Washington Post opinion columnist Eugene Robinson was online Tuesday, Nov. 13 at 1 p.m. ET to discuss his recent columns and the latest news.

Latest Column: 'Socialized Medicine' Snake Oil (Post, Nov. 13)| Discussion Group: Mr. Robinson's Neighborhood

The transcript follows.

Archive: Eugene Robinson discussion transcripts

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Eugene Robinson: Hi, folks. As I've said before: So much to talk about, so little time. So, without preliminaries, let's get started.

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Chapel Hill, N.C.: Fascinating column today. Two questions: Regarding your closing comment that you'd rather be treated here (provided you have insurance), is that exclusively because of perceived degree of patient input/autonomy in our system? Or are there other reasons? I'd argue that patient input varies wildly between educated consumers such as yourself and those who have less knowledge or ability to confidently assert their care preferences. Secondly, what sort of change do you think would be most effective and practical to implement in our country? Many thanks!

Eugene Robinson: Today's column was about an international Commonwealth Fund study showing that the myths about single-payer health care systems -- that you can't get in to see the doctor when you want to, that you don't have a regular doctor, that you have to wait years for elective surgery, etc. -- are indeed myths.

My comment that I would rather be treated here for a life-threatening illness stems from the fact that we do "overkill" medicine here. I was just being honest in saying that if I thought my life was on the line, I'd want doctors to throw the book at whatever ailed me. But there's little difference, I know, in outcomes between the two philosophies of care.

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Baltimore: Thanks for holding this discussion. For 11 years, I lived in Japan, which has a two-tier governmental health system. Under this system, you can choose your doctors and hospitals. Not everything is covered: catastrophic illness insurance is needed for extremely expensive treatments. The system does a pretty good job of keeping costs down. In contrast, health care here is viewed more as a big business than as health care per se. Politically, is it even possible for us to change to a system that actually makes sense?

Eugene Robinson: I hope so. People forget that we already have two "socialized" health care programs -- Medicare and Medicaid -- plus a new prescription-drugs program, so it's not as if the idea of single-payer is completely alien to us. Maybe some kind of mixed system will be the solution. I do know that it makes no sense to leave things as they are, with 47 million Americans uninsured. That's barbaric.

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Giuliani and the Truth: Is Giuliani's refusal to admit that he was wrong about the cancer figures something personal, or is it something he picked up from Bush to help win over the GOP faithful?

Eugene Robinson: Obviously I don't know what's in Giuliani's head. But if this indicates a tendency to disregard inconvenient facts -- "I believe it, therefore it must be so" -- then, well, we've already seen that movie.

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Seattle, Wash.: I think you should cut Giuliani some slack on the prostate cancer numbers. He is right with one proviso: That you only compare rich whites between the countries. The British rate accounts for less-aggressive screening but better care at the lower end of the income scale, and the American rate accounts for aggressive screening and treatment at the upper end but neglect at the lower end. Giuliani was telling the people he is wooing -- rich white Republicans -- exactly what they want to hear. So he was being somewhat accurate. (P.S. I am being ironic about defense of Giuliani, in case that gets overlooked.)

Eugene Robinson: You were right to put that parenthetical note at the end. Irony does not always translate on the Web, I've learned.

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Kensington, Md.: Mr. Robinson, I love your column and love it when you are on "Meet the Press." Can you tell me why think that Giuliani has been so popular early, and do you think the lead can be sustained?

Eugene Robinson: I think he has run a good campaign so far, and I know he has articulated a clear, easy-to-understand message: I'm tough enough to protect you from terrorists and beat Hillary Clinton. I have thought for a long time that his numbers would have to head south as more Republicans realized that he doesn't share their views on social issues, but so far I've been wrong. Nevertheless, I'm sticking with my view that the GOP race will become much more fluid and that at this point it could go to Mitt, Rudy, maybe Fred, or even the comeback kid, John McCain.

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Anonymous: Re: Your discussion of Obama's recent Iowa speech -- while I have heard rave reviews of the Obama speech discussed by you today ( YouTube video), I was very disappointed by his "Meet the Press" appearance. Approaching it as someone who wants Obama to succeed, I still found his performance disheartening. He had less enthusiasm and energy than Al Gore. And despite the criticism of Clinton for not having clear positions, Obama's position on what's on the table for social security reform (as he described it on Russert's show) was borderline incoherent. I very much hope that Obama's recent speech is some sort of turning point, but I am skeptical that he can translate the enthusiasm and energy of his stump speech into debates or policy discussions.

While I think "Meet the Press" sound bites and debate gotchas are given too much value by the media and public, I also think he will have real trouble increasing his following with this wonkish, sober and intelligent style he displays on forums such as "Meet the Press." Anyway, that's just my two cents, but I was wondering what you think of this seeming disconnect in Obama's campaign.

washingtonpost.com: Obama Makes His Move (washingtonpost.com, Nov. 12)

Eugene Robinson: Beats me. That speech he gave in Iowa was electrifying, it really was. But on "Meet the Press" -- admittedly, not a forum for great speechmaking -- I thought he was good-not-great. Sometimes "cool" works better on television than "hot," though.

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Fairfax, Va.: I have medical insurance. I will need a hip replacement in next 6-12 months. Why should I vote for a single-payer candidate over one who would allow me to have my surgery on my schedule and with my surgeon of choice?

Eugene Robinson: I wouldn't. But the point of the Commonwealth Fund study that I wrote about is that a single-payer system wouldn't keep you from having the surgeon and the date that you want.

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Anonymous: Hi Mr. Robinson, a poster in "Mr. Robinson's Neighborhood" commented: "White America will not put an African American in the White House. And, that's why African Americans are supporting Clinton." So far, "white" Iowa is significantly supporting Obama, and "white" New Hampshire is supporting a black man too. So I challenge that black-female poster. If the sweeping generalization she made is true -- that blacks will vote for Clinton -- it is black America that will not put an African American in the White House. Can you name five people whom you know who will not vote for Obama because he is black? (And they must be known to you personally -- so not David Duke, for example.)

Eugene Robinson: No, I can't name five people known to me personally who would not vote for Obama because he's black. At least, I don't know five people would would admit that. Nevertheless, there have been times in fairly recent memory when pre-election polls showed black candidates winning and actual election results showed them losing -- and I'm talking about vote swings that are way outside the margin of error of any poll. If people voted the way they said they would vote, Tom Bradley would have been elected governor of California not once but twice.

Maybe we really have gotten beyond that phase in our development as a nation. But it's not hard to understand, given American history, why many black voters would be skeptical. If Obama were to win Iowa and New Hampshire, that would change some minds.

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Richmond, Va.: What's your take on the article today income decline in middle class African American families?

washingtonpost.com: Middle-Class Dream Eludes African American Families (Post, Nov. 13)

Eugene Robinson: I'm still digesting the study, so I have to confess that I haven't really decided what I think. My preliminary guess is that if the numbers are right, this phenomenon probably is related to the huge gap in wealth between blacks and whites, which as you know is far larger than the gap in income. The suggestion is that without a cushion, the consequences of one misstep -- losing a job, suffering a serious illness, etc. -- can be much more profound for middle-class blacks than whites. But I'll have to finish reading the study and giving it a little thought.

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Scotch Plains, N.J.: I always have been insured, and I still think our system stinks. I have worked for small businesses for the past decade, and as costs have risen they have tended to switch plans year to year. Often that means getting a new physician because the network changes -- not to mention that the cost keeps rising and rising. Even for the fully insured, this patchwork system is a pain and keeps you guessing all the time as to what is covered, who you can see, etc.

Eugene Robinson: I think just about everyone has had that experience. Our current system really is a messy hodgepodge. Starting from scratch, no one would come up with what we have now.

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Washington: Hi there. You posted about Obama's speech this weekend in Iowa. I saw it and I thought it was very good. Did you happen to see footage of the pre-speech rally/march? He was with a full marching band, with Mrs. Obama along dancing and enjoying the moment. The last shot I saw (on YouTube) was of them walking with their arms around each other. Very cool. Honestly, more inspiring to me than even his great speech.

washingtonpost.com: Obama in Pre-Jefferson-Jackson Dinner March (YouTube, Nov. 10)

Eugene Robinson: Agreed, very cool. But, um, do pay attention to the candidates' speeches. Dorkiness should not be a deal-breaker.

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Chicago: Thanks much for your column today -- it is a much needed diversion from the daily dissection of Sen. Clinton's evil character and motives. I wonder if you will lose your gigs on the Kill Hillary Show("Hardball")? Is this a temporary diversion, or is the MSM now turning its attention to the Republican frontrunner? I wonder if Rudy can withstand the intensity of the attacks that have been directed at Clinton. But I'm sure we will hear weeks of analysis of the planted question in Iowa. I'm curious about the lack of MSM outrage about President's seven years of staged events that they covered as legitimate. Orwell's predictions were just 20 years early.

Eugene Robinson: Now, now. I seem to recall many, many stories about George Bush's stagecraft, along with his continuing refusal to talk to groups of people who don't already support him. Look, Hillary Clinton had a bad couple of weeks. But she's still leading in all the national polls, and also in New Hampshire and South Carolina. The people around her are smart enough to know that they're still in a position that all the other candidates would die to be in -- and that it was never going to be a cakewalk to the nomination. The next eight weeks will be a real battle.

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Baltimore: Re: Giuliani and Sept. 11: I long have been perplexed by the amount of political mileage Giuliani has gotten out of the fact that he happened to be New York's mayor when the planes hit the Twin Towers. How does that make him an arch-fighter of terrorism? Columnist Mike Lupica of the New York Daily News had it exactly right when he said of Giuliani and his disgraced protege Bernie Kerik that " all they did was help pick up the pieces along with everybody else."

Eugene Robinson: That would be my view as well. But in politics, you use what you've got. Giuliani became a national figure after 9/11 -- not "one of the four or five best-known Americans," as he has claimed, but a national figure nonetheless -- and so far the association is working well for him.

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Hilton Head Island, S.C.: Mr. Robinson, I watch you on "Hardball" all the time. Thank you for taking my question. With the new Pew study out today that reports that more than half of the children from black middle-class families have fallen into poverty in the next generation, do you think this will become a campaign issue? The study was shocking to most of those interviewed, and seemingly points to a rather large block of voters who are going to want to know what is going to be done.

Eugene Robinson: This study is part of a larger, ongoing Pew/Brookings project on economic mobility in the United States. I don't know if economic mobility among African Americans will become an issue, but I think the broader issue of economic mobility for all Americans certainly should be.

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Re: Quote:"American doctors do tend to give patients more information and thus involve them more meaningfully in their own care. That's a good thing, and I'd hate to give it up." What are you basing this on? I sometimes feel like I have to bar the door to keep the doctor from leaving before I'm done talking to them, and it has been well publicized that they are under pressure to fit in more and more patients.

Eugene Robinson: That is from the Commonwealth Fund study. That specific question wasn't asked, but the survey found that American doctors are much more likely to give patients a detailed, written plan for follow-up care at home, for example, and to remind them of follow-up appointments.

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Anonymous: Michelle Obama's response to the question as to why her husband wasn't doing well with black voters suggested that black-on-black racism is a problem. Black youths I've worked with tell me that black cops are much more hateful and harsh toward them than are white cops. Is Obama's biggest hurdle to election getting the white vote or the black vote?

Eugene Robinson: You're drawing the wrong inference from Michelle Obama's remarks. She wasn't suggesting black-on-black racism. She was saying that many blacks couldn't yet bring themselves to believe that a black man could actually win.

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Bluffton, S.C.: Any idea what a Mitt Romney speech about his religion would contain, and do you think it is necessary for him to give it? Doesn't he have bigger problems than his religious beliefs?

Eugene Robinson: His religious beliefs might actually be a real problem for him. They shouldn't be. But polls have shown that a surprisingly large number of respondents say they would have trouble voting for a Mormon. You ask a good question, though -- what on earth would he say in such a speech? It would be hard to say that religion doesn't matter, since all the candidates are making such an unvarnished appeal for religious voters. So what would he say?

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Charleston, S.C.: Why does "electability" seem to be the primary concern of Republican primary voters but not Democratic primary voters? Like it or not, Rudy Giuliani's positions on the issues are more popular nationwide than most of the other Republican and Democratic candidates. His appeal to me seems to be that he actually articulates his positions and does not shy away from his views. Most of the others, especially Clinton, come across as pandering to their base and whatever audience they are in front of at the moment. It amazes me that the general media and political pundits don't seem to recognize the fact that people are willing to overlook some policy disagreements in favor of someone who actually believes something and is not afraid to voice their positions.

Eugene Robinson: I disagree with your premise, since I think that in many ways this whole primary season has been about electability, in both parties. One reason Hillary Clinton has such a big lead is that some Democrats worry that Obama might not be enough of a street fighter to beat Giuliani.

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Boston: Have we "lost Pakistan"? If so is Cheney to blame, given reports that he -- not the State Department -- had Pakistan in his portfolio? Weren't Pakistani officials who visited Washington in recent months taken to the vice president's office instead of Foggy Bottom? Can Bush/Cheney still credibly argue that Iraq is the central front in the war on terror?

Eugene Robinson: I'm not sure we ever "had" Pakistan. I think Cheney would probably be happy to throw Musharraf under a bus if he thought whoever came next would be equally cooperative with the administration's agenda. And no, I don't see how they can claim Iraq is the "central front." But of course it never was.

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Eugene Robinson: That was a quick hour! Thanks for dropping by, everyone, and talk to you again next week.

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