20th debate

I’m watching the debate tonight in Ohio between Barack Obama and Hillary Clinton. I’ve actually cringed for Hillary. Such bad, even embarrassing responses: complaining that she’s being “picked on” first and picking fights over insubstantial matters. This is clearly last-gasp maneuvering. You can almost see it in her face — this is all over.

The issue that still gets me is health care. They spent the first 17 minutes debating it. But neither seems at all interested in discussing the merits or demerits of a single-payer plan. By that I mean that all people would pay into one plan — getting us lots of economy of scale — and that this plan would then pay for your trip to your own local doctor. I know single payer is controversial. But it’s worth debating. And I’m missing a debate on that now.

By Noelle McAfee

I am professor of philosophy at Emory University and editor of the Kettering Review. My latest book, Fear of Breakdown: Politics and Psychoanalysis, explores what is behind the upsurge of virulent nationalism and intransigent politics across the world today. My other writings include Democracy and the Political Unconscious; Habermas, Kristeva, and Citizenship; Julia Kristeva; and numerous articles and book chapters. Edited volumes include Standing with the Public: the Humanities and Democratic Practice and a special issue of the philosophy journal Hypatia on feminist engagements in democratic theory. I am also the author of the entry on feminist political philosophy in the online Stanford Encyclopedia of Philosophy and well into my next book project on democratic public life.


  1. Paul Krugman’s discussion of single-payer health care in Conscience of a liberal was quite good considering its non-academic target audience. Boiling things down to three theses:
    1. Economically speaking, single-payer health care is the only rational choice. We should just be debating about whether the national health care plan is going to look more like Canada’s or more like France’s.
    2. But single-payer health care will never happen in a one-fell-swoop kind of way in this country. Voters will be spooked by the `socialised medicine!’ meme just as easily as they were in 1994.
    3. So what we need is a health care system that, through market forces, will gradually evolve into a single-payer system. Krugman argues that the sort of system the Democratic candidates have been talking about for the past year will do exactly this: you subsidise insurance for people below some multiple of the poverty line, so everyone can actually afford it, then set up a government insurance company that, by avoiding the inefficiencies of private insurers, simply outcompetes them.

    Before reading the book, I was just as annoyed that no-one except Kucinich was talking about a single-payer system. But I think Krugman’s practical strategy makes a lot of sense.

  2. On the universal healthcare issue, and more specifically addressing Obama’s plan as non-universal, (as according to Clinton, it supposedly leaves approx. 15 million Americans out of the option) I heard Clinton say “Shame on you, Barack Obama! Shame on you!” This was at a rally briefly after her 10th consecutive loss. It seems obvious to me her disposition and tactics have suffered great change in lieu of Obama’s hard-to-ignore movement and winning streak. Unfortunate really.

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