Kaiser Daily Health Policy Report rounds up health news from the campaign trail

Jun 17 2008

Fifty-three percent of U.S. adults trust presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) more than presumptive Republican nominee Sen. John McCain (Ariz.) to address the issue of health care, compared with 33% who trust McCain more than Obama to address the issue, according to a recent Washington Post-ABC News poll, the Post reports.

For the poll, conducted between June 12 and 15, TNS interviewed via telephone a random sample of 1,125 adults nationwide. The poll had a margin of sampling error of plus or minus three percentage points (Washington Post graphic, 6/17).

AARP

Medicare should be a key part of discussions about health care reform, advisers to Obama and McCain said on Friday during AARP's Solutions Forum, CQ HealthBeat reports. According to Obama adviser David Cutler, an economics professor at Harvard University, big changes in the private sector are impossible without changes in the public sector. McCain adviser Thomas Miller, a resident fellow at the American Enterprise Institute, said neither campaign is willing to make significant changes to Medicare, adding it is politically difficult to do so without more public attention paid to the program and because the ground work for changes has not been laid yet. In addition, Miller said that it is also difficult to make changes to Medicare because no one has begun the process.

Both advisers agreed that health care costs are too high and could be reduced by the implementation of health information technology. Cutler one-third to half of all health care spending is not for "anything useful." Miller said the focus of health care is on quantity rather than quality, and called for measuring performance based on outcome. He added that the U.S. should invest in its youth to ensure a young, healthy population in the future. Cutler also advocated for more focus on preventive care. Both advisers discussed their candidates' health care proposals.

According to Cutler, Obama's plan would be financed through expiring tax cuts implemented by President Bush. He added that Obama's proposal would save families about $2,500 annually. Miller countered, saying the current system is already spending too much, and increasing spending or shifting costs are not solutions (Parnass, CQ HealthBeat, 6/16).

McCain and Bush

The New York Times on Tuesday examined the policy similarities and differences between McCain and Bush. McCain's "market-oriented model" for health care is "similar to the one that Mr. Bush proposed to little effect in 2007," according to the Times. McCain, like Bush, is proposing to shift from an employer-based insurance market to privately purchased coverage, offset by a tax subsidy. However, McCain's proposal "is more progressive" than Bush's because it offers a refundable credit of up to $5,000 to families who purchase their own health coverage.

According to the Times, experts question whether a $5,000 tax credit would be enough to cover the cost of private insurance. Experts also note that Bush's plan -- which featured a $15,000 tax deduction for families purchasing private coverage -- "was more valuable to higher-income people."

Drew Altman, Kaiser Family Foundation president and CEO, said, "In general, they're much more similar than different," adding, "In terms of their goals, they're more focused on making the market more efficient than in expanding coverage" (Bumiller, New York Times, 6/17).

Opinion Piece

Obama's proposal to insure every U.S. resident, reduce premiums and mandate that insurers accept all applicants regardless of pre-existing conditions "sounds very reassuring," but "if you think you will be getting the state-of-the-art treatment Sen. Ted Kennedy (D-Mass.) is now receiving for his brain cancer, Obamacare is not the sort of change you can believe in," Robert Goldberg, vice president for the Center for Medicine in the Public Interest, writes in a Washington Times opinion piece. According to Goldberg, the foundation for Obama's plan is to expand Medicaid and SCHIP, while making private coverage affordable "by having the government force doctors to accept below-cost rates for their services and impose a 4% tax on physician earnings."

Goldberg writes that Obama's plan also would establish a national health board that would "determine which drugs and procedures the government would pay for under his new plan." According to Goldberg, many states already have implemented similar plans, which "have driven many doctors out of government-run programs and have rationed access to new medicines." The proposals also have resulted in "[p]rivate insurers ... leaving markets" and forced patients "to wait months for needed care, often winding up not getting the medicines they need," he adds.

Goldberg concludes, "Affordable coverage should not be difficult or substandard. Under Obamacare, it will be both" (Goldberg, Washington Times, 6/17).