Candidate Review - Health Care - Fred Thompson

I think this is my final one of the day. Fred Thompson's plan is pretty homespun - he wants everybody to have healthcare, but doesn't really want to ponder the question of what to do about those who can't currently afford it.

Americans have the best healthcare in the world. Some, however, choose not be insured; others cannot afford it. Every American should be able to get health insurance coverage that is affordable, fully accessible, and portable. Coverage should meet their individual needs and put them in control. Those who propose a one-size-fits-all Washington-controlled program ignore the cost, inefficiency, and inadequate care that such a system offers. Access to affordable, portable health care can be made available for all Americans without imposing new mandates or raising taxes. Current government programs must also be streamlined and improved so that those who truly need help can get the health care they need.

I like the reference to those who choose not to be insured - makes this a personal responsibility issue; those who choose not to be insured are obviously irresponsible. Of course you wouldn't want to force people who choose not to be insured to get insured; let those bums take care of themselves.

Or so the logic goes, I gather.

Anyway while Thompson seems aware that some people who want health care can't afford it, it doesn't seem like he's spending a lot of time worrying about them. And of course he's all about streamlining the government programs. Which usually involves making them smaller and weaker.

Candidate Review - Health Care - Wayne Wilson

I was kind of down after my review of McCain's health plan, but here comes Wayne Wilson to pick me right up.

. . . well-to-do liberals are indignant that ordinary folks like you and me can walk into any doctor’s office or hospital and receive the finest health care in the world. That’s a privilege that they think only they and their rich buddies deserve. That’s why when conservatives point out the waiting lists and inefficiencies of other state-run health care systems, the elitists know it, but don’t care. They want it that way. They want the quality and efficiency to go down so that ordinary citizens are denied or delayed service.

Yeap Wayne Wilson saw through our brilliant plan to keep ordinary Americans from having health care by giving them access to health care. We are so diabolical. Also of course we want to take more money away from you and we want social engineering. According to Wayne Wilson.

I will note that other than opposing Liberals evil plans, Wilson has no plans to address American Health Care. With it being the finest in the world, I guess I can see why. Funny how so many others seem to think it's an issue worth addressing, including all the Republicans. But oh well, I'm sure Wilson knows best.

Oh we'd like to thank Captain Oblivious for pointing out that "The FDA IS the Medical and Pharmaceutical industry, moron." down below. I'm not sure that's accurate - I thought there were these things called insurance companies and doctors and hospitals and what not, but possibly I've been misinformed.

Candidate Review - Health Care - John McCain

Well McCain's health plan is pretty daunting. It is a list of bullet points. 19 Bullet Points then a paragraph (on Insurance Company Reform) then 5 Bullet Points, then a paragraph (on Personal Responsibility) then 3 more Bullet Points. For those playing along at home, that's 27 bullet points.

Lord Almighty.

Anyway I will note some highlights. Using Bullet Points. One turn deserves another.

• McCain is in favor of allowing Vets better access to local health care. "America's veterans have fought for our freedom. We should give them freedom to choose to carry their VA dollars to a provider that gives them the timely care at high quality and in the best location."
• He does favor providing Access to Health Care for all. "While we reform the system and maintain quality, we can and must provide access to health care for all our citizens - whether temporarily or chronically uninsured, whether living in rural areas with limited services, or whether residing in inner cities where access to physicians is often limited." I suspect the phrase "Access to" to be key. Many people have Access to health care right now who can't avail themselves of that access do to lack of money.
• He also specifically favors moving away from employer sponsored health plans. "Reform the tax code to eliminate the bias toward employer-sponsored health insurance, and provide all individuals with a $2,500 tax credit ($5,000 for families) to increase incentives for insurance coverage. Individuals owning innovative multi-year policies that cost less than the full credit can deposit remainder in expanded health savings accounts."
• Like others he does treat it primarily as a consumer issue; the American medical consumer isn't being served as well as he or she should be. Of course this leaves out those who aren't being served at all.
  

Bullet points are annoying.

Candidate Review - Health Care - Rudy Giuliani

Well Giuliani isn't going to be accused of being a Socialist either. It is interesting how many Conservatives treat the inaccessibility of medical care to sick people as if it were a simple consumer problem, almost on the level of an inconvenience.

"America is at a crossroads when it comes to our health care. All Americans want to increase the quality, affordability and portability of health care. Most Republicans believe in free-market solutions to the challenges we face. I believe we can reduce costs and improve the quality of care by increasing competition. We can do it through tax cuts, not tax hikes. We can do it by empowering patients and their doctors, not government bureaucrats. That's the American way to reform health care."

A lot of Americans want access to health care, not just increases in quality and portability. And a lot of Americans aren't comfortable with the idea that life saving medical procedures are the province of a chosen few.

But that's the problem that Republicans have with this issue; they are fundamentally in favor of the system we currently have, although perhaps with even less government involvement (Giuliani mentions reforming the FDA for example).

He mentioned Tort Reform, which Tancredo mentioned as well, but which hasn't been a big stand out. Which I have to admit I find a little surprising. Tort Reform has been a big republican issue for years, I'm surprised they aren't hitting it harder.

Candidate Review - Health Care - Tom Tancredo

For Tom Tancredo the chance to comment on Health Care leads naturally to a discussion of Illegal Immigration. As do all other issues.

The two major problems are the high cost of care and the number of uninsured. Tort reform and immigration enforcement would save the system billions and drive down costs. In California alone, illegal immigrants cost the system $800 million annually and have forced 84 hospitals to close.

I find myself imagining Tancredo being asked "Representative Tancredo, what is your favorite parade?" "Well I'll tell you one parade I don't like. The Parade of Illegals across our border!" At any rate he has some other ideas as well, but you don't have to worry about socialized medicine with Tancredo.

As for the uninsured: as many as 25% of them are illegal aliens and should be deported or encouraged to leave. For citizens and legal residents who are employed by businesses which cannot afford coverage, I favor association health plans which band small businesses together to access lower cost insurance. For those out of work, state governments should be the primary source of relief, although I would not rule out federal incentives or limited subsidies to make sure families who have fallen on hard times are not without coverage.

Does that mean he thinks Association Health Plans are simply a good idea? Or does it mean that he favors using his office as President to encourage and support them in some fashion? Hard to say.

Candidate Review - Health Care - Mike Huckabee

Well Mike Huckabee strides the line very skillfully; he is, I have to say, quite a skillful politician. He says that Government doesn't need to mandate health, but that does need to encourage preventative medicine.

The health care system in this country is irrevocably broken, in part because it is only a "health care" system, not a "health" system. We don't need universal health care mandated by federal edict or funded through ever-higher taxes. We do need to get serious about preventive health care instead of chasing more and more dollars to treat chronic disease, which currently gobbles up 80% of our health care costs, and yet is often avoidable. The result is that we'll be able to deliver better care where and when it's needed.

I advocate policies that will encourage the private sector to seek innovative ways to bring down costs and improve the free market for health care services. We have to change a system that happily pays $30,000 for a diabetic to have his foot amputated, but won't pay for the shoes that would save his foot.

I'm not sure exactly how he's going to accomplish this; Insurance companies won't pay for anything not covered; they have an incentive to turn down services. I don't know how you change that through logic.

I also don't know how this helps people who don't currently have insurance. But then again, maybe it's not supposed to.

Candidate Review - Health Care - Ron Paul

There are too many Republican Candidates. Oh well. Here's Ron Paul who is busy protecting the Medical and Pharmacutical industry from the FDA.

Americans are justifiably concerned over the government’s escalating intervention into their freedom to choose what they eat and how they take care of their health.

The Food and Drug Administration (FDA), in order to comply with standards dictated by supra-national organizations such as the UN‘s World Food Code (CODEX), NAFTA, and CAFTA, has been assuming greater control over nutrients, vitamins and natural health care providers to restrict your right to choose the manner in which you manage your health and nutritional needs.

I have been the national leader in preserving Health Freedom.

If Ron Paul has an opinion on Uninsured Americans, I can't find it. And I'm not sure the FDA is the bogey man that Ron Paul portrays it as.

Candidate Review - Health Care - Mitt Romney

Romney likes to have you watch him speak rather than read his words. I don't have time to listen and transcribe and frankly I'm not interested in doing that anyway. So you have to put up with what little text he has on his website, which is a brief statement and two quotes.

The health of our nation can be improved by extending health insurance to all Americans, not through a government program or new taxes, but through market reforms.

"We can't have as a nation 40 million people -- or, in my state, half a million -- saying, 'I don't have insurance, and if I get sick, I want someone else to pay."

The quote is from a USA Today story, and I'm not sure how flattering it is. Certainly a section of the Republican base wants to hear "Sick people who don't have health insurance get what they deserve." But I don't know how that will fly in America as a whole. The other quote isn't much better.

"It's a conservative idea," says Romney, "insisting that individuals have responsibility for their own health care. I think it appeals to people on both sides of the aisle: insurance for everyone without a tax increase."

Again from USA Today. But of course what is lacking (and I've not reproduced the entire page) is any suggestion of how people who aren't insured now are going to get insured. Is Romney just going to take the presidential podium, look America in the eye and say "You uninsured people - get insured. Thank you and goodnight." Or what?

In other Romney related news, there's a post by Glenn Greenwald on Romney's service as a Mormon Missionary during the Vietnam War - a war he supported but didn't feel much desire to participate in (he got a mission deferment and then an educational deferment).

Candidate Review - Health Care - Duncan Hunter

Well Duncan Hunters plan likewise steers well clear of socialism. Rather his plan is to give consumers more options.

Since World War II, when employer sponsored health care became a more widely offered employee benefit, spending has increased from 5% of GNP to 16% today. Systematically, the eye of the health care consumer has been removed from the market place. Whether it is employers offering a single insurance option or the government making health care choices on behalf of the elderly and the poor, consumers have been increasingly removed from the market place. The result has been a system with costs increasing at rates that are neither sustainable nor practical.

The solution is freedom for the consumer to pursue their own health care choices. Therefore, I propose three major reforms that will bring the consumer back into the health care equation: 1. freedom to buy health insurance across state lines; 2. freedom to make informed health care choices; and 3. freedom to innovate to save money and improve medical outcomes.

The problem with this plan is something Hunter notes in the first paragraph quoted. Most individual consumers don't make decisions on their health care. I am not tempted to go into Alabama to get my health care, because my health care decisions are made by the Human Resources director at the place I work at. And there is also a real question if, even if the government allowed me to buy health insurance in Alabama, would the insurance companies be interested in selling it here?

And his second plank falls on the same problem; there are some who buy individual insurance but a lot don't. His final plank calls for four test hospitals which will be free of government interference, apparently, and free to provide experimental treatments to those who qualify. Good enough as far as it goes, but not that exciting.

Candidate Review - Health Care - Dr. Alan Keyes

As I said Tuesday, the challenge for Democrats is to push for improved and, in most cases, universal health care WITHOUT appearing socialist. For Republicans the challenge is to defend the current system WITHOUT appearing unaware of the problems faced by Americans without Medical Insurance.

Well Keyes is a pretty hardline guy when it comes to the market, and his issue page makes it clear that there will be no socialism in the medical profession on his watch. That said, he also makes it clear that he is aware of the plight of the uninsured.

I don't believe in government-controlled health care, and I think that what we need to look at is ways in which we can put the consumer in proper charge of their own health care plan, so we can drive the cost down, instead of up.

Part of the problem with our present system, which I think has contributed to skyrocketing costs, is the fact that we have a third-party-payer system. You go home after you get the service, and you don't even know what it costs. If we bought cars that way, what do you think would happen to our car industry?

We need to adopt plans, such as the one that President Bush is talking about, where people can set up tax-deductible medical savings accounts and combine that with catastrophic insurance that will guarantee them against the major liability and at the same time give them greater freedom, greater control, and a greater reward when they are making good, effective judgments on how to get their health care.

This does sound hard on the Insurance industry, but really it is kind of a gift to the Financial industry. That said, I think that Keyes has accurately determined the problem in the industry, the lack of connection between costs and services. His solution, though, seems like more of a band-aid. If you can't afford medical insurance, how are tax deduct able accounts going to solve the problem?

Candidate Review - Health Care - John Edwards

John Edwards plan seems a bit short on details - I know just a while ago I was complaining about an excess of details, but what I can I say? I'm a fink!

Anyway what's here is good - Edwards wants universal coverage, he wants to make it better for people who already have insurance and businesses will have it easier too. And to accomplish these goals.

* Requiring businesses and other employers to either cover their employees or help finance their health insurance.
* Making insurance affordable by creating new tax credits, expanding Medicaid and SCHIP, reforming insurance laws, and taking innovative steps to contain health care costs.
* Creating regional "Health Care Markets" to let every American share the bargaining power to purchase an affordable, high-quality health plan, increase choices among insurance plans, and cut costs for businesses offering insurance.
* Once these steps have been taken, requiring all American residents to get insurance.

I guess it will be a bit like auto insurance, only more affordable? Or about the same? Will some people have the bare minimum coverage, while others will have good complete coverage? Hard to say.

Candidate Review - Health Care - Dennis Kucinich

Well Kucinich avoids mentioning the Congressional Health Plan - he's got something better. Single payer.

America's patchwork of for-profit, private insurers waste billions of dollars on spending that has nothing to do with paying for care. Elaborate underwriting, billing, sales and marketing divert huge amounts of money away from delivering health care. Huge profits and staggering compensation for the insurance companies' top executives and CEO's.

To cope with the endless bureaucracy of private insurers, health care providers maintain huge administrative staffs. The administration of the health care system today consumes approximately 31% of the money spent for health care. The potential savings, as much as $350 billion per year, are enough to provide comprehensive coverage to every American without paying any more than we already do.

In Congress, Representative Dennis Kucinich has co-authored HR 676, legislation which would establish Medicare for All - a universal, single-payer, not-for-profit health care system that leaves no American behind.

Either Kucinich isn't ready for the Country or the Country isn't ready for Kucinich.

Probably the latter.

At any rate this is pretty clearly socialized medicine, and Kucinich isn't ashamed to make it clear what he's doing. You kind of have to admire him for that.

Candidate Review - Health Care - Bill Richardson

After the last two discourses, Richardson's health care page is much more manageable. He does mention the magic words.

Working families and small businesses will be able to purchase coverage through the same plan that members of Congress enjoy. Americans 55 and older will be able to purchase coverage through Medicare. Veterans will get access to the high-quality care they deserve, when they need it, without bureaucratic hassles.

I should think the idea of ordinary citizens getting the same health care as our senators must be a powerful one. Enough Democrats seem to be pushing it at any rate.

Anyway Richardson references his experience as a Governor on this issue a number of times, and talks about a "Heroe's Health Card" provided to all veterans so that they aren't trapped in the VA system.

Candidate Review - Health Care - Joe Biden

Joe Biden, like Obama, has a long and complex page on Health Care. This is why I am somewhat wary of this one, because I feel like a punk if I don't read the whole thing, but being incredibly lazy, I don't want to go to the trouble of reading it.

Don't laugh; it's laziness like that that has made Stupid Enough Unexplanation Americas 434th most trusted news source.

Anyway I just read his plan and he has four key components.

1. Cover all Children
2. Access for Adults
3. Reinsurance For Catastrophic Cases
4. Encouraging Prevention and Modernization

The first one is straightforward enough; the second is giving the uninsured the option to buy into the Senate system - which to give it's official name, is called the Federal Employee Health Benefit Plan. They can buy in on a sliding scale depending on their means.

The third reflects the problem of one member on an insurance plan developing a big problem - say Cancer. Obviously in a big company that might not be too big a deal, but in a small company that can be a big problem.

By creating a federal reinsurance system for catastrophic costs, the risk and burden of covering these patients are spread among the general population, instead of smaller subgroups of employees.

. . . Ken Thorpe, a professor at Emory University, has estimated that a stop-loss plan that pays 75 percent of claims above a catastrophic threshold would, on average, reduce the variance in claims costs by more than 50 percent. Reducing the risk factor for health plans would translate into lower health insurance premiums.

Make a certain amount of sense; but of course Free Market Conservatives would counter by saying that risk is part of the market place. You can't take out the risk without taking out the ability to succeed.

The fourth one contains a lot of interesting ideas as well, such as standardizing billing and claims.

When the Utah Health Information Network (UHIN) was created in 1994, health officials there estimated the state could save $100 million to $200 million per year by switching to a common system for medical billing. UHIN created a computer system that allows the many different billing systems used by doctors, insurers and hospitals to communicate with one another. But the network also required substantial cooperation from Utah's competing insurers. They agreed, for example, to cut a list of 900 codes for accepting or denying medical claims down to 90 and also agreed on common definitions.

The cost of health insurance has remained flat in Utah while it has increased an average of 13 percent per year in the rest of the United States. Several states are already studying what Utah was able to accomplish.

This reminds me a lot of Clinton and the West Wing - a bit of policy wonkery - but the good kind of policy wonkery - the kind that actually makes things better.

Candidate Review - Health Care - Barack Obama

Obama also uses those magic words; the Congressional Health Care plan. I should note that his health care plan is unusually complete even in it's initial presentation - many of the candidates have additional websites you can go to and read their policy; Obama has those too, but also a lot of information just on his page on health care. Some emphatsis on the problem of health care which is a good enough Idea i suppose. And then his plan. It has 6 planks.

1. Obama's Plan to Cover the Uninsured. Obama will create a new national health plan to allow individuals without access to affordable insurance coverage to buy coverage similar to that available to members of Congress. . . .

2. National Health Insurance Exchange. Obama will create a National Health Insurance Exchange to help individuals who wish to purchase private insurance. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible.

3. Employer Contribution. . . .

4. Mandatory Coverage of Children. . . .

5. Expansion of Medicaid and SCHIP. . . .

6. Flexibility for State Plans. Obama's plan allows states to continue innovating on health care reform.

And that doesn't count his plans to modernize our health care system. It's very comprehensive. I do think he does emphasize the choice and of course that its based on the Congressional Health Plan. On the other hand the completeness of this plan probably doesn't help it much. You look at a plan like this, and it becomes evident that Obama does want to change how Healthcare works.

Candidate Review - Health Care - Chris Dodd

Dodd says at the beginning of his section on health care, "There is no more important issue this election than getting health care right." I'm not sure I can go along with that. It is important, but I'd say getting foreign policy, particularly Iraq, might be more immediate and, therefore, more important.

At any rate his plan is the popular give to the people what Senators already have.

The Dodd plan will create a health insurance marketplace called Universal HealthMart that is based on, and parallel to, the Federal Employees Health Benefits Plan (FEHBP). Every American will have access to the same plans that members of Congress have. Alternatively, people and businesses can keep their existing insurance arrangements if they want to.

He then has this fascinating phrase.

Universal coverage will be achieved through a shared mandate on individuals and businesses: universal coverage through universal responsibility.

Republicans like the term responsibility so maybe that's what he is shooting for; but I'm not sure if Dodd and the Republicans are using it in the same way. I think Dodd means that Everybody is responsible for Everybody's Health Care; Republicans mean, I believe, that Everybody is responsible for their own health care.

At any rate this is a crowd pleasing plan and does walk the line pretty nicely, I think.

Candidate Review - Health Care - Mike Gravel

Mike Gravel proposes eliminating the Income Tax and replacing it with a national Sales tax. We'll get back to that in due course, but since he mentions it in his very very short section on National Health Care, I thought I would explain what he is talking about.

Senator Gravel advocates a universal healthcare system that provides equal medical services to all citizens, paid for by a retail sales tax (a portion of the Progressive Fair tax). Citizens would pay nothing for health benefits.

Sounds nice doesn't it? So Mike Gravel would eliminate the IRS and the Medical Insurance Industry at one fell swoop, eh? That's gonna be one hell of a sales tax, I'd guess.

Candidate Review - Health Care - Hillary Clinton

This is one of the bigger issues; but I figure I'm going to have to do the hard one's sooner or later.

What will be interesting is that both Demcorats and Republicans do have different selling points. Democrats are assumed to be doing something about health care, so they have to be careful to assure voters that their plans won't be intrusive and won't be overly socialized. Republicans (which we'll get to on Thursday) are assumed to be opposed to socialized medicine, so have to convince America that they actually do care about health care (except for those who say nuts to the whole thing).

Anyway Clinton, as you might expect, balances this line pretty well, and is careful to stress the non-socialistic side of her plan.

Hillary's American Health Choices Plan covers all Americans and improves health care by lowering costs and improving quality. It speaks to American values, American families, and American jobs.

It puts the consumer in the driver's seat by offering more choices and lowering costs. If you're one of the tens of million Americans without coverage or if you don't like the coverage you have, you will have a choice of plans to pick from and that coverage will be affordable. Of course, if you like the plan you have, you can keep it.

She stresses that her plan is no threat to successful health plans that you might currently have; of course if you feel like your company health plan is a crappy, you can switch over to hers. Or to put it another way, in the marketplace of health insurance, the Government will now be a player. Not sure how that would work.

In striving to head off socialistic accusations, she underlines that her plan will be good for small businesses (almost certainly true) and will allow freedom of choice (we'll see, but probably true). I don't know if that will be enough, but then I don't know who those reassurances are aimed at. If they are aimed at Conservative Idealogues, well, Clinton could propose, word for word, the same plan as Mike Huckabee and they would call her a socialist. On the other hand if it's aimed at Middle America, giving them just enough coverage to buy into the plan, well that could work. We'll see.