Wednesday, February 6, 2008
As the presidential race has become more competitive, media are starting to focus attention on specific issues that directly affect the American public. One of the more popular topics in presidential debates in the recent weeks has been health care. There is much need for reform in a severely broken system of inflated premiums and costly plans that doesn't even guarantee coverage to people with pre-existing conditions who can afford it. But the question is, with whom should that reform begin?
In September 2007, Democratic candidate Sen. Hillary Clinton unveiled a $110 billion "American Health Choices Plan," which allows Americans who are satisfied with their private insurers to keep their coverage, while requiring the 47 million Americans without insurance to seek out coverage. Her plan includes an affordable public plan similar to Medicaid and provides tax credits for working families to ensure that premiums do not exceed a certain percentage of that family's income. She seeks to compensate for some of the funding by ending the Bush tax cuts for those earning more than $250,000.
One major problem I see with Clinton's plan is that it calls for the federal government to mandate that all Americans have a health-insurance plan. Since Clinton revealed her plan, many critics have speculated about how she can enforce this facet of the plan. With more than 300 million people living in the United States, it seems impossible to insure every American citizen. It doesn't seem realistic. How does Clinton respond to the question of enforcement? She has no specific plan at the moment. "We will have an enforcement mechanism, whether it's (garnishing people's wages) or it's some other mechanism through the tax system or automatic enrollments," Clinton told ABC last week.
Sen. Barack Obama was the first Democratic candidate to release a heath-care plan, and while it takes liberties on behalf of the federal government, it is not as extreme as Clinton's. While Obama's plan does not require all Americans to have health insurance, it does stipulate that all children have it. He also plans to increase competition between private insurance providers with the formation of a watchdog group, the National Health Insurance Exchange. The Exchange would create regulations and standards, guaranteeing that consumers have access to quality, affordable insurance. The group would also compile information from companies and publish differences in cost and services.
Beyond the label of "watchdog group," Obama's plan does not include a term to describe what kind of "group" it will be. He does say, however, that it will exist to ensure competitive services and prices in the health insurance market and prevent monopolies from dominating.
Another notable facet of Obama's plan, which resists the urge to fall into a Democratic stereotype of focusing on social, domestic issues, is the states' right to keep current health-reform plans in place, as long as they meet minimal federal standards. This approach allows the federal government to have a say in the matter, without being heavy-handed in its approach.
One state that has taken the lead in health-care reform is Massachusetts, where Republican presidential candidate Mitt Romney passed legislation that would cover virtually every resident through a three-pronged approach which includes subsidies and other incentives for health care. To address the health-care problem on the national level, Romney proposes that the federal government deregulate insurance companies to increase the number of providers and increase competition among them. The move would be similar to the deregulation of media with the Telecommunications Act of 1996, which had the same motives.
"Help people buy their own private insurance," Romney said in an August 2007 Republican debate on ABC. "Get our citizens insured, not with a government takeover, not with new taxes needed, but instead with a free market-based system that gets all of our citizens in the system. No more free rides."
This plan would be one of the more favorable options, because consumers would be able to shop around for the best coverage that fits them. For someone like myself who only gets sick once or twice a year, it would be convenient to choose a low-coverage plan that fits my lifestyle and health condition. People with pre-existing conditions or a family history of disease could also choose insurance options that fit them.
While I don't necessarily love Republican Mike Huckabee, he has what seems to be a practical long-term approach to health-care reform: implementing "health" reform. The former self-proclaimed "foodaholic" governor of Arkansas lost a whopping 120 pounds over a two-year span and is now trying to eliminate the need for "care" by emphasizing prevention. Huckabee's health plan seeks to create federal policies that encourage private companies to "experiment" with innovative ideas to reduce the money that companies and consumers have to pay for procedures and prescription drugs by ensuring that they never need them.
The problem with Huckabee's plan, however, is that it looks too far into the future. He writes that as president, he will "work with the private sector, Congress, health-care providers, and other concerned parties to lead a complete overhaul of our health care system," but that does not address the immediate health-care problem staring us in the face.
Huckabee also emphasizes that health care should move from employer-based to consumer-based, much like Romney. He argues that employers spend exorbitant amounts to insure employees, citing that "General Motors spends more on health care than it does on steel, $1,500 per car," and "Starbucks spends more on health care than it does on coffee beans."
In 2005, GM Chairman and CEO Richard Wagoner Jr., who favors federal aid to alleviate the health-care crisis, cited the strain of health care on American employers. "The cost of health care in the U.S. is making American businesses extremely uncompetitive versus our global counterparts," he told The Washington Post in February 2005.
Despite the specifics of Huckabee, Romney, Obama, Clinton and others, the evident truth is that the U.S. health-care system desperately needs reform. While many of the Republican candidates and both of the Democratic candidates have the same basic concepts regarding health care, they each seem to have something that makes their plan unique.
I like aspects of each plan, and I commend the candidates for presenting viable solutions to a growing problem in America. But it's now America's turn to decide what they want from a federal health-care system. Don't wait until the parties select their respective candidates to begin taking an interest in your health-care options. When it's time for the Mississippi primaries on March 11, show the parties who you want and how you want to be covered.
Demand specifics from candidates, because it will be too late once they are in office. Especially in Mississippi, which has the highest numbers in the U.S. for heart disease, diabetes and hypertension, it is past time to change the system, and it begins with our own habits.
I truly hope that the healthcare system can get overhauled so that so many people wouldn't have to go without insurance. I don't know which way is best, but anything's got to be better than what we have now.