Monday, September 3, 2007

2008 Presidential Candidate Health Care Reform Proposal Wrap Up 9/1/07


Democrats and Republicans are scrambling to come up with a promising way to overhaul America’s Health Care System. Almost all of the candidates recognize that something has to change. Unfortunately, the road to hell is paved with good intentions. Let’s start with the Republicans.

Governor Mitt Romney thinks individuals should be more responsible for their own care. He insists that States should remain in control of health care and the Feds should not mandate to the States. But the current system with States in control to a large extent is failing miserably. He supports a Free Market System…you know, like the one that got us into this mess to begin with. Massachusetts has made little progress towards lowering health care costs. Mitt recognizes that preventive care and education are important. He even suggests that Europe’s economic slowdown is somehow directly correlated to their practice of Socialized Medicine. Reality is that Americans are not that naïve. There is no substance here…only disaster.

Senator John McCain has not spent as much time on the health care issue as many of the other candidates. I don’t know why. Maybe he doesn’t think we have a problem. He certainly has not offered any solutions. He has addressed Veteran’s needs and would ensure that they receive the funding and care that they need. However, that goes without saying for any candidate. Lost on this issue.

Senator Sam Brownback wants to put consumers back in the driver’s seat by offering more choice thru a market based system. He wants to encourage the use of more high deductible plans combined with price transparency. Price and cost are the problem. Showing what each provider charges is not a direct reflection on quality and solves nothing. HDHP’s are responsible for the highest increase in consumer medical debt in history. Thanks for nothing.

Senator Mike Huckabee says the private sector should drive cost relief. Demand for medical services is at an all time high with an unsustainable growth rate. Mike, what will the private sector do provide relief? Take the money and run? That has been the pattern. Mike, you do not have a clue.

Mr. Rudy Giuliani says no to a single payer system. Improve the current system with some significant changes. He proposes a major tax deduction of up to fifteen thousand dollars and the promotion of health savings accounts. Rudy, we already know that HSA’s are creating other problems like medical debt. A tax deduction for low to middle income Americans who already have a low tax rate and can’t afford insurance to begin with, does little to help. Rudy suggests that insurance policies are Government dominated and when permitted to offer low cost options without Government mandates that require minimum amounts of coverage in many areas, premiums will be less expensive. So what? Insignificant amounts of health insurance protection will only lead to more consumer medical debt. Rudy wants to cover wellness and encourage healthy lifestyles. He is for investing in Health Information Technology and for reforming Medical Liability, which is promising. He is the only Republican that recognizes the urgent need for change in the U.S. Health Care System besides Senator Romney. Mr. Giuliani has proposed the most innovative Republican position on health care reform.

The Democratic candidates follow:

Senator Joe Biden wants to insure all children under 18, modernize medical records and provide catastrophic coverage to the 46 million who can’t afford it. What about the currently insured population who can’t afford rising contributions to escalating premiums? Or what about the astronomical out of pocket costs due to high deductibles prescription costs or other cutbacks in benefit plan designs? Not a clue.

Senator Chris Dodd is suggesting a health insurance marketplace much like the FEHBP which is the Federal Employees Health Benefits Plan. FEHBP is an excellent program. He believes contributions should be based upon your ability to pay. Spreading risk, investing in technology and preventive care are other concepts that he endorses. Chris feels health care is the most important issue for the 2008 Presidential Candidates. We are looking forward to more specifics from the Dodd campaign on this issue.

Senator Barack Obama preaches Universal Health Care by 2012 implementing a new National Health Care Program for individuals and small business with no preexisting conditions and subsidies for all of those in need. He wants to reform the private insurance market, expand Medicaid and SCHIP. Barack believes that Employers should be paying their fair share. He endorses Health Information Technology, access to preventive care and chronic disease management programs. Senator Obama wants to regulate hospitals to report all data and to reform the market structure to increase competition. His understanding and intelligence of the health care issue are evident. His command of the subject matter is a different issue completely. Senator Obama has a plethora of well intentioned changes to suggest, but with no glue to join them together. Except for the National Health Care Program--a precursor, I suppose, to socialized medicine--Barack has taken a position on many of the issues, but is not very convincing about how changes would get done.

Senator Hillary Clinton knows that America is ready for change. Hillary claims that Americans will have Universal Health Care by the end of her second term which is very optimistic on all fronts. The Clintons are masters of artfully dodging how anything specifically will be achieved. However, Hillary says it will take a collaborative effort from Government, Business, Labor and the Private Sector. Hillary has put her neck on the line with the health care issue and understands the challenges facing our nation to create a more effective health care system. Although a single payer system is not the only answer, it is the most obvious solution. Senator Clinton has endorsed Electronic Medical Records, creating large insurance pools and improving the quality of care through the Best Practices Institute. She wants to remove barriers to genetic drugs and reform malpractice insurance. Although she faces considerable opposition, her persistence and the political climate suggest that Americans could endorse evolving the U.S. Health Care System towards something that looks like the best socialized medicine has to offer with our own American spin on it. If elected, Hillary has the drive, perseverance and vision of a leader who can reform health care in America.
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When it comes down to it, either a Free Market Driven System or a more drastic move towards a Socialized System of Health Care can improve the current U.S. Health Care crisis. Which system is best for America’s long term future will be decided by the voters in the 2008 President Elections. Keep your children’s future and the future of America in mind when you think about health care. Vote with your emotions in tact. Changes to the health care system are going to be costly and painful, whatever side you take. Be well.

1 comment:

Jack Lohman said...

I wish it were as simple as that. No matter what "your president" wants, it will be decided by the cash that flows from the insurance and healthcare industry. Only a supermajority in the senate will give the democrats a chance to fix it, and with the money flowing that is even questionable. If we could get the money out of the political system first, with a Clean Elections proposal like John Tieney's (D-MA), perhaps the politicians will start voting for their constituents rather than their pocketbooks.

What you didn't mention was the best proposal, by John Kucinich, for Medicare-for-all. This would eliminate the 31% middleman costs of the insurance bureaucracy that adds nothing to direct patient care. But even Hillary is the largest recipient of insurance money. I'm on Medicare. I get sick, I get care and the caregiver gets paid. Simple as that.

But sorry, even that leaves out the cash-fat insurance industry and they are not going to sit still for it.