Monday, May 5, 2008

Health Care and the Campaign

Americans have been watching the current Presidential political race with more enthusiasm this time than in recent years. An historic battle of epic proportions has been going on in the Democratic party between two candidates that have serious potential to be the 44th President of the United States. Democrats will be choosing between the first woman and the first African-American candidate ever to win the nomination for this national office. This horse race may actually come down to the wire and need a photo finish to verify who will go up against the Republican candidate, John McCain. Although not officially nominated until the national convention, Senator McCain will likely be the clear winner as he is the only candidate to qualify with enough delegates. This foregone conclusion in the Republican party has allowed him to move ahead with a strategy that will help galvanize Republicans to win in November--or at least that's the common hope among the party faithful.

According to Market Watch, health care has figured prominently in the Democratic presidential candidates' domestic policy proposals, with Sen. Hillary Clinton and Sen. Barack Obama promoting similar visions for expanding health coverage and reducing wasteful spending in the current system. Both candidates call for greater insurance industry regulation to ensure that people with pre-existing conditions can get health coverage. The biggest difference between the two is that Clinton wants to compel individuals to buy coverage while Obama only wants mandated coverage for children. On the other side of the campaign aisle, John McCain, the presumed Republican nominee, released details of his health-care plan at the end of April, 2008. It would grant refundable tax credits to people who buy their own health coverage outside of the employer-sponsored system. His plan, according to Reuters, would use tax credits to help shift from employer-based insurance coverage to an open market system where people can choose from competing policies.

Likely, the candidates likely will shift their health-care focus as the campaign progresses as reported by the Kaiser Foundation on Market Watch. As we move to the general election where the candidates are no longer speaking to the base but in particular to independent voters. If all the candidates begin to understand the public is viewing health care as a pocketbook issue, health care will be increasingly framed as an economic issue. Also, there will be opportunity for elected officials, not just candidates, to view health care differently according to the Foundation.

Lawmakers may start to include health care more in their broader economic policies similar to climbing the high hill of health reform. The Kaiser Foundation also suggests that reaching an agreement on how best to overhaul the health-care system remains elusive. There exists a profound ideological divide in Washington in particular about how to reform health care, and it will not be easy to come up with the money to pay for reforming health care. Changes in the economy and the public's growing insecurity about health-care costs are laying the groundwork for nationwide reform.

As reported by Reuters, the sharply contrasting health care visions of Republican John McCain and his Democratic presidential rivals offer the promise of a grand campaign debate -- if the candidates find room on a crowded agenda. While health care reform ranks as the second-biggest domestic issue after the economy in most national opinion polls, it will compete with the Iraq war, taxes, high gas prices and other topics for a prime-time spot in the campaign for November's presidential election. Nearly two decades of health care debate has made little headway toward finding a consensus approach, and the issue has not been a key factor in a presidential election since the collapse of the Hillary Clinton-led reform effort in 1994.

Additionally, as reported in the Reuters article, at least some of the political fury that doomed Clinton's health care initiative in 1994, when she was first lady, was fueled by the reluctance of people to abandon their employer health coverage. The Commonwealth Fund, a private nonpartisan foundation that supports health policy research, found in a 2007 survey that four of every five Americans, including about 75% of Republicans, believed employers should either provide health insurance for workers or contribute to the cost.

Currently, Senators Clinton and Obama seek universal health coverage for the 47 million Americans without insurance. Clinton would mandate coverage, while Obama would require it only for children.The Democratic plans would keep the existing job-based insurance system but expand government involvement in a hybrid public-private system. McCain calls the Democratic plan a "big government" solution that limits choice. Democrats say his plan reduces the incentive for companies to offer coverage and puts workers at risk of not getting it -- particularly those with pre-existing conditions that insurance companies will not cover according to the Reuters news release this month.

Market Watch also indicates that health care is certainly front and center on the minds of most Americans. Because most working-age Americans receive health insurance through their jobs, their worries about the economy are often interwoven with their anxiety about getting and keeping coverage. For many, losing a job or having their hours cut means losing access to affordable health insurance. About 158 million people had employer-sponsored health insurance last year, but job-based coverage has been eroding as costs climb, according to the Kaiser Family Foundation. In 2007, 60% of employers offered health benefits to at least some of their workers, down from 69% of firms that offered it in 2000. Health-care costs have been rising much faster than wages and general inflation. Since 2001, insurance premiums for family coverage have ballooned 78%, while wages have risen 19% and inflation has gone up 17%, according to Kaiser's annual employer health benefits survey.

As we get closer to the respective party conventions this summer, the focus on health care will heat up. Americans are tired of costs going up on everything from the price of gasoline to the cost of a visit to the doctor's office. Now with pricing at an all time historical high point to fill up your tank, getting to the family doctor is more critical than ever before. Although universal health care is not a viable option for the nation's economy, the current slate of Presidential candidates will need to work with Congress for an affordable solution. Whomever occupies the Oval Office this time next year will have lots of work to do.

Until next time. Let me know what you think.

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