Obama, Clinton Charges on Health Plans Spark Analysis

Presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) "is right" that a health care proposal announced by presidential candidate Sen. Barack Obama (D-Ill.) likely would leave millions of U.S. residents without health insurance, but "she is being misleading in implying that her own plan covers everyone," the New York Times reports.

During her campaign, Clinton has said that the Obama proposal would leave 15 million residents without health insurance because the plan would not require all residents to obtain coverage. According to the Times, the 15 million figure -- which is an "estimate," although "no one appears to have a better figure" -- first appeared in the New Republic.

The Clinton proposal would require all residents to obtain health insurance, but, according to experts, such mandates "rarely achieve 100% compliance" and "are almost impossible to enforce," the Times reports. In Massachusetts, which recently implemented a law that requires all residents to obtain health insurance, some residents still lack coverage, an indication of "how difficult it is to force everyone to comply," according to the Times.

Joseph Antos, a health policy expert at the American Enterprise Institute, said, "If Obama's plan were to leave 15 million people without insurance, I think Sen. Clinton's plan would certainly do the same, not because of a mandate but because of the fundamental problems of getting people to recognize that they should buy insurance and making them buy it."

According to Austan Goolsbee, an economics professor at the University of Chicago and an Obama adviser, Clinton should acknowledge that her proposal would leave as many residents without health insurance as the Obama plan, in part because she "has not suggested a penalty" to enforce her mandate. He said, "If there's no penalty for skipping out on insurance, people will skip out on it" (Seelye, New York Times, 12/5).

The Wall Street Journal on Wednesday examined which of the health care proposals from the major Democratic candidates would "do more to provide health coverage for the uninsured." According to the Journal, Clinton and Obama "have been engaged in a bitter back-and-forth over whose health care plan covers more people," and former Sen. John Edwards (D-N.C.) has said that "his plan is the best of all."

Clinton, whose proposal would require all residents to obtain health insurance, has said that Obama, whose plan would require coverage only for children, would leave 15 million residents without coverage, a claim confirmed by outside experts, according to the Journal.
The Edwards proposal also would require all residents to obtain health insurance.

According to the Journal, the Obama campaign acknowledges that his proposal would leave some residents without health insurance but also claims that "Clinton's plan would also leave millions without coverage" because she will have to waive the mandate for about 10 million residents who cannot afford to purchase coverage. Goolsbee argues that the Clinton proposal includes inadequate funds to make health insurance affordable for all residents.

However, Ken Thorpe, a professor at Emory University who has advised all three major Democratic candidates, said that estimates made at the request of the Clinton campaign indicate her proposal would make health insurance affordable for all residents (Meckler, Wall Street Journal, 12/5).

Two recent polls examined health care issues in the presidential election. Summaries appear below.

• USA Today/Gallup: Domestic and economic issues, such as health care, are more of a concern for voters in the presidential election than the war in Iraq, terrorism and foreign policy, according to a recent USA Today/Gallup poll, USA Today reports (Page/Risser, USA Today, 12/5). According to the poll, 22% of Democratic voters surveyed cited health care as their most important concern, compared with 46% who cited the war in Iraq and 15% who cited the economy. Seven percent of Republican voters cited health care as their most important concern, compared with 29% who cited the war in Iraq and 13% who cited the economy, the poll found. The poll also found that 14% of independent voters cited health care as their most important concern, compared with 34% who cited the war in Iraq and 19% who cited the economy (USA Today graphic, 12/5).
• Washington Post/ABC News: Republicans likely to vote in the New Hampshire primary trust former Massachusetts Gov. Mitt Romney (R) to address health care more than they trust all other Republican candidates, according to a recent Washington Post/ABC News poll, the Post reports (Cohen/Balz, Washington Post, 12/5). According to the poll, 37% of respondents trust Romney most to address health care, compared with 13% who trust former New York City Mayor Rudy Giuliani most and 11% who trust Sen. John McCain (Ariz.) most (Washington Post graphic, 12/5). The poll is available online.

The three major Democratic presidential candidates have proposed "extensive health care plans that are heavy on dessert and light on spinach" and "make few tough choices on containing Medicare's exploding costs, such as higher copayments or more means testing," according to a USA Today editorial.

According to the editorial, Democratic candidates have attributed the "fiscal difficulties the nation faces" to President Bush, but, as "deserving of criticism as Bush's fiscal policies are, he did not invent the baby boomers or tell them to retire now," establish the "current mess of a health care system" or "cause people to live longer."

This lack of willingness among Democratic candidates to discuss issues of financial responsibility is "a serious problem because the next president will have to prepare the nation for some difficult choices and reach out to the other party if anything is to get done," the editorial states (USA Today, 12/5).