[CONTEST NOTE: Yesterday, we held a contest to select someone to receive a copy of Olive Riley's DVD, All About Olive. And the winner is - Darlene Costner. Darlene does not keep a blog, but she comments frequently and is a long-time member of the TGB community. Email me your snailmail address, Darlene, and I will send on the DVD - and congratulations for being number 15.]
A minor campaign shoe dropped this week when Senator Hillary Clinton, after months of dragging her heels behind most of the other presidential candidates, announced her proposed healthcare plan if she is elected president. (Don’t you love how all the candidates keep saying “when I’m elected” when they have not yet secured the nominations?)
Of the other seven major Democratic candidates, all but Mike Gravel had already issued their healthcare proposals, sketchy as they all are - including Senator Clinton’s. Among the Republicans, two – Rudy Giuliani and Duncan Hunter - either have not announced healthcare plans or do not have one.
As you read through these lists and weigh this critical issue in deciding whom to support, be sure to ask yourself this question: when was the last time an elected official kept a campaign promise? Remember the 2006 mid-term election...
Be that as it may, we have nothing to go on except their talking points and pandering, so we must do the best we can with what little they give us. The Democratic candidates have dutifully picked up the two think tank and media watchwords in regard to healthcare reform: “universal coverage” and “the system in broken.” With all this in mind, let’s take a look first at the Democratic candidate’s proposals starting with Senator Clinton:
[Where possible, all names link to the candidate’s healthcare issue webpage.]
- Requires all Americans to have health insurance (like auto insurance)
- Choice of coverage among private, employer-provided, a new public plan and an expanded version of the federal employees plan
- Tax subsidies for small businesses and individuals
- Bans insurance companies from turning down people for health or pre-existing conditions
- Would require no new federal bureaucracy (huh?)
- Estimated cost: $110 billion per year
- Would end tax cuts for people who earn more than $250,000 per year
- Combination of existing employer-based system and new government program
- Limits on profits of biggest insurance providers
- Would not renew President Bush’s tax cuts for those earning more than $250,000 per year when they expire in 2010
- Require employers to provide coverage or pay government a percentage of their payroll
- Small business would be exempt
- Require all children to be covered providing subsidies to parents who cannot afford it
- Create heath insurance exchange as a regulated marketplace of competing private health plans
- Require employers to provide health coverage or pay six percent of payroll for government to provide insurance
- Invest in more preventive care
- Create a federal health insurance agency that would eventually do away with private health insurance
- Provide subsidies or tax credits for low-income families
- Expand Medicare and the federal healthcare program for children
- Create regional healthcare markets to drive down premiums
- Would add $120 billion a year to cost of healthcare in U.S.
- Eliminate tax cuts for families earning more than $200,000 per year
- Universal, single-payer, not-for-profit healthcare system - essentially Medicare for everyone
- Plan already exists in the Kucinich-Conyers bill – HR676
- Covers all healthcare needs including prescription drugs, vision and long-term care
- Quotes economist Paul Krugman as saying, "covering everyone under Medicare would actually be significantly cheaper than our current system."
- Promises to develop a comprehensive plan to insure all Americans within six months of taking office
- Require insurers participating in federal programs to provide preventive care
- Invest $1 billion per year to switch to electronic health records
- Allow federal government to negotiate prices with pharmaceutical companies for Medicare Part D
- Expand Medicaid to cover low-income families and childless adults
- Allow all families to buy into SCHIP with a sliding scale of payments
- Establish federal reinsurance pool to reimburse employers and insurers for 75 percent of catastrophic coverage
- Promises that all Americans will have quality, affordable coverage during first term
- Responsibility for coverage shared by employers, individuals, insurance companies and the government
- According to their ability to pay, individuals and businesses will contribute to a Universal HealthMart based on the Federal Employees Health Benefits Plan.
- Premiums will be affordable based on leveraged negotiating power, spreading risk, reduced administrative costs, and incentives for technology and preventive care.
- Coverage will be portable; insurance purchased in Universal HealthMart will follow individuals.
- Americans will have personal responsibility to obtain healthcare coverage
- Tax credits available to those who cannot afford coverage
- Relief from high interest charges when medical debt is placed on credit cards
- Streamline healthcare administration
- Invest in prevention
- Promote transparency on price and quality
- Restructuring incentives for high-quality care
- Improve patient safety
- Reduce health disparities
- No increas in taxes
According to his website, no healthcare plan.
The watchword of Republican candidates is “no socialized medicine”. Does that McCarthy Era word, "socialized,” really scare off anyone these days? Apparently the Republicans think so. Several Republicans echo the Democrats in declaring that our current healthcare system is broken, but their solution appears to be to leave everything as it is; the marketplace solves all problems. And we all know how well that is working right now. But that's just my opinion.
- Require everyone to purchase healthcare coverage as in his current Massachusetts plan
- No federal coverage; leave it to individual states
- Make healthcare a market-driven entity
- Increase consumer choice, consumer control and competition
- Allow consumers to choose from plans that are tailored to fit their family needs and values
- Allow individual to purchase coverage across state lines
- Give consumers control over their personal healthcare records
According to his campaign website, no healthcare plan.
- Move from employer-based system to consumer-based
- Encourage the private sector to seek innovative ways to bring down costs and improve the free market for health care services
- Adopt electronic record-keeping
- Reform medical liability
- Make health coverage portable from one job to another
- Expand health savings accounts
- Make healthcare premiums for individuals deductible on income tax returns
- Tax credits, not income tax deductions for low-income families
According to his campaign website, no healthcare plan.
Based on these lists of particulars – if all else were equal which, of course, it is not – there is only one choice for me. What about you?
[At The Elder Storytelling Place today, kenju writes about the disappearance of small town America in Downtown is Gone Forever.]