life movement further than any Democrat because he cedes the moral high ground and governs amorally as he did in NYC.
April 28th, 2007 at 6:32 pm
HeavyM…
How long and how hard have we fought to be called pro-life, not anti-abortion?
Then how come, as a pro-choice individual, I have been called, by conservatives, “pro-abortion” and “a baby-killer?”
I’m not entirely disagreeing with your point, I just want to get the semantics down.
April 28th, 2007 at 6:41 pm
Nusrat, I’d prefer to just call you anti-life. Or if I was being more literal I’d say you support a woman’s right to have the baby growing inside her crushed or poisoned or dismembered.
April 28th, 2007 at 6:51 pm
I’m neither.
April 28th, 2007 at 6:55 pm
But let’s go back to health care.
So far, between Romneycare and vouchers, I support vouchers…
Can a Romney supporter tell me what would happen, under a mandate of health insurance, if someone couldn’t afford health insurance?
April 28th, 2007 at 7:02 pm
Romney has said he doesn’t favor a national approach. He instead favors a state by state way of dealing with health care.
April 28th, 2007 at 7:05 pm
Nusrat, I know “Romneycare” is the popular term, but anyone who has looked at the issue personally knows that Romney didn’t get everything he wanted. He vetoed several things anti-business provisions that the legislature put back in by overriding his veto.
Romney isn’t saying this is what he wants to enact on a federal level. Check your facts if you want to post about what a candidate supports or doesn’t support.
As far as your question. The Mass. plan includes subsidies or graduated vouchers for those who can’t afford insurance.
April 28th, 2007 at 8:19 pm
Nusrat, I can also tell you what happened before Romneycare: the rest of us paid higher taxes to provide healthcare, gratis, to the freeloaders who “couldn’t afford healthcare,” but could somehow mysteriously afford plasma TVs, McMansions, and SUVs. In other words, pre-Romneycare was socialized medicine, post-Romneycare is mostly market-based medicine.
April 28th, 2007 at 8:44 pm
Exactly HeavyM! You just expressed virtually every negative thought I have about a Giuliani led Republican ticket. I think this was inevitable really, in retrospect. As much as I’ve chided Giuliani, over insistence on continually defending his radically pro-choice position (rather then just letting it lie, and asking to agree to disagree), I don’t think he many other options. Nor do Giuliani’s supporters. The positions he supports on this issue, are so fundamentally as odds with virtually everyone in the Republican Party, that he’d die the moment the campaign seriously kicked into gear, unless he and his supporters hijack the pro-choice movements terminology. There’s no way, consistent with pro-life language, to defend Giuliani on this issue. You have say things like “he doesn’t want to throw women into jail”, or “he doesn’t want to make people criminals for abortion”, or “he thinks that ultimately, it’s decision he’s not comfortable making for a struggling woman”. His popularity makes all the more dangerous. Giuliani is a trojan horse, and we will awake, from a deep slumber, in the middle of the night to find our walls have been destroyed from within.
April 28th, 2007 at 8:57 pm
On vouchers: I’m unclear what DaveG and others mean by “health vouchers”. It sounds like a neat idea, but it doesn’t take much thought to see it’s enormous failures. One sentence, in particular, from DaveG, strikes me as utterly bizarre. “I agree completely with Rudy’s commentary that the way to deal with uninsured Americans is to give them vouchers to purchase private health insurance.” These uninsured Americans aren’t currently receiving much, if any, federal aid for health care. Even the free care that they receive is largely handled by state governments. If we’re giving people vouchers, people that we currently don’t spend any money on at the federal level, then we’re MASSIVELY increasing the amount of money the federal government spends on health care. 47 million people, even if we could find a way to get the average plan to about $250 a month nationwide, is an absolutely absurd amount of money. Absurd to the tune of 141 billion a year. If you’re talking about vouchers that aren’t intended to cover all health care costs, then it’s hard to understand the difference between a voucher and a subsidy. Now of course, some of those costs are going to be defrayed when overall costs decreased, because the risk is now more widely spread, but that will occur in a socialized system as well (or in Romney’s for that matter). It strikes me that this “vouchers” idea, is just socialized medicine in disguise (and not a very clever one either), something which certainly can’t be said (whatever you might think of it’s “anti-libertarian” components) about Romney’s plan.
April 28th, 2007 at 9:05 pm
Matt,
Let me rephrase. I agree with Rudy that if something is to be done at the federal level regarding insuring the uninsured, then a vouchers plan is the least harmful solution. Of course, I am not sold that something need be done at the federal level. But if the public demand ever becomes so great that we have to choose between doing something nationally or losing everything to the Dems, then I would support a vouchers idea that provides only those who can’t afford their own plan, or who can’t get a plan through their workplace, with a voucher to purchase a private plan of their choice until their situation changes. Lots of people would only qualify for such a plan temporarily, maybe while between jobs or in grad school, and I assume that the voucher would be enough for a no-frills health plan just to get the individual through the rough patch. I’m far from an expert on an insurance, but I’m not sure how the Romney plan is preferable to this idea.
April 28th, 2007 at 9:30 pm
“Why does every solution to the problem of the uninsured involve creating an American version of the NHS?”
Deeply dishonest.
As far as I can tell, NOT ONE single proposal by any of the candidates (at least the mainstream ones) has anything whatsoever to do with a NHS-type government takeover of the health care system.
Very bad show, Dave.
April 28th, 2007 at 9:34 pm
DaveG,
I know a bit about healthcare. So here’s why Romney’s plan is better then the vouchers idea. Currently, around 60% of the 47 million uninsured people, can’t “afford” private insurance. In Massachusetts, it was roughly 50-50, but the nation as a whole is less wealthy then Massachusetts. So that’s 28 million people who would need these vouchers. For all intents and purposes, Romney’s plan provides “vouchers” to the Massachusetts equivalent of these 28 million. They’re forced to buy health insurance (which is exactly, by the way, what providing someone with a voucher does…they can’t, after all, spend it on anything else), and are given free rein to purchase whatever sorts of plan they’d like, with government aid.
There are small differences of course. The most obvious being that while the types of subsidies Romney’s plan provides vary with the cost of the plan, vouchers a lump sum gifts. Thus, vouchers have always had the benefit of forcing people to make more economical and thoughtful choices (though the type of subsidies the Mass plan gives are “free market” enough to limit this difference). So chalk a positive in the voucher column. But wait a second. Does RomneyCare pay for “all” of the cost of the uninsured? Nope. It slightly expands medicaid, then subsidizes plans, on a sliding scale, up to 300% of the poverty level (roughly 40k I believe).
Vouchers on the other hand can’t be adjusted in such a way (after all, they would hardly be vouchers if the amount “choice” you had functioned on a sliding scale). You might decide to have a voucher plan intended to allow people the choice to cover the cost of entire health insurance plans with the voucher. So you might want to give out vouchers worth 2-3k per year. Well, first of all, you’re spending alot more with this type of plan then you would be with Romney’s. Secondly, now you’ve caught alot of people who are essentially on the edge of that 300% of the poverty level. You’ve decided to pay entirely for health care, for tons of people who could afford to pay on their own. So it’s really inefficient.
So maybe you decide to hand out more modest vouchers. 700-1000 a year. Now you’re spending roughly what Romney’s subsidies cost. Only now, you’ve got alot of people, on the lower end of the 100-300% of the poverty level, who aren’t helped at all by this voucher. Even with an additional 1k a year, they’re not able to purchase plans.
Finally, there are some real problems with attempting to devise a system targeting only those who are the least able to afford insurance. Because people who are unable to afford insurance, are overwhelmingly, most likely to need it. They live less then healthy lifestyles. They’re more likely to allow small sicknesses to develop into debilitating illnesses. They’re entirely unable, or unwilling, because of a variety of socioeconomic factors, to obtain preventive medicine. In short, you’re adding the WORST economic risks into the private insurance pool, without doing anything to compensate for that. At the very least, insurance costs are going to remain, for everyone, as high as they currently are (i.e., twice as high as most developed nations). And at the worst, you’re going to increase costs for everyone. Romney’s plan has the advantage of bringing in many healthy, capable, young adults, who can spread risk, and bring costs down for others (including themselves ultimately). Sorry, I just think it’s a pretty poorly thought out idea.
April 28th, 2007 at 9:58 pm
I think if we’re inventive on health care, there many reasonable ideas to A.) Really bringing down costs, and B.) Insuring most if not all Americans. Awhile ago, before I’d really studied the health care issue much, I came up with, what I think is a pretty out of the box idea for health. Here are the main elements.
1. People can purchase health insurance a year in advance, if they pay the yearly bill in one sum instead of monthly payments.
2. Those who do this will gain a 10% subsidy from the government, and a 10% subsidy (or price reduction) from the insurer.
3. Individuals can purchase multiple plans, which are then transferable to any person within their “tier” (for instance, 20-25 single white males).
4. If a person chooses to take part in this system, they must retain one insurance plan for themselves. Thus, if they purchase 5 plans, they can only sell 4 for profits (the sale of these plans will likely take place over various online networks).
Expected Effects: Most of those making significant amounts of money, who are not yet insured, will purchase at least one plan. Many of them will purchase multiple plans, then, because of the 20% discount they received, re-sell the plans for profit, yet cheaper then the price the insurer was offering. This will bring additional people into the system; those wishing to make a profit, and those who are now able to afford health care at it’s cheaper price. This will, in turn, likely cause the market price to dip, because adverse selection will have been decreased. Insurers will like the plan for a few reasons. One, they’ll have guaranteed sales of many plans, even though the individuals who purchased them, in the hopes of selling them off, might not be able to find a market for them. Two, they’ll have significant numbers of plans paid for in lump sums. This is helpful for precisely the same reasons banks are able to function: having money that you’d otherwise have to wait for, is enormously helpful (for expansion purposes for instance). Three, more customers enter the market, many of them quite healthy.
There are a couple of problems I’m sure need addressing. For instance, there’d have to be some sort of penalty to dumping one’s current plan, to purchase the new, cheaper plans. You could, for instance, purchase new plans, but you’d have to retain your current plan (or face a hefty fee). Otherwise, it’d simply become a way for the rich, who are already insured, to find cheaper plans. There are probably some other difficulties I haven’t forseen.
But I think it allows the health care system to be much more of an entreprenurial enterprise.
April 28th, 2007 at 11:09 pm
There quite are a few faces of the problem on the soaring cost of health care:
- The insurance industry is way too regulated by the Federal Government. We do need deregulate a whole lot, and let the insurance companies offer the products that the customers could afford (This is one part “RomneyCare” took care of, but not to the extension that Romney would like).
- Trot Reform: The cost of the manipractice protection get passes to the “customers”, or us patients. Yes, it is appropriate that we ensure the doctors are responsible for their practices, but, the award costs of uncapped many millions dollars, when we do not even earn that much in our lifetime? I could go on about this, but it is enough that we need to look into this factor that contribute greatly to the cost of the healthcare.
- And this voucher, whether it be at the federal level as proposed by Rudy or at state level as preferred by Romney, I am all for it on two account: 1) If we can get it to replace the current medicare and medicaid programs, we will see a great decrease in the government employees, not to mention the overhead cost, and 2) this put the individual in charge of his own health care choices.
April 29th, 2007 at 6:05 pm
There is a very simple way for Giuliani to up the ante on this issue – simply ask, when Elizabeth Edwards needs cancer treatment, or when Bill Clinton needed heart surgery, did they go to the sort of govt hospital that a socialized medicine program would provide? No. They went to the finest private hospitals available. This is hypocritical…they want *us* to go to govt hospitals, while they get the finest private care.