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8 - 10 - 2008
Fariba and her daughter Ava have travelled from Sari (near the Caspian coast) to Maydon Shoosh in working-class south Tehran to buy a dinner-service for Ava's wedding trousseau. They are determined to pick up a bargain today as a lot of the Shoosh shopkeepers personally import the china that is distributed and inevitably sold on at a higher price in the provinces.
Fariba and her daughter Ava have travelled from Sari (near the Caspian coast) to Maydon Shoosh in working-class south Tehran to buy a dinner-service for Ava's wedding trousseau. They are determined to pick up a bargain today as a lot of the Shoosh shopkeepers personally import the china that is distributed and inevitably sold on at a higher price in the provinces.
Nasrin Alavi is the author of We Are Iran: The Persian Blogs (Portobello Books, 2005). She spent her formative years in Iran, attended university in Britain and worked in London, and then returned to her birthplace to work for an NGO for a number of years. Today she lives in Britain. Among Nasrin Alavi's articles on openDemocracy: "Mahmoud Ahmadinejad's fear" (1 November 2005) "Inside Iran" (14 February 2006) "Iran: the elite against the people" (22 May 2006) "Iran's election backlash" (19 December 2006) "Women in Iran: repression and resistance" (5 March 2007) "The Iran paradox" (11 October 2007) "Iran's circle of power" (23 October 2007) "Iran: the uses of intelligence" (6 December 2007) "Iran's new order" (28 January 2008) "Iran's election signals" (18 March 2008)For Fariba, her daughter's trousseau has been a lifelong labour of love and a matter of honour. As a teacher she cannot afford the handmade (in Tabriz or Qom) Persian rugs costing tens of thousand of dollars that have become a mandatory part of wedding trousseaus amongst affluent families. But over the years she has saved up enough to buy an assortment of pots and pans, small electrical goods, a crimson Kashan rug; she also has a trunk full of hand-embroidered linen that she started making when Ava was born.
Fariba regrets not buying Ava a dinner-service years ago and says that what she had in mind has doubled in the last year alone, adding: "but I wanted her to be old enough to choose her own china pattern". The rising prices notwithstanding, the shops are full of goods (mainly imported) and ready customers. Fariba leaves with an Arcopal dinner-service that the shopkeeper assures her is made in France. "Why buy Iranian china when this stuff is cheaper and more respectable? Anyway, you'll mainly find 'French' Arcopal or pyrex around here."
There is little outward sign of a credit-crunch in Maydon Shoosh; the record prices of Iran's petrodollar exports (the country had reserves of $175 billion by mid-2008) mean that there is plenty of cash about - coupled with a desire to spend it as quickly as possible to get the better of rapidly rising inflation. Iran's central bank estimates that consumer spending is keeping pace - and needs to, for the official rate of inflation in September 2008 is said to be 29% (though experts maintain that it is even higher). The Iranian daily newspaper Kargozaran (29 September 2008) showed that the cost of a basket of forty-five staple foods had increased by nearly 50% in a single month.
Iranians are as ready as ever to complain about inflation, corruption and an overall lack of opportunity - but try and talk politics, and the most likely response is disinterest. True, at the top levels the attitudes and the rhetoric are still often vehement; the country's president, Mahmoud Ahmadinejad, was in routine form at the United Nations general assembly's annual meeting in New York, prophesying the end of the "American empire" and scorning the "few bullying powers" who were trying to ruin his country's "peaceful nuclear activities". But in much of Iran, in the marketplaces and cafes and streets, people have other concerns: this sort of thing appears to be just irrelevant background noise.
Ferraris and warranties
If their own politics are remote to many Iranians, the talk of economic sanctions from the United States - itself at the centre of the western world's financial turmoil - seems on the surface almost farcical. Iranian shops are flooded with American goods; some, like Electrolux's Frigidaire shop on Tehran's Shariati Street, sell only American brands (with the customary US warranties to boot). The official figures say that there has been a 30% rise in the value of total imports in recent months (90% in the case of cars and 50% in washing machines). It is hard to see sanctions making a big difference here, though perhaps their real target is elsewhere.
Iran has long been dominated by a "grey" economy dominated by unaccountable and oligarchic figures. During the reformist era of then-president Mohammad Khatami (1997-2005), parliamentarians often tried openly to challenge the way that (for example) the Revolutionary Guards ran some "unofficial" docks, or that as many as a third of Iran's imports came through unlawful routes.
Yet the downside - an echo of the west here - may be that Iranians are shopping themselves and their country into economic collapse. Ahmadinejad has faced rising criticism by reformers and conservatives alike for his confrontational rhetoric and economic mismanagement. Iran's former top nuclear negotiator Hassan Rowhani has accused the president of squandering the record oil revenues. He argued that instead of channelling funds to diversifying economic programmes, the government has used the privatisation laws to hand over industries to political allies. Rowhani asked: "other than buying oranges, apples and grapes and importing them to Iran, what big long-term projects" has the government implemented?
Mahmoud Ahmadinejad was elected in June 2005 on a pledge to share Iran's oil wealth with the people. In the process of meeting it, he has passed on to Iran's poor a host of inflationary benefits, contributing to a vast increase in the money-supply and leaving them barely (if at all) better off. Most investors have ploughed extra funds exclusively into foreign imports and the housing market at the expense of other sectors. The hard-pressed owners of small businesses have also been hit hard enough to organise resistance to a steep increase in VAT, forcing the government to retreat.
The already propertied rich are alone in benefiting from inflation. So the presidency of the frugal man who promised justice to the poor has been marked by the emergence of Ferraris and private homes with helicopter-pads on the streets and in the exclusive suburbs of revolutionary Iran.
Also in openDemocracy's articles on Iran:Kamin Mohammadi, "Voices from Tehran" (31 January 2007) Fred Halliday, "The matter with Iran" (1 March 2007) Sanam Vakil, "Iran's hostage politics" (2 April 2007) Rasool Nafisi, "Iran's cultural prison" (17 May 2007) Omid Memarian, "Iran: prepared for the worst" (30 October 2007)Jan De Pauw, "Iran, the United States and Europe: the nuclear complex" (5 December 2007)Rasool Nafisi, "Iran's majlis elections: the hidden dynamics" (11 April 2008)Sanam Vakil, "Iran's political shadow war" (16 July 2007East meets west
The housing boom has indeed made many Iranian homeowners US-dollar millionaires overnight. It has also created a huge increase in demand in businesses such as furniture, often at the fatal expense of Iranian producers. Yaft-Abad, in a working-class area of south Tehran, traditionally teemed with artisans and carpentry workshops that supplied most of Iran with home furnishings such as sofas, tables and chairs. Most have disappeared, and the area has being overtaken by huge western-style shopping-malls that sell mainly imported furniture from around the world.
The long and winding Suhrawardi Street in central Tehran is named after the 12th-century Persian philosopher who (it is said) tried to blend western Greek philosophy with eastern Persian Zoroastrian and Islamic ideas into a way of thinking that has in many ways shaped the modern Iranian psyche. The anti-establishment Suhrawardi is credited with influence on the desire of Iran's ex-president Mohammad Khatami to launch a "dialogue among civilisations" (a pointed rebuttal to Samuel Huntington's "clash of civilisations"). Be that as it may, today east meets west on Suhrawardi Street in a very different way: via the ever-increasing number of kitchenware shops.
Here you can buy anything from cheap Chinese to designer Italian kitchens costing the moon. An almost surreal spectacle - right in the middle of Suhrawardi - is Belka, a hardware store specialising in fancy foreign-made kitchen door-handles. It has the distinct feel of a fast-food hamburger joint; the youthful staff skid through the air taking orders from the jostling clientele who leave cradling bagfuls of overpriced metal, with every appearance of being thrilled to have a choice of something they have been denied for so long.
The new blogosphere
The excitement of the crowd is eerily reminiscent of, yet a world apart from, the height of the reform movement. Then you would queue outside newspaper kiosks and huddle in groups reading revelations of regime corruption by investigative journalist such as Akbar Ganji, or debates by Islamic thinkers about the cultural need for an "Islamic reformation". This, the "Prague spring" of Iranian journalism, faded with the closure of hundreds of publications and the arrest, intimidation and imprisonment of activists and journalists.
Iranians adapted in ways familiar to those in comparable conditions of repression: by resisting, retreating, reconciling. Many found a new "virtual" space for free speech by creating one of the largest communities of bloggers in the world. I compiled a book about the early years of the Iran's vibrant blogosphere, We Are Iran. To me the phenomenon expressed the voices of a burgeoning generation of educated young people and mirrored the uncensored dialogue and conversation you would hear around university campuses. This was, is, the post-war (that is, the Iran-Iraq war of 1980-88) baby-boom generation that will determine the future of their country (hence the title).
But this phenomenon too now has a history; things have changed, both in Iran's blogosphere and on Iranian campuses.
Mahmoud Ahmadinejad's presidency has also seen an onslaught against publishing and the internet; Iranian officials have been unashamed to announce that they have blocked or filtered more than 10 million websites. This has meant that many Iranian bloggers who write under their own names use self-censorship, and their later observations bear no resemblance to the earlier unbridled writing in their archives. It is also true that their views have evolved as Iran and the world have changed around them, and as they have grown older.
The shift is seen in the reaction of the authorities too, a dual one. They have seen bloggers (especially critical ones) as part of an enemy within, yet they have also tried to encourage the formation of what they often label "Islamic bloggers". The resources spent on this effort can be seen in the plush conferences held to celebrate and award the chosen few; in the blogging lessons offered by basij (militia) centres around the country and seminaries in the holy city of Qom. Even here, however, in the segments of Iranian blogosphere championed by the government, the medium has proved its capacity to be liberating; calls for accountability and criticism of the president's failure to deliver social justice and distribution of oil money to the poor have grown.
The once unconstrained blogosphere that I tried to highlight on the pages of We Are Iran - the fundamental democracy of cyberspace - may no longer exist in the same way, but the young people who raised their voices then remain very much alive. Some have moved on in more than age or in opinion. A prominent and once prolific blogger closed his blog by writing a final note about the growing risks for bloggers, about self-censorship, and about his reasons to stop writing: "It's not that I have nothing to say, but I no longer want to write if I can't be myself."
Then and now
There had up to 2004 been very few blogs kept by Iran's hardline conservatives and their supporters. The political argument in the blogosphere and on Iranian campuses alike was until the mid-2000s dominated by passionate, critical and liberalising voices. The period had seen mass student demonstrations in many parts of Iran, sparked by a month-long student protest at Tehran University in November 2002 following the death sentence imposed on university professor Hashem Aghajari, a devout Muslim condemned for calling on Iranians "not to blindly follow" Islamic clerics.
Most of Iran's online debates throughout this period echoed the disturbances, as the community furiously debated Aghajari's case. This grew into a broader concern with Iran's political condition and direction. By contrast, the blogosphere today and the campuses (allowing for the limits of such generalisation) seem largely silent on political matters. As I look through the piles of blog printouts from the two eras, there is an enormous gap between then and now.
Then, as the students demonstrated on campus, the 29-year-old basij leader Mehrdad Bazrpash famously managed the crackdown. Now, Bazrpash (who has no relevant professional experience) has for his efforts been appointed by Ahmadinejad as the president of Saipa, one of Iran's main automobile manufacturers. Now, empowered people like him are more visible today around the blogosphere and Iranian campuses; they appear confident and powerful; they have silenced their detractors.
Here is another Iranian paradox. For the evidence also suggests that these people are still part of an unpopular minority. In the local council elections of December 2006, Mehrdad Bazrpash - then the president's youth-affairs advisor - failed even to win a seat. Yet this defeat and similar setbacks have not meant a reformist resurgence. This outcome was avoided by the mass disqualification of candidates by the Guardian Council that vets candidates for loyalty to the Islamic republic; in addition, an incomplete boycott and voter apathy have meant that recent elections have largely been between the right and the extreme right. The official ministry of the interior figures say that in the March-April 2008 parliamentary elections, less than 30% of eligible voters took part in the capital.
It is not so long ago that 70%-80% of eligible voters participated in such elections, and saw reformists elected as a result. It is sometimes hard for people who lived through the reform era to fathom the current political disengagement of Iranian society.
The intermission
Davoud and Amin are architects in their early 30s. I can clearly remember their student days; they had both passionately campaigned for Mohammad Khatami's reformist agenda. Davoud shrugs in disgust as we talk about the news of Ahmadinejad's interior minister Ali Kordan, who had added to his credentials a fake honorary doctorate in law from Oxford University. A lot of apathetic, dismayed shrugs can be seen in Iran these days.
Mohammad Ali Abtahi, deputy president under Mohammad Khatami, writes in his blog that most regimes are reliant on public opinion - but that in Iran the authorities have not even bothered to address the Kordan issue. He says that instead of a logical "relationship of public opinion and survival of power, the relationship of the money gained from oil and survival of power exists and that is why public opinion is ignored in this way."
For the time being, Abtahi's argument may well be true. The authorities don't see a need for transparency. They can merely disregard challengers and appease the people with petrodollars through farming subsidies or the import of flash new cars. But just like the rise in consumer spending it is unsustainable; as surely is the prevailing political apathy. Iran is not immune to the global financial crisis; its budget deficit is growing, despite the record oil prices; inflation corrodes the savings of those who can afford to save; the figures in the treasury no longer add up.
Mahmoud Ahmadinejad's response to this situation has been to replace the director-general of Iran's central bank, Tahmasb Mazaheri. The daily newspaper Sarmayeh published a letter by Mazaheri addressed to the president (29 September 2008); it referred to all these problems and warned that "bitter and hard days" lay ahead.
I ask Davoud and Amin: "Can Ahmadinejad get elected again? Who would you like to see as the next president?" The reactions are evasive. Amin even self-mockingly repeats the famous slogan of the reform movement: "Patience, our dawn is near". He adds: "our day will come, but now is not it."
Davoud says: "They [the authorities] have made the price for activism too high. We don't want to spend the best years of our lives in jail... I'm just being realistic. But the authorities have no choice sooner or later to be realistic too and face the demands of the population".
Reformist politicians have long argued against the hazards of such political disengagement. Mohammad Khatami, on 4 October 2008, set two preconditions that must be met before he would enter the race for the presidential election scheduled for June 2009: an assurance that he would be allowed to implement his programmes, and that "the demands of the nation" would be conceded.
It is not clear whether such rhetoric can again mobilise the kind of enthusiasm that accompanied Khatami's victory in 1997. Yet Iranians in the past - including in the post-revolution era - have shown a capacity for dramatic and largely unforeseen mood swings. The victories of Khatami and Ahmadinejad seemed to many people almost to come out of nowhere. It seems possible that Iran, which nearly three decades ago introduced a bemused world to political Islam, may yet surprise the world all over again.
(Source:Open Democracy)
N.B.Editor is not responsible for any feature or comments
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Election 2008 New York Times Examines Business Organizations' Concerns About McCain's Health Care Proposal [Oct 07, 2008]
Businesses, "typically a reliable Republican cheerleader," remain "decidedly lukewarm" about the health care proposal announced by Republican presidential nominee Sen. John McCain (Ariz.), according to trade group officials, the New York Times reports. According to the Times, officials with groups such as the U.S. Chamber of Commerce and the National Federation of Independent Business have raised concerns that the proposal -- which would replace a tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families for the purchase of coverage through their employers or the individual market -- would "accelerate the erosion of employer-sponsored health insurance and do little to reduce the number of uninsured." In addition, they have raised concerns that the proposal "would impose particular burdens on small businesses and old-line manufacturers that are already struggling," the Times reports.Officials with eight trade groups contacted by the Times said that the proposal would increase health insurance costs and prompt some businesses to drop coverage for employees. In addition, a recent survey of 187 business executives conducted by the American Benefits Council and Miller & Chevalier found that three-fourths of respondents believe the proposal would have a "strong negative impact" on their employees.Bruce Josten, executive vice president for government affairs at the Chamber of Commerce, said, "To some in the business community, this is very discomforting," adding, "The private marketplace, in my opinion, is ill-prepared today with an infrastructure for an individual-based health insurance system."Helen Darling, president of the National Business Group on Health, said, "The last thing you want to do to the average working person, especially when you're bailing out big financial companies, is take something they hold near and dear partially away."According to the Times, "health economists are ideologically divided over Mr. McCain's plan" and disagree over its potential effect on cost and spending, as well how many people it would insure (Sack, New York Times, 10/7).
Governors Criticize McCain Proposal In other news, five Democratic governors on Monday during an event at the campaign headquarters of Democratic presidential nominee Sen. Barack Obama (Ill.) criticized the McCain health care proposal and promoted the Obama plan, the Philadelphia Inquirer reports. The governors said that the McCain proposal would prompt many businesses to drop health insurance for employees, limit requirements for health insurers and make coverage more expensive for many U.S. residents. Pennsylvania Gov. Ed Rendell (D) said of the tax credits that the proposal would provide, "Please go out and find me a health care plan for a family of four for $5,000." According to New Jersey Gov. Jon Corzine (D), the proposal has similarities with a plan that President Bush has promoted for several years that "barely draws sponsors even among Republicans because it's such a failed concept." Maryland Gov. Martin O'Malley (D), Iowa Gov. Chet Culver (D) and West Virginia Gov. Joe Manchin (D) also spoke at the event (Burling, Philadelphia Inquirer, 10/7).
Health Care as Election Issue The Politico on Tuesday examined how, although "there were many who believed -- and hoped -- health care reform had recovered from its 1993 thrashing and would rise anew to become a deciding issue in 2008," the recent economic downturn has moved health care to "Nos. 3 and 4 on the lists of issues of most concern to voters." However, "proponents of the issue are hoping for a comeback Tuesday in the presidential debate at Belmont University in Nashville," according to The Politico. The Partnership to Fight Chronic Disease has partnered with WebMD and Belmont to submit questions related to health care for the debate. In addition, the partnership has run ads on health care and has written letters to the editors of newspapers to promote the issue. The partnership also held a health care rally on Monday on the Belmont campus, as well as a health care reform breakfast and panel discussion near the university on Tuesday morning. Andrew Kohut, president of the Pew Research Center for the People and the Press, said, "The health care issue has significant resonance with people, and it can be made an important discriminator between the two candidates," adding, "It's a big issue under the surface because of the overwhelming concern about the economy" (Cummings, The Politico, 10/7).
Health Care Advisers The Politico on Tuesday also examined the backgrounds of the health care advisers to the McCain and Obama campaigns. According to The Politico, "McCain's team of advisers is dominated by free market advocates and government waste hunters," and "Obama's health care team reads like a who's who of broad reform advocates" from Capitol Hill and academia (Frates, The Politico, 10/7).
Opinion Pieces Summaries of several opinion pieces that address health care issues in the presidential election appear below.
Gilbert Welch, New York Times: Both McCain and Obama have "champion[ed] one of medical care's most pervasive myths": that, "like magic, preventive medicine will simultaneously reduce costs and improve health," Welch, an author and a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, writes in a Times opinion piece. According to Welch, McCain has said that, "by emphasizing prevention" and other measures, "we can reduce health care costs," and Obama has said that, "in the absence of a radical shift towards prevention and public health, we will not be successful in containing medical costs or improving the health of the American people." Welch writes, "It may sound like common sense," but "it is still a myth." The "term 'preventive medicine' no longer means what it used to: keeping people well by promoting healthy habits, like exercising, eating a balanced diet and not smoking," he writes. The "medical model for prevention has become less about health promotion and more about early diagnosis," Welch writes, adding, "It boils down to encouraging the well to have themselves tested to make sure they are not sick," and "that approach doesn't save money; it costs money." Welch writes, "If preventive medicine were effective in improving the nation's health, it might warrant these added expenditures," but "you can't assume it is," adding, "Early diagnosis may help some, but it undoubtedly leads others to be treated for 'diseases' that would never have bothered them." He writes, "Both presidential candidates need to challenge the conventional wisdom about preventive medicine" and "ask whether the path to a healthy society is the one that turns those who are well into patients anxious about their future" (Welch, New York Times, 10/7).
David Gratzer, Wall Street Journal: The McCain health care proposal "is the right prescription for what ails our health care system," Gratzer -- a physician, author and senior fellow at the Manhattan Institute -- writes in a Journal opinion piece. The foundation of the employer-sponsored health insurance system "is crumbling," and the number of U.S. residents who receive coverage through their employers "has been shrinking" for decades, Gratzer writes. According to Gratzer, McCain "recognizes that a large part of the problem is that the tax code favors employer-funded health insurance" and "wants to fundamentally change the way the system works and instead give the self-employed and individuals a tax break for buying their own insurance." The proposal has some "flaws," but "Mr. McCain is fundamentally right on health care," Gratzer writes (Gratzer, Wall Street Journal, 10/7).
Ruth Marcus, Washington Post: "Overall, Barack Obama's health care plan is preferable to John McCain's," as "Obama's approach ... would cover more people and would help those who have the hardest time obtaining insurance," but "McCain's plan is not the ill-intentioned monstrosity of Obama's ominous portrayal," Post columnist Marcus writes. "In important ways, it would be an improvement over current law, making a health insurance system that is now tilted in favor of the rich significantly more progressive," according to Marcus. She writes, "Tying insurance to employment makes little sense in a world where workers hop from job to job" and "favors better-off employees who, because they pay higher marginal rates, derive a greater benefit from not being taxed on their health insurance." Marcus adds, "Eliminating this distortion -- if done the right way, and that's a big if -- could help more Americans obtain insurance, push down costs and reduce the drain of health care costs on the federal budget." However, the McCain proposal has "serious flaws," she writes. Marcus concludes, "In a perfect world, the candidates could have a rational discussion about the merits of their two approaches. In this one, they are reduced to trading inflated charges about tax hikes and government-run health care" (Marcus, Washington Post, 10/7).
Gary Andres, Washington Times: Partisan differences "create a prism through which citizens evaluate presidential candidates' positions on health care reform," and that "leaves independent voters -- always a key electoral constituency -- somewhere in between" the proposals of the two major candidates, Andres, vice chair of Dutko Worldwide, writes in a Times opinion piece. According to Andres, partisan differences "are most pronounced on issues related to the role of government in financing and regulating this sector," but "in other areas of health care -- like promoting prevention and coordinated care -- partisan differences shrink, highlighting some opportunities for bipartisan cooperation." In addition, "voters across party lines favor a focus on making health care more affordable over reducing the number of people without health insurance," Andres writes. He concludes, "So despite predictable partisan patterns in voters' views of many health care reform ideas, areas such as reducing costs and reimbursing for prevention draw strong bipartisan support and may serve as the foundation for legislative action in the next Congress" (Andres, Washington Times, 10/7).
Broadcast Coverage
Businesses, "typically a reliable Republican cheerleader," remain "decidedly lukewarm" about the health care proposal announced by Republican presidential nominee Sen. John McCain (Ariz.), according to trade group officials, the New York Times reports. According to the Times, officials with groups such as the U.S. Chamber of Commerce and the National Federation of Independent Business have raised concerns that the proposal -- which would replace a tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families for the purchase of coverage through their employers or the individual market -- would "accelerate the erosion of employer-sponsored health insurance and do little to reduce the number of uninsured." In addition, they have raised concerns that the proposal "would impose particular burdens on small businesses and old-line manufacturers that are already struggling," the Times reports.Officials with eight trade groups contacted by the Times said that the proposal would increase health insurance costs and prompt some businesses to drop coverage for employees. In addition, a recent survey of 187 business executives conducted by the American Benefits Council and Miller & Chevalier found that three-fourths of respondents believe the proposal would have a "strong negative impact" on their employees.Bruce Josten, executive vice president for government affairs at the Chamber of Commerce, said, "To some in the business community, this is very discomforting," adding, "The private marketplace, in my opinion, is ill-prepared today with an infrastructure for an individual-based health insurance system."Helen Darling, president of the National Business Group on Health, said, "The last thing you want to do to the average working person, especially when you're bailing out big financial companies, is take something they hold near and dear partially away."According to the Times, "health economists are ideologically divided over Mr. McCain's plan" and disagree over its potential effect on cost and spending, as well how many people it would insure (Sack, New York Times, 10/7).
Governors Criticize McCain Proposal In other news, five Democratic governors on Monday during an event at the campaign headquarters of Democratic presidential nominee Sen. Barack Obama (Ill.) criticized the McCain health care proposal and promoted the Obama plan, the Philadelphia Inquirer reports. The governors said that the McCain proposal would prompt many businesses to drop health insurance for employees, limit requirements for health insurers and make coverage more expensive for many U.S. residents. Pennsylvania Gov. Ed Rendell (D) said of the tax credits that the proposal would provide, "Please go out and find me a health care plan for a family of four for $5,000." According to New Jersey Gov. Jon Corzine (D), the proposal has similarities with a plan that President Bush has promoted for several years that "barely draws sponsors even among Republicans because it's such a failed concept." Maryland Gov. Martin O'Malley (D), Iowa Gov. Chet Culver (D) and West Virginia Gov. Joe Manchin (D) also spoke at the event (Burling, Philadelphia Inquirer, 10/7).
Health Care as Election Issue The Politico on Tuesday examined how, although "there were many who believed -- and hoped -- health care reform had recovered from its 1993 thrashing and would rise anew to become a deciding issue in 2008," the recent economic downturn has moved health care to "Nos. 3 and 4 on the lists of issues of most concern to voters." However, "proponents of the issue are hoping for a comeback Tuesday in the presidential debate at Belmont University in Nashville," according to The Politico. The Partnership to Fight Chronic Disease has partnered with WebMD and Belmont to submit questions related to health care for the debate. In addition, the partnership has run ads on health care and has written letters to the editors of newspapers to promote the issue. The partnership also held a health care rally on Monday on the Belmont campus, as well as a health care reform breakfast and panel discussion near the university on Tuesday morning. Andrew Kohut, president of the Pew Research Center for the People and the Press, said, "The health care issue has significant resonance with people, and it can be made an important discriminator between the two candidates," adding, "It's a big issue under the surface because of the overwhelming concern about the economy" (Cummings, The Politico, 10/7).
Health Care Advisers The Politico on Tuesday also examined the backgrounds of the health care advisers to the McCain and Obama campaigns. According to The Politico, "McCain's team of advisers is dominated by free market advocates and government waste hunters," and "Obama's health care team reads like a who's who of broad reform advocates" from Capitol Hill and academia (Frates, The Politico, 10/7).
Opinion Pieces Summaries of several opinion pieces that address health care issues in the presidential election appear below.
Gilbert Welch, New York Times: Both McCain and Obama have "champion[ed] one of medical care's most pervasive myths": that, "like magic, preventive medicine will simultaneously reduce costs and improve health," Welch, an author and a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, writes in a Times opinion piece. According to Welch, McCain has said that, "by emphasizing prevention" and other measures, "we can reduce health care costs," and Obama has said that, "in the absence of a radical shift towards prevention and public health, we will not be successful in containing medical costs or improving the health of the American people." Welch writes, "It may sound like common sense," but "it is still a myth." The "term 'preventive medicine' no longer means what it used to: keeping people well by promoting healthy habits, like exercising, eating a balanced diet and not smoking," he writes. The "medical model for prevention has become less about health promotion and more about early diagnosis," Welch writes, adding, "It boils down to encouraging the well to have themselves tested to make sure they are not sick," and "that approach doesn't save money; it costs money." Welch writes, "If preventive medicine were effective in improving the nation's health, it might warrant these added expenditures," but "you can't assume it is," adding, "Early diagnosis may help some, but it undoubtedly leads others to be treated for 'diseases' that would never have bothered them." He writes, "Both presidential candidates need to challenge the conventional wisdom about preventive medicine" and "ask whether the path to a healthy society is the one that turns those who are well into patients anxious about their future" (Welch, New York Times, 10/7).
David Gratzer, Wall Street Journal: The McCain health care proposal "is the right prescription for what ails our health care system," Gratzer -- a physician, author and senior fellow at the Manhattan Institute -- writes in a Journal opinion piece. The foundation of the employer-sponsored health insurance system "is crumbling," and the number of U.S. residents who receive coverage through their employers "has been shrinking" for decades, Gratzer writes. According to Gratzer, McCain "recognizes that a large part of the problem is that the tax code favors employer-funded health insurance" and "wants to fundamentally change the way the system works and instead give the self-employed and individuals a tax break for buying their own insurance." The proposal has some "flaws," but "Mr. McCain is fundamentally right on health care," Gratzer writes (Gratzer, Wall Street Journal, 10/7).
Ruth Marcus, Washington Post: "Overall, Barack Obama's health care plan is preferable to John McCain's," as "Obama's approach ... would cover more people and would help those who have the hardest time obtaining insurance," but "McCain's plan is not the ill-intentioned monstrosity of Obama's ominous portrayal," Post columnist Marcus writes. "In important ways, it would be an improvement over current law, making a health insurance system that is now tilted in favor of the rich significantly more progressive," according to Marcus. She writes, "Tying insurance to employment makes little sense in a world where workers hop from job to job" and "favors better-off employees who, because they pay higher marginal rates, derive a greater benefit from not being taxed on their health insurance." Marcus adds, "Eliminating this distortion -- if done the right way, and that's a big if -- could help more Americans obtain insurance, push down costs and reduce the drain of health care costs on the federal budget." However, the McCain proposal has "serious flaws," she writes. Marcus concludes, "In a perfect world, the candidates could have a rational discussion about the merits of their two approaches. In this one, they are reduced to trading inflated charges about tax hikes and government-run health care" (Marcus, Washington Post, 10/7).
Gary Andres, Washington Times: Partisan differences "create a prism through which citizens evaluate presidential candidates' positions on health care reform," and that "leaves independent voters -- always a key electoral constituency -- somewhere in between" the proposals of the two major candidates, Andres, vice chair of Dutko Worldwide, writes in a Times opinion piece. According to Andres, partisan differences "are most pronounced on issues related to the role of government in financing and regulating this sector," but "in other areas of health care -- like promoting prevention and coordinated care -- partisan differences shrink, highlighting some opportunities for bipartisan cooperation." In addition, "voters across party lines favor a focus on making health care more affordable over reducing the number of people without health insurance," Andres writes. He concludes, "So despite predictable partisan patterns in voters' views of many health care reform ideas, areas such as reducing costs and reimbursing for prevention draw strong bipartisan support and may serve as the foundation for legislative action in the next Congress" (Andres, Washington Times, 10/7).
Broadcast Coverage
(Source:Kaiser Familly Foundation)
