Health Insurance and Care Powerful Issue in 2008 Elections

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Health Insurance and 2008 Elections

Democratic and Republican presidential candidates who promise to "overhaul" the U.S. health care system and find ways to cover the uninsured are focusing on health care early in their campaigns "in response to the growing anxiety among voters -- and much of American business -- about the cost of health care," the New York Times reports. Some recent polls show that health care is the leading domestic issue among Democrats, Independents and voters overall. According to a June poll by the Kaiser Family Foundation, health care ranks third among Republicans, after Iraq and immigration.

However, Democrats' and Republicans' proposals "are very different, reflecting longstanding divisions between the parties on the role of government versus the private market" in making health care affordable and accessible, the Times reports. The interest among some Republican candidates in discussing health care so early in their campaigns is notable because GOP candidates "often wait until the general election to roll out detailed health plans," according to the Times.

Republican candidates former New York City Mayor Rudy Giuliani and Sen. John McCain (Ariz.) are expected to release details of their health care proposals this summer, while former Massachusetts Gov. Mitt Romney talks about getting "everybody inside the health care system" through "market reforms," rather than "with a government take-over" of health care. According to Sally Canfield, policy director for the Romney campaign, the health plan that Romney signed into law in Massachusetts "was crafted for Massachusetts," adding that a national plan would be different. Romney aides said he did not support a federal requirement that individual obtain insurance, as in Massachusetts.

Meanwhile, "Democrats are competing furiously among themselves over who has the bigger, better plan to control costs and to approach universal coverage, a striking change from the party's wariness on the issue a decade ago after the collapse of the Clintons' health care initiative," the Times reports. According to the Times, the "major Democratic proposals" -- from former Sen. John Edwards (N.C.); Sen. Barack Obama (Ill.); and Sen. Hillary Rodham Clinton (N.Y.) -- "are arguably ambitious and costly but do not try the wholesale reinvention of the system or move explicitly toward the government takeover Republicans so often predict."
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Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Foundation's Commission on Medicaid and the Uninsured, said that candidates are responding to recent successes at the state level, including Massachusetts and plans currently under consideration in California. Rowland said, "To get something enacted, you need a lot of people who think they will gain from it," adding, "It's a new way of talking about health reform because it shows people with health insurance what they could gain. These proposals are not just about the haves versus the have-nots."

Democratic pollster Geoffrey Garin said, "There are a bunch of issues that candidates can take a pass on. This is not one of them."

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Jonathan Gruber, an economist and health care expert who worked for the Clinton administration, said that the environment for health care reform is "radically different" than it has been in previous years. Gruber added, "If the Democrats win, it will be very hard not to take this issue on. It will be as promising as it was in the early 1990s" (Toner, New York Times, 7/6). The Times also published online a graphic examining the candidates' views on health issues.

Candidates' Experiences
The Times also examines how "almost every candidate can speak from experience" when it comes to dealing with difficulties in the health care system. Obama talks about spending time in the hospital with his mother, who died from ovarian cancer at age 53. Obama said that she "was spending time worrying about whether or not she would have anything left over, if she was able to survive the illness." Obama also said that he had to "spend a lot of time arguing with the insurer about when she had been diagnosed with this ovarian cancer because they started making arguments that she had a pre-existing condition."

Edwards discusses experiences that he has had dealing with insurance companies and access to quality care since his wife, Elizabeth, was diagnosed with breast cancer in 2004. Edwards during a recent trip to Iowa said, "Here you have a former senator, presidential candidate, vice presidential candidate, and I'm a lawyer. I'd get those statements from the insurance companies, I had no idea what they meant. I felt like a blooming idiot."

Clinton at an event in New Hampshire talked about the massive amount of paperwork and bills that she encountered when former President Bill Clinton had heart surgery in 2004 to illustrate the need for a more cost-effective and modern system of electronic recordkeeping.

Giuliani, who was treated for prostate cancer in 2000, largely focuses on positive aspects of the U.S. system. Giuliani said that the U.S. has "the best health care system in the world," although he acknowledges that there are flaws he will address (Toner [2], New York Times, 7/6).

"Reprinted with permission from www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation .

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