Commonwealth Fund report examines health care proposals of major Presidential candidates

The health care proposal of Democratic presidential nominee Sen. Barack Obama (Ill.) is more likely to improve health care affordability, accessibility, efficiency and quality than the plan of Republican presidential nominee Sen. John McCain (Ariz.), according to a report released on Thursday by the Commonwealth Fund, Reuters/Boston Globe reports.

The report discusses recent estimates from the Tax Policy Center that found the Obama proposal would reduce the number of uninsured by 33.9 million in 10 years, relative to a projected 67 million U.S. residents who will lack by 2018 coverage (Steenhuysen, Reuters/Boston Globe, 10/2). In the first year, the proposal would lower the number of uninsured by 18.4 million at a cost of $86 billion, according to the Tax Policy Center figures. They estimated that the proposal would cost $1.6 trillion over 10 years (Stanchak, CQ HealthBeat, 10/2).

The Tax Policy Center found that the McCain proposal would reduce the number of uninsured by two million in 10 years. In the first year, the proposal would lower the number of uninsured by 1.3 million at a cost of $185 billion, according to the estimates. The McCain proposal is projected to cost $1.3 trillion over 10 years.

Comments

Karen Davis, president of the Commonwealth Fund, said that the Obama proposal "tries to deal in a serious way with the uninsured." She added, "That is clearly a top priority. He doesn't eliminate it, but in my view he cuts it in half over a 10-year period" (Reuters/Boston Globe, 10/2). In addition, Davis said, "It's not a fundamental change from where we are, but it would make significant repairs to places in the system which don't work well for people, which is really the individual insurance market" (CQ HealthBeat, 10/2). She added, "I think Senator McCain's plan is more concerned with health care costs and doing something about that through a market solution. It's basically saying let's have people buy their own insurance" (Reuters/Boston Globe, 10/2).

Neera Tanden, domestic policy director to Obama, said that the Tax Policy Center estimates used in the report make a "number of assumptions that we can't agree with, in regard to cost and coverage." McCain Policy Director Douglas Holtz-Eakin said of the report, "This report is hardly the work of a neutral third party providing the American public a fair and unbiased assessment of the candidates' health care visions" (CQ HealthBeat, 10/2).

The report is available online.

Advisers To Obama, McCain Discuss Health Care Proposals

Advisers to Obama and McCain on Wednesday discussed the health care proposals of the candidates during a forum at the University of Virginia, the Charlottesville Daily Progress reports.

Irwin Redlener, a health care adviser to Obama and a clinical professor at Columbia University, said, "Sen. Obama believes that every person in the United States should have access to health care" but should not have to participate in a government program. He added, "The basic mechanics of John McCain's plan does not match the rhetoric of his vision."

William Winkenwerder, a health care adviser to McCain and a former assistant secretary of defense for health affairs, said that the Obama proposal would overburden taxpayers and businesses. He added that "Sen. Obama's plan would put us at the doorstep of a single-payer health care system," which he said the public does not support. In addition, Winkenwerder said that the McCain proposal "would absolutely help people become covered" and would "expand coverage for 20 to 25 million more Americans."

Both advisers said that their candidates consider health care a priority, but Winkenwerder expressed doubt that the next president would have the ability to implement a broad proposal to address the issue in his first year (McNeill, Charlottesville Daily Progress, 10/1).

Palin on Health Care

The vice presidential debate between Democratic vice presidential nominee Sen. Joseph Biden (Del.) and Republican vice presidential nominee Alaska Gov. Sarah Palin might offer voters their first opportunity to hear her views on health care and other issues, as, "by and large, oil and gas issues have dominated her tenure," the New York Times reports.

During her 22 months as governor, Palin proposed to eliminate a requirement that new health care facilities receive a "certificate of need" from the state before they open. According to Palin, the requirement has reduced competition and has contributed to increased health care costs. Palin in an opinion piece published in the Anchorage Daily News in February wrote that the elimination of the requirement, "with certain exceptions, will allow free-market competition and reduce onerous government regulation."

The Times also examined her views on other issues, such as embryonic stem cell research, which Palin opposes (Yardley, New York Times, 10/2).

Elizabeth Edwards Criticizes McCain Health Care Proposal

The McCain health care proposal is "truly dangerous to our health care system," Elizabeth Edwards, the wife of former Democratic presidential candidate and former Sen. John Edwards (N.C.), said on Wednesday during a roundtable discussion at Piedmont Health Services Carrboro Community Health Center, the Raleigh News & Observer reports. According to Elizabeth Edwards, who has incurable breast cancer, private health insurance for her family would cost $24,000 annually under the proposal.

During the discussion, Jonathan Oberlander, associate professor of social medicine and health policy and administration at the University of North Carolina-Chapel Hill, said, "She is a walking example for the problems of the McCain plan." Individuals with pre-existing medical conditions who currently have employer-sponsored health insurance would pay much more for coverage on the individual market in the event that their employers dropped their coverage under the proposal, Oberlander said (Johnston Sadgrove, Raleigh News & Observer, 10/2).

Editorials, Opinion Pieces

Summaries of two recent editorials and an opinion piece that addressed health care issues in the presidential election appear below.

• Concord Monitor: The "long-term strength of the nation's economy can't be separated from the drain caused by the cost, inefficiency and unfairness of what passes for America's health care system," a Monitor editorial states. According to the editorial, the Obama health care proposal has some problems but "would likely do more good than harm," but the McCain plan "would blow up the current system and ensure that fewer Americans are covered." The McCain proposal includes a number of proposals to reduce health care costs, but "none would offset the enormous damage his on-your-own, in a wide-open market approach would do," the editorial states. The editorial states, "McCain is willing to destroy the existing health care system, which bad as it is, does provide excellent, albeit costly, care for almost all who have employer-based insurance" and "would throw consumers on the mercy of a marketplace that he believes will fight for their business by offering high quality at lower prices and make health care more affordable." The editorial concludes, "That's a plan that only a maverick who's strayed off the range and into a swamp would take" (Concord Monitor, 10/2).
• Port Huron Times Herald: Voters "need to pin ... down" Obama and McCain "on one key question: What are they going to do about health care?" according to a Times Herald editorial. "Both candidates have health care platforms" and "quick-and-easy answers to the questions that arise," the editorial states, adding, "The reality, however, is this: We are miles away from dealing with health care in our country ... and it may be the most critical issue we face." Obama and McCain have offered "little specificity" about their proposals and "not much indication of how to pay for the plans," the editorial states, adding, "Where is either McCain or Obama going to find the money to do anything substantial with health care? But find it they must." The editorial states, "A strong argument can be made that the problems of the economy will not be solved until we solve the problems of health care," adding, "Obama and McCain need to provide some real answers in the next couple of weeks" (Port Huron Times Herald, 10/2).
• Robert Goldberg, New York Post: The Palin "record on health care reform is far more impressive than Barack Obama's," Goldberg, vice president of the Center for Medicine in the Public Interest, writes in a Post opinion piece. As governor of Alaska, Palin has "put the state health agency on a performance-based footing"; "taken on the hospital industry by trying to eliminate" the requirement that new health care facilities receive a "certificate of need" before they open; "launched 'telemedicine' initiatives to provide care to the state's most remote areas and co-sponsored a Web-based electronic medical record system with a private foundation"; and "proposed health savings accounts ... to make health care even more affordable," Goldberg writes. Meanwhile, "Obama claims that, as a state senator, he provided health care for 154,000 more people in Illinois by extending coverage under" KidCare, the state version of SCHIP, although "nothing like that number actually enrolled or found doctors," according to Goldberg. He concludes that the "care promised by the Obama-Biden ticket will endanger the lives of children everywhere" (Goldberg, New York Post, 10/2).