No, but seriously, what is your proposal for health insurance?

It's way past official Giuliani simply does not care about health reform. Because anyone who understood the magnitude of the health care disparities in this country would not seriously believe that a plan like this could make a significant impact on the number of uninsured Americans. Then again, it is not designed to - the plan "does not even cite universal coverage as a goal." Giuiliani's plan strikes out right there and not just in the opinion of raving Leftist ol' me, but in the opinion of all 69% of Americans who agreed in November of 2006 that the government has a responsibility to guarantee coverage for everyone. Yet another example of how far out of the mainstream so-called-moderate Republicans truly are when it comes to social policy. And tactically speaking, If Giuliani manages to wrest the Republican nomination away from Romney, any Democrat who runs against him should be making health care the strongest part of their campaign.

That crucial flaw bracketed momentarily, Giuliani's plan does not aspire to alter the current market-based system much at all. It comes down to a Health Insurance Credit and a tax deduction for low income families. Both of those proposals, fortunately, would alleviate some of the tremendous burden that poor Americans face when purchasing health care - although we have to hope that Giuliani is more generous with the eligibility on those than he was with, say, welfare, food stamps, subsidized housing and essentially every major social service offered in NYC under his mayorship.

All the same, what Giuliani is offering fails on two critical counts - highlighted by Matt Miller's recent piece in Time. First, for whatever aid it provides them with, Giuliani's plan still holds out that " individuals' buying their own solo health insurance can be the answer to the problem of the uninsured." Without any new mandates, health insurance companies are still free to reject clients with a history of illness (and these are the men and women who need insurance most) or to cheat their poorest customers out of any real coverage by offering plans with low premiums but through-the-roof deductibles that render the plan useless. Secondly, Giuiliani does not "support limiting a family's annual exposure to medical costs to some reasonable percentage of its income." In fact,

Giuliani actually boasts of an approach certain to hurt people. His health-care tax deduction, he gushed in Iowa recently, "allows you to go out and buy cheaper and cheaper policies [because] you can have higher and higher deductibles." When Americans earning $25,000 a year get sick and end up paying $10,000 or more in hospital charges, their "affordable" insurance courtesy of Giuliani will become a ticket to bankruptcy.

Avoiding political hyperbole is nice, but any critical analysis of what America's Mayor has put on the table for health care reform makes it clear: Giuliani does not care about poor and sick Americans.

I will be personally responsible for ensuring that Giuliani never comes close to the White House

I'm currently reading Why Social Justice Matters by Brian Barry. So far,my verdict is that the book is inessential from a theoretical standpoint, but certainly informative as it marshals a staggering amount of empirical data to depict the damage of cumulative disadvantages on individual life-chances and the structural maintenance of gross inequality in the US and UK. But this post is just meant to share a choice passage on Giuliani, which comes up in the context of comparing a couple different models of social policy.

Giuliani embraced the ethic of the Work and Personal Responsibility Reconciliation Act with such fervor that he actually instructed city employees not to welfare recipients that they were also eligible for food stamps.

ARE YOU KIDDING?

That line actually almost made me throw up. The media depicts Giuliani as “Rudy!”, this big-hearted grinning guy who was “America's mayor”. And in reality, he is exactly the type of person who will jeopardize the ability of his own citizens to feed themselves and their families, just so he can shave some money off the food stamp budget and score whatever political points come from reducing the number of people on food stamps. Which to be honest, I didn't even fathom was a type of person so much as an utterly disturbing caricature of a person that might be a villain in a Dickens novel.

Only slightly less terrifying is Giuliani's approach to helping homeless people:

His first homeless service commissioner, Joan Malin (who resigned in 1996),

recalled that in 1995 the Mayor had determined to shrink the soaring shelter population the way Richard J. Schwartz, his senior policy adviser, was shrinking the welfare rolls: tighten eligibility rules, deter applicants at the front door, and eject those who failed to meet work requirements. ... 'What Richard's done in the welfare system is what you need to be doing' , She was told by Giuliani. 'It became his mantra.'

To back up this policy, he 'reduced subsidized housing placements from the shelters to a 10-year-low, and let the pipe-line of city-owned apartments dry up'.

Unfortunately, Giuliani's theory that the homeless were responsible for their own plight did not seem to be borne out by reality. 'By February of 2001, the number of people lodging nightly in the shelter system equaled the 1980s peak of 28,737...

In the end, it turns out that the simple-minded explanation of homelessness – that it is due to lack of affordable housing – was right all along. 'A New York University Study that followed homeless families in 1988 and a random group on public assistance who had not been homeless found that only one factor – subsidized housing - determined whether a family in either group was stably housed five years later'.

Surprise, surprise.

My earliest memories of politics are from the Clinton years, New Democrats who climbed on-board the conservative rallying cry of “personal responsibility”. And since then, I've had six years of W., a man who finds it endearing, not unsettling, when a woman has to work three jobs to support her family. This whole idea that social policy should chiefly entail preaching to underprivileged women and men about their bad life choices while we cut off their support systems is absurd, but the political mainstream seems content with the “condescend-and-let'em-fend” approach. Sure, people make choices. But those choices are undeniably constrained by systems of which individuals have no control. Hell, the consistent ability of privileged employers and wealthy tax-payers to control the domestic policy agenda suggests that even an organized coalitions of individuals have few chances when it comes to, say, creating a market for affordable housing. So exactly how can one feel justified in demanding that a family demonstrate more personal responsibility for their position in the market we do have? And what about the responsibility of the privileged to ensure a minimally decent standard of living for our neighbors? It's a unique kind of cruelty that blames the homeless – perhaps America's most stigmatized and excluded sub-class – for their plight.

But leaving the esoteric mattes on hold, I think even Americans of a less determinist bent than I would find Giuliani's approach unacceptable. And yet the “values voters” of our country could care less about how many families he's sent to the streets, so long as he'll come around on sending women to jail for having abortions. He may have been America's mayor, but if he becomes America's president, I'm going to grad school in Canada.