Health Care News From the Campaign Trail for the Week of March 28
Sens. Hillary Rodham Clinton (D-N.Y.), Barack Obama (D-Ill.) and John McCain (R-Ariz.), along with their parties, have "sharply different philosophies" about health care, USA Today reports.
According to health care consultant Robert Laszewski, Kaiser Family Foundation President and CEO Drew Altman, and other experts, there are three major areas in which Democrats' and Republicans' plans differ:
- Clinton and Obama propose covering "all or nearly all" people, while McCain "says worry about [reducing health] costs first and expand coverage later";
- Democrats would require "most, if not all," people to have health coverage and would require insurers to cover everyone who applies to purchase coverage, while Republicans would not mandate anyone to purchase coverage or require insurers to sell coverage to people with pre-existing medical conditions; and
- Democrats would enhance the current system of employer health coverage, while Republicans "lean more on tax incentives" to encourage people to purchase their own coverage and less on coverage provided by a job.
According to USA Today, McCain's proposals could "continue to leave millions of people without insurance" and could increase the number of employers who drop coverage or limit health plans, while Clinton's and Obama's plans could cost more than anticipated because of expanded coverage.
Former HHS Secretary Tommy Thompson said that 2008 will be the "first presidential election that will have a good share of the campaign fought around health care." Thompson added that "2009 will be the biggest successful year in the transformation of health care that we have seen since the passage of Medicare and Medicaid in the 1960s."
However, Harvard University health policy professor Robert Blendon said he predicts a "huge stalemate" on health care because "[t]here used to be a sense of a moderate middle that shared some of the values and concerns of each party," but now "there are not a lot of people in the middle" (Appleby, USA Today, 3/26).
About 70% of likely voters in the Pennsylvania Democratic primary have concerns about their ability to afford health care, according to a Quinnipiac University poll released last week, the Wall Street Journal reports.
According to the poll, voters ranked health care as their third most important issue in the election after the economy and the war in Iraq. Among voters who cited health care as their most important issue in the election, 56% said that they supported Clinton, and 38% said that they favored Obama (Timiraos, Wall Street Journal, 3/27).
- During an interview with the New York Times on Wednesday, Clinton said that she would seek to limit health insurance premiums to between 5% and 10% of the annual incomes of individuals as part of her proposal to expand coverage to all U.S. residents. Clinton said that she would prefer to establish a single limit on health insurance premiums for all residents, rather than a cap based on income. In addition, she said that she might seek to require health insurers to spend a significant percentage of health insurance premiums on patient care. Clinton said that she would allow the federal government to negotiate prices directly with pharmaceutical companies under the Medicare prescription drug benefit and would "rein in" subsidies for private Medicare Advantage plans (Sack, New York Times, 3/28).
- The Times has posted a video with excerpts of the interview with Clinton on its Web site (Harris/Sack, nytimes.com, 3/28).
- During her campaign, Clinton has said that she helped lobby for the passage of the 1993 Family and Medical Leave Act, but in an e-mail obtained by The Hill, former Rep. William Lacy Clay (D-Mo.) said that Clinton had "nothing to do with" the approval of the bill. According to Clay, the bill had passed by large margins in 1990 and 1992, but former President George Bush vetoed the legislation. "All we needed was a president to sign it," Clay said, adding, "If Hillary played a role in its passage, it was without my knowledge." Judy Lichtman -- who led the lobbying effort for the bill by the Women's Defense League, which became the National Partnership for Women and Families -- said that Clinton helped make FMLA an important issue in the campaign of former President Clinton in 1992. (Youngman, The Hill, 3/27).
- In an interview with the Pittsburgh Tribune-Review editorial board on Tuesday, Clinton discussed how her proposal to require all U.S. residents to obtain health insurance would increase access to organ transplants. Clinton said, "The question of transplants is extremely sensitive because it's not only people maybe getting them when they are not critically ill, but also a hospital looking at, 'Do we give a transplant to the uninsured person and eat all that cost, or do we give a transplant to a highly insured person?'" (Conte/Fabregas, Pittsburgh Tribune-Review, 3/26).
- McCain's "longtime effort to crack down on tobacco is being put to a new test" as the Senate is set to vote on whether to allow FDA to regulate tobacco, the Boston Globe reports. According to the Globe, McCain's "decade of work" to regulate tobacco is "one of the most significant efforts of his congressional career" and has "earned him enmity from the industry and from some fellow Republicans." However, McCain recently has "dropped his support" for increasing cigarette taxes. Tobacco could become a focus in McCain's presidential campaign "because of his opposition to taxing cigarettes, rather than his support for it," the Globe reports (Kranish, Boston Globe, 3/26).
- During a breakfast with reporters on Friday, four fellows of the Center for American Progress Action Fund criticized McCain's health care and economic proposals, the Washington Post's "The Trail" reports. Two of the fellows, Peter Harbage and Jeanne Lambrew, questioned whether the McCain health care proposal would expand access to high-quality health insurance and noted similarities with the proposals of President Bush. McCain adviser Douglas Holtz-Eakin called the comparison between the McCain and Bush proposals unfair, as the McCain plan would provide refundable tax credits to help low-income individuals and families purchase health insurance rather than a deduction as Bush has proposed (Eilperin, "The Trail," Washington Post, 3/23).