Democratic Presidential Candidates' Health Insurance Plans On Single-Payer

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"Democratsbacking universal health care long favored a single-payer system," and,although most Democratic presidential candidates have announced proposals toexpand health insurance to all U.S. residents by "building on theemployer-based system," the "ghost of single-payer past loomslarge," the Wall Street Journal reports.

Sen. Hillary Rodham Clinton (D-N.Y.) earlier this week criticized Sen. BarackObama (D-Ill.) for shifting his support from a single-payer health care systemto his current proposal, which would require health insurance only for childrenand would build on the employer-sponsored system. In response, Obama deniedthat he supported the implementation of a single-payer health care system. Hesaid, "What I said was that if I were starting form scratch, if we didn'thave a system in which employers typically provided health care, I wouldprobably go with a single-payer system."

The exchange "showed how politically sensitive the idea of a single-payersystem remains," the Journal reports. According to theJournal, when Democratic candidates say "something too kind" about asingle-payer health care system, "there's a Republican around the cornerready to brand you a socialist," and, when they say "something tooharsh," they "alienate many on the left wing of the party."

David Nexon, a senior executive vice president with AdvaMed andformer adviser to Sen. Edward Kennedy (D-Mass.), said of health care reformproposals, "There are a lot of different ways of skinning this cat."He added, "The key is to get one that can pass and providesdecent-quality, affordable coverage to everyone, not the one that is theperfect system in the eye of whatever beholder it is" (Meckler, WallStreet Journal, 1/25).

Webcast of forums featuring a number of the major presidential candidatesdiscussing health care are available online. The forums were organized by Families USA and the Federation ofAmerican Hospitals.The Kaiser Family Foundation hosted the forums in its BarbaraJordan ConferenceCenter in Washington, D.C.Webcasts provided by kaisernetwork.org are available on a dedicated Web site,http://presidentialforums.health08.org.

Edwards on Health Care

Former Sen. John Edwards(D-N.C.) on Thursday in an interview in Patrick, S.C., said that his healthcare proposal, which would allow U.S. residents to pay to participate in publichealth plans modeled on Medicare, could develop into a single-payer health caresystem and that he would not oppose such a development, the New York Times reports.

He said that, under his proposal, residents would decide "which worksbest" -- private or public health plans. He added, "It could continueto be divided," but "it could go in one direction or the other, andone of the directions is obviously government or single-payer. And I'm notopposed to that."

According to the Times, in the event that public health plans canoffer health insurance at lower prices than private plans, the federalgovernment "theoretically" could become the "de facto insurerfor the nation." Edwards said, "There is nothing back-door aboutit," adding, "It's right through the front door. We're going to let America decidewhat health care system works for them" (Sack, New York Times,1/25).

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AMA Addresses Issue ofthe Uninsured

American Medical Association President-elect Nancy Nielsen onThursday at the Economic Club of Florida said the group has visited stateswith early presidential caucuses or primaries to "raise concerns amongcandidates and voters" by "becoming part of the voice for theuninsured," the Tallahassee Democrat reports. The issue of the uninsuredis "worsening," she said, adding, "Doing nothing is not anoption."

AMA supports a proposal that would provide tax credits to help uninsured U.S. residentspurchase health insurance and would eliminate federal tax exclusions forcoverage. In addition, the proposal would seek to provide all residents with achoice of portable health plans. AMA does not seek to eliminate theemployer-sponsored health insurance system, Nielsen said.

She said, "We need to work together to find a uniquely American solution.... What we know is that uninsured people live sicker and die younger."She added, "This is not about doctor income" (Liner, TallahasseeDemocrat, 1/25).

Editorial

Democratic presidentialcandidates are "careful" not to use the phrase "socializedmedicine" when discussing their health care plans, but "make nomistake, three of the party's remaining hopefuls advocate changes that wouldpush us closer to precisely such a system," the Las Vegas Review-Journal writes in an editorial. Clinton, Obama andEdwards "all agree that the government should essentially expand Medicareto give every American a choice of enrolling in the federal program,"according to the editorial. These candidates "should be forced toaddress" concerns that government-run insurance would "crowd outcompetitive private plans" by offering less-expensive, taxpayer-subsidizedcoverage, and that the cost of such a plan would "far surpass"savings achieved by reducing the number of uninsured individuals (LasVegas Review-Journal, 1/25).

Letter to the Editor

Republican presidentialcandidate and former Arkansas Gov. Mike Huckabee's reference to the work performedby caregivers as "'emptying a bedpan' was insensitive and insulting,leaving the impression that [caregivers' work] is unimportant and ... unworthyof respect," Lin Salasberry, a certified nursing assistant from Iowa, and10 other caregivers write in a Des Moines Register letter to the editor. The lettercontinues that Iowacaregivers last month sent a letter to Huckabee asking him to explain thestatement and inviting him to "walk a day in the shoes of a professionalcaregiver," but "no response has been received." The caregiverswrite that they hope "Huckabee and other candidates understand that thereare more than three million professional caregivers in America who areconcerned about his words and failure to respond" (Salasberry, DesMoines Register, 1/25).

Opinion Pieces

"The sad state ofhealth care is one of the leading issues in the presidential campaigns,"because the U.S.health system "is a national disgrace," Thomas Preston, a physician,writes in a Seattle Post-Intelligencer opinion piece. "The owners,investors and employees of Big Pharma and device or instrument suppliers reapbillions in profits through the present form of insurance," so"transformation ... will never come from within the industry,"according to Preston. He adds, "The electorate must insist on changethrough the political process." Preston adds, "To succeed,politicians must begin with consensus to eliminate financial self-interest fromhealth care decision-making, guarantee health insurance for everyone andrestore independence in evaluation of treatments" (Preston,Seattle Post-Intelligencer, 1/22).

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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