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A Healthy Debate

Our healthcare system is broken. Here's how some candidates say they'll fix it.

By Fred Minnick

Wednesday, September 26, 2007

Recently Michael Moore—whose documentary SiCKO charges insurance companies, pharmaceuticals and politicians with accepting millions of dollars to do health-related companies' bidding—posted a challenge on his blog: "I am calling on each presidential candidate to pledge to refuse their free government healthcare until every person in this country also has it."

As of press time, no candidate had taken Moore's challenge. But healthcare is at the forefront of voters' minds, and they overwhelmingly trust Democrats over Republicans on healthcare, according to a Harris Interactive/Wall Street Journal poll. Here's a closer look at the candidates' healthcare policies.

Democrats
New York Sen. Hillary Rodham Clinton says her plan for universal healthcare will reduce costs and improve quality. She says it lowers national health spending by at least $120 billion by focusing on prevention, electronic medical records and managing chronic illnesses. One of her many ideas: Use chronic care coordination models within federally funded programs, such as Medicare and the Federal Employees Health Benefits Program (FEHBP), to provide care for Americans with costly and difficult-to-manage illnesses.

Former N.C. Sen. John Edwards hopes to provide universal healthcare and has developed a plan that he says will allow families without insurance to get affordable coverage. Families with insurance will pay less with more security and choices, and some employers will find it cheaper and easier to insure their workers. His plan requires businesses and other employers to cover their employees or help finance their health insurance. He'll also create new tax credits, expanding Medicaid and the State Children's Health Insurance Program (SCHIP).

Illinois Sen. Barack Obama says his plan provides affordable, comprehensive and portable health coverage by allowing individuals and small businesses to buy healthcare similar to that available to federal employees. Obama wants to make available a National Health Insurance Exchange to reform the private insurance market. Some employers will have to contribute a percentage of payroll toward the cost of the national plan. In addition, Obama says his plan lowers drug costs by allowing the importation of safe medicines from other developed countries.

Republicans
Former New York City Mayor Rudy Giuliani says healthcare is already too government- and employer-dominated. He wants to move Americans away from employer-sponsored health insurance to private coverage. In the second debate, Giuliani said he'd give families a $15,000 tax credit to buy private insurance policies. He believes health coverage should become like car insurance, covering only the "big stuff" and not the checkups.

Arizona Sen. John McCain has said government-run systems such as those in Canada and Europe will not work in the United States. He's mentioned expanding community health centers and SCHIP, offering tax incentives for poor people, putting healthcare online and promoting health savings accounts. McCain also believes that medical malpractice is a major factor hurting the healthcare system. And he's said he is not interested in raising taxes for more healthcare.

Former Mass. Gov. Mitt Romney wants to help the uninsured receive health insurance. His plan takes federal money normally used to reimburse hospitals for treating the uninsured and use it to help low-income people buy insurance at a lower cost. His proposal also includes a state-based system that allows governors to tailor their approach for specific populations.

Former Tenn. Sen. Fred Thompson opposes universal healthcare, saying "experiments in bureaucratic medicine are coming apart at the seams" in Europe and Canada. In 2002, he voted against the reimportation of prescription drugs from Canada; in 2001, he voted against allowing patients to sue HMOs and collect punitive damages. As of press time, he had not stated a healthcare plan.

Which candidate has the best healthcare plan? Take our poll at eldr.com/candidates.

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