Health Care News From the Campaign Trail for the Week of March 7

A debate about "whether universal coverage should even be a national priority" will replace the current "skirmish" over the "mechanics of universal health coverage" when the general election campaign begins, the New York Times reports.

Presumptive Republican nominee Sen. John McCain (Ariz.) has announced a health care proposal that focuses on "cost containment over assuring coverage for all," while Democratic Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) have spent more time discussing universal coverage, according to the Times.

Experts have raised concerns that the general election campaign could prompt a "debate that pits coverage against cost," which they maintain "would be regrettable" because the federal government "must fight on all fronts simultaneously to have any chance at meaningful change," the Times reports (Sack, New York Times, 3/2).

Clinton and Obama have highlighted their proposals to expand health insurance to more U.S. residents, but they have said "little" about the "more immediate challenge" of "how to tame the soaring costs of Medicare and Medicaid," the Times reports.

Medicare and Medicaid cost a combined $627 billion last year and accounted for 23% of all federal spending. In 10 years, Medicare and Medicaid will cost about twice as much and account for 30% of all federal spending, according to the Congressional Budget Office. In addition, Medicare trustees estimate that the Part A hospital trust fund will become insolvent in 11 years.

According to the Times, neither Democratic candidate has said, "in any detail, how they would slow the growth of Medicare and Medicaid or what they think about the main policy options" -- such as "rationing care, raising taxes, cutting payments to providers or requiring beneficiaries to pay more."

In addition, neither Democratic candidate has outlined a strategy to "overcome the health care industry lobby, which has blocked proposals for even modest reductions in Medicare payment rates," the Times reports.

According to the Times, McCain has described Medicare as a "fiscal train wreck," and he opposed the Medicare prescription drug benefit in 2003 because it added to the cost of the program (Pear, New York Times, 3/3).

The pharmaceutical industry has increased campaign contributions to Democratic candidates in the current election cycle, a change from recent years, the Philadelphia Inquirer reports. In the current election cycle, Democratic candidates have received 51% of campaign contributions from the pharmaceutical industry, and Republicans have received 49%, according to the Center for Responsive Politics.

Among presidential candidates, Clinton ranks first in campaign contributions from the pharmaceutical industry, and McCain ranks fifth (Stark, Philadelphia Inquirer, 3/2).

• In the event that Clinton wins the Democratic nomination, the Republican nominee likely will use her failed effort to implement health care reform in the 1990s to "rile up the Republican base," the Raleigh News & Observer reports. According to the News & Observer, the Republican nominee likely will cite the effort as a "bloated, complicated, government-run step toward socialized medicine" and an indication that Clinton "loves big government" (Douglas, Raleigh News & Observer, 3/2).