May 13 2008
The AP/Miami Herald on Sunday looked at the health plans proposed by Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.). While likely Republican nominee Sen. John McCain said the Democratic plans would "move closer to a nationalized health system," AP/Herald describes that characterization as "a stretch."
Both Clinton and Obama would use the federal government to establish a marketplace in which residents could purchase private or public health insurance, with subsidies for lower-income residents, and would prohibit health insurers from rejecting applicants because of pre-existing medical conditions. The most significant difference in the proposals involves the question of whether to mandate that all residents obtain health insurance. Clinton would implement such a mandate, but Obama would require coverage only for children.
However, a "vast distance" exists between the Clinton and Obama health care proposals and a nationalized health care system, as neither candidate is "proposing government hospitals or government doctors," the AP/Herald reports. In addition, both candidates would "continue the split system that the U.S. has when it comes to health coverage," with coverage for some residents funded in large part by government and for others funded in part by employers, according to the AP/Herald.
Karen Davis, president of the Commonwealth Fund, said of the Democratic candidates, "Their approach is not taking any other country's system. It's building on what we have in the U.S."
Heather Higginbottom, policy director for the Obama campaign, said, "We don't eliminate the employer-based side of the equation. We don't dismantle private insurance." She added, "We still have competition and choice and all the things that would lead to adequate supply and good care." Neera Tanden, policy director for the Clinton campaign, said that Clinton would "build on the system we have rather than radically reshape it" (Freking, AP/Miami Herald, 5/11).
Health Care Important Issue for Voters
Concerns among voters about access to health insurance and health care costs have become an "important part of how they choose presidential candidates, the Miami Herald reports. "Ask voters about their top domestic concern, and most name the economy, then quickly mention health care," according to the Herald.
Andrew Kohut, president of the Pew Research Center, said, "The economy overall is the most important issue" for voters, and, "to a certain extent, health care is a component of that."
According to the Herald, although the candidates "find it easy to get voters' attention" on health care, "convincing a voter" that their proposals "can help ease his or her specific problem is a more difficult matter," and, "because the solutions are so complex -- involving affordability, better care, access to care and so on -- it's hard to judge just what motivates people to support one candidate over another" (Lightman, Miami Herald, 5/11).
Poll
About 11% of U.S. adults cite health care as their most important election issue, compared with 56% who cite the economy and 34% who cite the war in Iraq, according to a recent Los Angeles Times/Bloomberg poll, the Times reports.
The poll, conducted earlier this month, included telephone interviews of 2,208 adults, 1,986 of whom are registered voters. Researchers asked adults to cite as many as two issues as their most important election concerns.
In addition, the poll asked adults about their opinions on the state of the economy and other issues, as well as which candidates they considered most able to address various concerns. The poll also examined who would win a general election between Clinton and McCain or an election between Obama and McCain (Alonso-Zaldivar, Los Angeles Times, 5/10).
The results of the poll are available online (.pdf).
Editorial
"You've heard a lot ... about which presidential candidate is best qualified to answer that 3 a.m. phone call in the White House," but, "if the caller were asking about health care reform, there's no doubt" Clinton "could give the best answers, even in her sleep," according to a Salt Lake Tribune editorial. "Despite what you may have heard," Clinton has not proposed a "single-payer government-financed health plan," according to the editorial.
Her proposal "retains private insurance companies and competition but makes a number of major reforms in tax policy and the market," and the plan "does attempt to achieve universal coverage," the editorial states. The Obama proposal "largely mirrors" her plan but would not require all residents to obtain health insurance, and the McCain plan "likely would fall far short of universal coverage," fail to "rein in cost-shifting" and do "nothing to prevent insurers from cherry-picking their insureds."
According to the editorial, without an individual mandate, "it will be impossible to end cost-shifting and get a handle on costs," and "HillaryCare shows the most promise for accomplishing these linked goals." The editorial concludes, "This is one area where Hillary Clinton's experience with an issue would pay off for all Americans" (Salt Lake Tribune, 5/9).
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. |