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News of the Day ... In Perspective6/14/2007
U.S. presidential candidates propose universal health insurance
Presidential hopeful Barack Obama says that �universal health coverage� has been debated for decades, and �the time had finally come to act� (Ireland Online 5/29/07).
His proposal would require every American to carry health insurance, and a National Health Insurance Exchange would monitor insurance companies. The plan �injects additional money to pay for the expanded coverage,� while claiming to save the average American �1,800 per year [about $2,500].
He plans to reduce waste and inefficiency by spending $10 billion on health information technology (IT) over 5 years.
Obama was the third Democratic presidential hopeful to propose sweeping reform. Sen. Hillary Clinton�s plan, released a week earlier, would spend even more, $3 billion per year, on IT. Sen. John Edwards introduced a plan in early February.
As summarized in the headlines, �shift in public attitudes since �94 Clinton fiasco� explains �why health care no longer makes politicians leery� (Jackie Calmes, Wall St J 5/30/07).
Medical expenditures have continued to rise �since the failure of the Clinton health-care plan in 1994,� Calmes points out, from $3,469 to $7,498 per person, and from 13.7% to 16.2% of GDP. During this period, Congress has engaged in �incrementalism� rather than �sweeping reform.� Still, no one, not even Clinton, is talking about �an overhaul as ambitious as the 1993-94 Clinton plan.� And Sen. Clinton �will seek consensus before moving ahead.�
The insurance industry is thought to be in the mood to try to shape the proposal, instead of opposing it with �Harry and Louise� ads.
The Edwards and the Clinton camps say that Obama�s proposal won�t achieve universal coverage because it has only an employer, not an individual mandate to buy insurance. Obama claims that his insurance watchdogs would set rules and standards to make coverage �affordable and accessible.� If it didn�t result in coverage so attractive that everyone would buy it, he�d revisit the issue. Meanwhile, Obama claims that the Edwards plan wouldn�t achieve universal coverage because individuals wouldn�t be mandated to have coverage until it becomes affordable.
�Many Americans�especially the healthy and young�won�t buy policies unless required to do so, thereby keeping premiums and costs higher,� writes Calmes.
Financing for expanded coverage, according to the article by Calmes, would come from healthy young persons who now forgo insurance because they don�t think it�s worth the cost; from the �wealthiest,� who would lose the �Bush tax cuts�; and apparently from the healthy not-so-rich as a consequence of �sliding scale� premiums based on income rather than risk. Other �losers� include insurers and drug makers.
Theoretical (but never proved) savings would come from spending more on �preventive� measures as well as IT.
Obama blasted the pharmaceutical and insurance industries for �profiteering and killing all past attempts at change,� Calmes writes. She says Obama will allow them a seat at the table, but �they don�t get to buy every chair.�
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