Printable Version

Health Care Reform: A Candidate's Perspective

(Nancy Weber) -- Access to health care has become a hot topic for conversation in the public policy arena. Recently, Congress failed to override President's Bush's' veto of its attempt to expand the State Child Health Insurance Program (SCHIP). All the presidential candidates are coming forth with health reform proposals. And right here in Howard County our community is launching an initiative to provide more access to health care for residents who do not have health insurance.

The disagreement over SCHIP centers on the amount of program expansion that should occur over the coming years.  The Democratically controlled Congress seeks to add $35 billion to the five year authorization for SCHIP while President Bush wants to limit the increase to $5 billion. A compromise must be reached soon in order to avoid jeopardizing the program.

Meanwhile, presidential candidates are developing their own health care policy platforms.  All the major candidates support expanded access to health insurance and health care, but they differ on how expanded access will be structured and financed.
 
Among Democrats, Hillary Clinton, Barack Obama and John Edwards have stated their plans for health care.  Senator Clinton proposes a seven step strategy for reducing health care costs that includes: a national prevention initiative, a “paperless” health information technology system, transformation of care for the chronically ill, ending insurance discrimination, establishing an independent “Best Practices” Institute, smart purchasing initiatives, and malpractice reforms.  Senator Clinton has provided no specific information on the cost of her program.

Senator Obama's policy calls for a modernization of the U.S health care system to contain health care costs.  The proposal includes offering federal reinsurance to some employers for unexpected or catastrophic illnesses, ensuring that patients receive quality care, adopting health information technology, and increasing market competition. Senator Obama would develop partnerships with state governments and businesses and provide federal health insurance to those who cannot afford other insurance.   His plan would cost between $50 – 65 billion. It would be financed at least partially by not renewing the tax cuts on dividends and capital gains and for individuals with annual incomes of more than $250,000, scheduled to expire in 2010.

John Edwards projects the cost of his health program at $90 – 120 billion.  He proposes a new tax credit to subsidize insurance purchased through health markets that will be available on a sliding scale for middle and lower income families and refundable for families without income tax liability.  He would also repeal President Bush's tax cuts for people with annual incomes greater than $200,000.

On the Republican side, the three leading candidates, Rudy Giuliani, John McCain and Mitt Romney seek to improve access through incentives to encourage individuals to purchase their own health insurance and to find ways to reduce health care costs.  To date, the three Republicans have not identified the actual cost of their proposals.

Rudy Giuliani proposes individual tax incentives to encourage anyone who does not receive health insurance coverage through an employer to purchase health insurance individually.  He is proposing a $15,000 family/$7,500 individual standard deduction.  He would also provide additional subsidies to help low income people buy health insurance.

Senator McCain believes that rising health care costs are making health insurance so expensive that hardly anyone, including employers and government can afford it.  He proposes allowing people to buy health insurance nationwide instead of limiting them to in-state companies to increase competition and reduce costs.  He would also streamline insurance paperwork by creating a national health insurance policy form that all insurers would use.

Based on his health reform experience as Massachusetts Governor, Mitt Romney plans to attack the tax code's discrimination against cost-effective private insurance. He proposes to allow individuals to deduct out-of-pocket health care expenditures from their taxable income and to permit those who purchase health insurance premiums on their own — rather than through their employer — to deduct health insurance premiums. He would also expand Health Savings Accounts (HSAs) by eliminating the requirement that a qualifying health plan contain a high deductible. 

Regardless of your political affiliation, health care reform is likely to be a deciding factor in the 2008 election.