Examining Presidential Candidates' Health Care Proposals

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Presidentialcandidate Sen. Hillary Rodham Clinton (D-N.Y.) "is right" that ahealth care proposal announced by presidential candidate Sen. Barack Obama(D-Ill.) likely would leave millions of U.S. residents without healthinsurance, but "she is being misleading in implying that her own plancovers everyone," the New YorkTimesreports.

During her campaign, Clintonhas said that the Obama proposal would leave 15 million residents withouthealth insurance because the plan would not require all residents to obtaincoverage. According to the Times, the 15 million figure -- whichis an "estimate," although "no one appears to have a betterfigure" -- first appeared in the New Republic.

The Clinton proposal would require all residents to obtain health insurance,but, according to experts, such mandates "rarely achieve 100%compliance" and "are almost impossible to enforce," the Timesreports. In Massachusetts, which recently implemented a law that requires allresidents to obtain health insurance, some residents still lack coverage, anindication of "how difficult it is to force everyone to comply,"according to the Times.

Joseph Antos, a health policy expert at the AmericanEnterprise Institute,said, "If Obama's plan were to leave 15 million people without insurance,I think Sen. Clinton's plan would certainly do the same, not because of amandate but because of the fundamental problems of getting people to recognizethat they should buy insurance and making them buy it."

According to Austan Goolsbee, an economics professor at the University ofChicago and an Obama adviser, Clinton should acknowledge that her proposalwould leave as many residents without health insurance as the Obama plan, inpart because she "has not suggested a penalty" to enforce hermandate. He said, "If there's no penalty for skipping out on insurance,people will skip out on it" (Seelye, New York Times, 12/5).

Health Care Proposals

Summaries of two recentarticles that examined the health care proposals of presidential candidatesappear below.

  • Expansion of health insurance: The Wall Street Journal on Wednesday examined which of the health care proposals from the major Democratic candidates would "do more to provide health coverage for the uninsured." According to the Journal, Clinton and Obama "have been engaged in a bitter back-and-forth over whose health care plan covers more people," and former Sen. John Edwards (D-N.C.) has said that "his plan is the best of all." Clinton, whose proposal would require all residents to obtain health insurance, has said that Obama, whose plan would require coverage only for children, would leave 15 million residents without coverage, a claim confirmed by outside experts, according to the Journal. The Edwards proposal also would require all residents to obtain health insurance. According to the Journal, the Obama campaign acknowledges that his proposal would leave some residents without health insurance but also claims that "Clinton's plan would also leave millions without coverage" because she will have to waive the mandate for about 10 million residents who cannot afford to purchase coverage. Goolsbee argues that the Clinton proposal includes inadequate funds to make health insurance affordable for all residents. However, Ken Thorpe, a professor at Emory University who has advised all three major Democratic candidates, said that estimates made at the request of the Clinton campaign indicate her proposal would make health insurance affordable for all residents (Meckler, Wall Street Journal, 12/5).

  • Inadequate proposals: Dow Jones on Tuesday examined how "there doesn't appear to be much in the way of strong shifts on the horizon" for health care "if current proposals from the handful of presidential hopefuls are not altered." According to Roger Feldman, a professor at the University of Minnesota who specializes in health insurance, "None (of the plans) revolutionize the system. They've kept all (of the plans) from (enacting) system redesign for the most part." According to Dow Jones, the lack of specific details in the proposals might serve as the "most critical hurdle to meaningful reform" (Britt, Dow Jones, 12/4).

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Polls

Two recent polls examinedhealth care issues in the presidential election. Summaries appear below.

  • USA Today/Gallup: Domestic and economic issues, such as health care, are more of a concern for voters in the presidential election than the war in Iraq, terrorism and foreign policy, according to a recent USA Today/Gallup poll, USA Today reports (Page/Risser, USA Today, 12/5). According to the poll, 22% of Democratic voters surveyed cited health care as their most important concern, compared with 46% who cited the war in Iraq and 15% who cited the economy. Seven percent of Republican voters cited health care as their most important concern, compared with 29% who cited the war in Iraq and 13% who cited the economy, the poll found. The poll also found that 14% of independent voters cited health care as their most important concern, compared with 34% who cited the war in Iraq and 19% who cited the economy (USA Today graphic, 12/5).

  • Washington Post/ABC News: Republicans likely to vote in the New Hampshire primary trust former Massachusetts Gov. Mitt Romney (R) to address health care more than they trust all other Republican candidates, according to a recent Washington Post/ABC News poll, the Post reports (Cohen/Balz, Washington Post, 12/5). According to the poll, 37% of respondents trust Romney most to address health care, compared with 13% who trust former New York City Mayor Rudy Giuliani most and 11% who trust Sen. John McCain (Ariz.) most (Washington Post graphic, 12/5).

Editorial

The three major Democraticpresidential candidates have proposed "extensive health care plans thatare heavy on dessert and light on spinach" and "make few toughchoices on containing Medicare's exploding costs, such as higher copayments ormore means testing," according to a USA Today editorial.

According to the editorial, Democratic candidates have attributed the"fiscal difficulties the nation faces" to President Bush, but, as"deserving of criticism as Bush's fiscal policies are, he did not inventthe baby boomers or tell them to retire now," establish the "currentmess of a health care system" or "cause people to live longer."

This lack of willingness among Democratic candidates to discuss issues offinancial responsibility is "a serious problem because the next presidentwill have to prepare the nation for some difficult choices and reach out to theother party if anything is to get done," the editorial states (USAToday, 12/5).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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