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Paul Krugman says that "the power of competition" does not drive down healthcare costs:

For one thing, even if you buy the premise that competition would reduce health care costs, the idea that it could cut costs enough to make insurance affordable for Americans with a history of cancer or other major diseases is sheer fantasy.

Beyond that, there's no reason to believe in these alleged cost reductions. Insurance companies do try to hold down "medical losses" — the industry's term for what happens when an insurer actually ends up having to honor its promises by paying a client's medical bills. But they don't do this by promoting cost-effective medical care.

Instead, they hold down costs by only covering healthy people, screening out those who need coverage the most [...]. They also deny as many claims as possible, forcing doctors and hospitals to spend large sums fighting to get paid.

And the international evidence on health care costs is overwhelming: the United States has the most privatized system, with the most market competition — and it also has by far the highest health care costs in the world.

In the Guardian, Michael Tomasky discusses the unfortunate influence of Mark Penn, Bill Clinton's former pollster and political adviser, on Hillary's campaign:

Pennism is a kind of Democratic politics that one could argue was right for an era of conservative dominance: take few risks, and move as far to the centre and even right as possible so you couldn't be labelled soft on defence or wobbly on support for the free market.

But George Bush and Karl Rove have seen to it that, after Iraq and Katrina and the US attorneys scandal and now a real-life recession, we are no longer in an era of conservative dominance. We're not in an era of liberal dominance either, of course, but we are in a place where, for the first time in a very long time, conservatism has discredited itself, and more Americans are open to progressive alternatives. This was apparent to anyone paying attention in September 2005, after the tragedy of New Orleans.

But it wasn't apparent to Penn. And by extension we can conclude it wasn't apparent to the Clintons either (revealing, considering Bill's alleged political genius). Hillary's refusal to renounce her vote in support of the Iraq war — a refusal that I have no doubt was based on Penn's advice, on the grounds that she had to continue to show she could be "tough" on foreign policy — was a disaster for her, as was the vote itself. If, in a few weeks' time, we're writing Clinton campaign post-mortems, her handling of Iraq will be deservedly high on the list of errata, and it was classic Pennism.