Democrats: Health Care For All!

This weekend, the Democrats managed to reach consensus on a platform that "commits the party to guaranteed health care for all." Sen. Obama still adheres to his standing position about not mandating coverage, but finding ways to make it more accessible.

While Sen. Obama still declines to adopt a mandate as part of his strategy, the fact that this plank in the platform has been finalized brings the Democratic Party's overall stance closer to the the approach favored by Sen. Clinton.

Now that the Dems have settled on their stance, I'm sure this will be heating up on the campaign trail. Sen. McCain will now have definite targets for debate, and with the recent scandal over John Edwards' affair keeping his wife Elizabeth out of the ring, the Republicans must be heaving a sigh of relief.

Advisers in both the Clinton and Obama camps seem happy, and activists within the party are mollified enough to have dropped their tougher stance demanding a single payer system.

SOURCE: "Democrats adopt goal of health care guarantee" 08/09/08
photo courtesy of Steve Rhodes, used under its Creative Commons license

"Nationalized Health Care"

It is a phrase used a lot in reference to the plans proposed by both Sen. Hillary Clinton and Sen. Barrack Obama should they attain the post of President. As Kevin Freking of the Associated Press points out in a recent article, it is an inappropriate usage of the phrase:

Last week, Sen. John McCain, the likely Republican nominee, described his challengers' health care plans as a "move closer to a nationalized health care system." But that's a stretch. To nationalize means to transfer ownership or control to the government. There's still a vast distance between what the Democratic candidates have proposed and nationalized health care.

Clinton and Obama aren't proposing government hospitals or government doctors. They want people to have health insurance, and they want people to be able to choose from a variety of policies. The menu would include private plans as well as an option similar to Medicare. Tax breaks would help lower- and middle-income people pay their monthly premiums.

In addition, proposed employer involvement and the rescinding of Bush administration tax cuts for the wealthy assure that there will be others besides the government paying into the program (whichever it ends up being) once it is enacted.

Such a system would continue the split system that the U.S. has when it comes to health coverage. The elderly, poor, disabled and many veterans would continue to get care paid for primarily by the government. Others would get coverage from private companies, usually through their employer, or through the Medicare-like option.

"Their approach is not taking any other country's system. It's building on what we have in the U.S," said Karen Davis, president of the Commonwealth Fund, which conducts health research.

Freking goes on to provide an illustrative comparison between our system here in the United States and those of Great Britain and Canada. He finds that while many more here in the U.S. chose to skip seeking care out of financial fear, residents of the other two countries tend to have much longer waits when specialist care is needed -- waits that are often a month or longer.

He also touches on economic side effects of the high cost of American health care, such as the fact that stateside manufacturers find it harder to compete in the global marketplace due to the high and rising cost of coverage.

"That's why it costs less to build a car in Canada than in the United States because you've got a bunch of money tied up in health insurance," said Steven Lewis, a Canadian health consultant.

As usual, Freking prescribes a solid dose of information for his readers, including an interesting observation about the one commonality that people in all three countries share. I'll let you read the article to find out what it is....

SOURCE: "Insurance model follows American tradition" 05/10/08
photo courtesy of *clarity*, used under its Creative Commons license

5th Annual World Health Care Congress

A stupendous array of health care expertise is gathered in Washington, D.C., supplemented by the health care policy advisors for U.S. Presidential candidates Sen. Barack Obama, Sen. Hillary Clinton and Sen. John McCain. It's the World Health Care Congress, and as you might expect, George C. Halvorson is there.

From the press release about this morning's panel:

-- Hear the Presidential candidates' platforms for health care reform

-- Compare proposals to address universal coverage and the fiscal
stability of Medicare

-- Reactor panelists provide an in-depth critique by evaluating the
economic and social impact of Democratic and Republican proposals

Panelists:
-- U.S. Rep. Jim Cooper (D-TN), Health Care Policy Advisor to Sen. Barack
Obama

-- Chris Jennings, Health Care Policy Advisor to Sen. Hillary Clinton,
former Senior Health Care Advisor to President Clinton.

-- Thomas Miller, resident fellow, American Enterprise Institute for
Public Policy Research, Health Care Policy Advisor to Sen. John McCain

-- George Shutlz, former U.S. Secretary of State, Labor and Treasury, co-
author "Putting Our House In Order: A Guide to Social Security and
Health Care Reform"

-- George Halvorson, Chairman and CEO, Kaiser Foundation Health Plans and
Hospitals

Health care reform, universal coverage, Medicare woes, and a solid analysis of the positions taken by our current crop of Presidential candidates should make for a fascinating (and hopefully productive) gathering.

The listing above covers on the first panel of the day for this event, in addition to those listed above there is an extensive roll call of movers and shakers in the Health Care scene in attendance who will be combining their expertise:

• Michael Leavitt, Secretary, U.S. Department of Health and Human Services
• James Hagedorn, CEO, Scotts Miracle-Gro Company
• Delos (Toby) Cosgrove, MD CEO, Cleveland Clinic
• Denis Cortese, CEO, Mayo Clinic
• Greg Tullman, CEO, Allscripts
• George Halvorson, Chairman and CEO, Kaiser Foundation Health Plans and Hospitals
• Mack Banner, CEO, Bumrungrad International (Thailand)
• Sam Nussbaum, Executive Vice President and Chief Medical Officer, Wellpoint
• Thomas Miller, health care policy advisor to Sen. John McCain
• Prof. Hans Rosling, MD, PhD Professor of International Health, Karolinska Institutet (Sweden)
• Michael Howe, CEO, MinuteClinic
• Paul Speranza, Chairman, U.S. Chamber of Commerce, Vice Chairman and General Counsel, Wegmans Food Markets
  

Best of all, in my opinion, is the fact that you can stream MP3 audio podcasts of the featured speakers here. Look for Mr. Halvorson's podcast, "Reforming the Delivery of Care to Impact 85% of Total Health Care Costs." It just went live!

Today, I would like to close with a quote about the event:

"This is the largest gathering of health care providers, thinkers and experts anywhere in this world."
—Lee Scott, President & CEO, Wal-Mart Stores, Inc.

Let us hope this massive array of talent and expertise can help us find our way down this complex and emotionally charged path to effective health care reform!

SOURCE: "5th Annual World Health Care Congress Kicks off April 21 With Obama, Clinton, McCain Health Care Policy Advisor Presidential Health Care Agenda Forum" 04/21/08
SOURCE: "5th Annual World Health Care Congress- Podcasts"
photo: Screencap of WHCC Website

Elizabeth Edwards backs Clinton on Health Care

Martina Stewart, an Associate Producer at CNN, reports that Elizabeth Edwards has now publicly endorsed the health plan of presidential hopeful Sen. Hillary Clinton. Details appear in Stewart's article on CNN's Political Ticker:

Elizabeth Edwards, wife of former Democratic presidential hopeful John Edwards, is picking sides in the Democratic nomination race – at least with respect to health care. In an interview that aired Wednesday on ABC’s “Good Morning America,” she threw her support behind Sen. Hillary Clinton’s health care plan.

“In order to ensure that we have universal coverage, we need to say everybody has to join,” Edwards told ABC’s Robin Roberts. “So, for that reason, the mandates that Sen. Clinton is talking about, I think are going to be more successful in achieving the goal,” she added.

Both health care plans have the same goals, said Edwards, but “I just have more confidence in Sen. Clinton’s policies than Sen. Obama’s on this particular issue.”

This is not the first time that Edwards, a cancer survivor, has had good things to say about Clinton's approach to health care. Last September she even noted its similarities to the one her husband, John Edwards, espoused during his bid for the Democratic nomination. As noted on this blog, she has also been quite critical of Sen. John McCain's plan, stating that is gives too much leeway for insurance providers to deny coverage based on pre-existing conditions.

This public statement is one that will certainly have an impact on the battle between Clinton and Obama for the Democratic nomination. Even though neither John nor Elizabeth Edwards have made a formal endorsement of either candidate, endorsing Clinton's health care plan carries a lot of weight due to the high profile of the issue in the current race for the Oval Office.

SOURCE: "Elizabeth Edwards backs Clinton's health care plan over Obama's" 04/09/08
photo courtesy of John Edwards 2008, used according to its Creative Commons license

Clinton Campaign Behind on Staff Health Care Benefits

Today, we are going to take a look at an aspect of the ongoing debate about health care amongst the U.S. Presidential candidates that is, for a change, new.

Politico's Kenneth P. Vogel broke this news:

Among the debts reported this month by Hillary Rodham Clinton’s struggling presidential campaign, the $292,000 in unpaid health insurance premiums for her campaign staff stands out.

Since health care reform is a major plank in Senator Clinton's campaign, this news has great potential to damage her efforts and credibility on that front.

Clinton campaign spokesman Jay Carson assured Politico that there was no interruption in staff benefits as a result of this situation. He also stated that Aetna Healthcare and Blue Cross Blue Shield, the health care providers for campaign staff, had been paid in full this month.

“Sometimes invoices are not paid immediately because we need additional information for our records, or to verify expenses,” Carson said in a statement e-mailed to Politico. “Sometimes invoices arrive at the very end of the month at the cutoff of the reporting period, which means that we are required to report them as a debt on the current FEC report, even where they are paid in regular course during the next month.”

But the unpaid bills to Aetna were at least two months old, according to FEC filings.

They show the campaign ended last year owing Aetna more than $213,000 for “employee benefits.”

During the first two months of the year, the campaign did not pay down any of that debt. In fact, it accrued another $16,000 in unpaid bills last month, and it finished the month owing Aetna $229,000.

Just like any other business, the Clinton Campaign faces employee benefits as one of their most major expenditures. Also just like other businesses, it is not uncommon to carry an unpaid balance from month to month. Carson emphasized that the campaign follows normal business practices in dealing with their bills, which are paid "regularly."

By contrast, Senator McCain had no unpaid health provider bills as of the end of February, and Senator Obama had a balance of $908 owed to AIG American International Group for "insurance." The contrast is already being touted across media and internet sources.

In a race that involves the issue of universal health care as a fundamental component, this news has potential to upset the political apple cart in fairly short order.

SOURCE: "Clinton didn't pay health insurance bills" 03/31/08
photo courtesy of Center for American Progress Action Fund , used under this Creative Commons license

Health Care: A Picture is Worth A Thousand Words

Craig Stoltz, a former editor of Health, has designed an interactive Web tool for Health Central. This tool, which Stoltz featured in an article in this week's Washington Post, allows readers to see exactly where the various Presidential hopefuls stand on different aspects of the health care issue. It also allows users to graph their own position in relation to said candidates.

The caveats: We report candidates' stated positions, not what they'll do if elected. Underlying the health-care debate is the matter of cost. Democrats' plans involve regulating insurers and offering all Americans a menu of insurance choices similar to those available to federal workers. Republicans would deregulate insurers, arguing that a free market will reduce costs and boost quality. All say savings will come from technology such as digital medical records and from disease prevention and chronic care.

And a note: Some say the focus on health care is not enough. A former assistant surgeon general, Douglas Kamerow, writing last week in the journal BMJ, says candidates' proposals don't address the "crisis" in U.S. primary care, the need for better pay for primary care doctors or ways to reward continuity of care.

Click here for an interactive tool that looks at the candidates positions.

They say a picture is worth a thousand words. It is our hope that this visual aid will help you to develop a picture of where the various candidates stand in relation to your own views on this urgent issue.

Where do you find yourself on this graph?

SOURCE: "Poligraph Web Tool" 01/12/08
SOURCE: "The Candidates on Health Care: Where Do They Stand?" 02/13/08
Screencapture IMage taken from Poligraph Web Tool

On The Road With Robert Reich

Today our media offering is from The Wall Street Journal. This morning in their commentary section we find Robert B. Reich, professor of public policy at the University of California at Berkeley and former U.S. Secretary of Labor under President Clinton, sharing his views on "The Road to Universal Coverage."

He begins by noting that on the Democratic side of the current race for the White House all three major candidates (Senators Clinton, Obama, and Edwards) have made health insurance issues a major part of their individual platforms. He also notes the despite overwhelming similarities in their plans they are focusing on the small differences in the battle for their party's nomination. "Mandates are a sideshow, and fighting over them risks turning away voters from the main event."

After a lucid and concise comparison of the plans presented by Democratic frontrunners, in which he demonstrates just how similar they are, he continues:

This fight is little more than a distraction, given that a mandate would matter only to a tiny portion of Americans. All major Democratic candidates and virtually all experts agree that the combination of purchasing pools, subsidies, easy enrollment and mandatory coverage of children will cover a large majority of those who currently lack insurance -- even without a mandate that adults purchase it. A big chunk of the remainder are undocumented immigrants, who aren't covered by any of the plans.

Should the remaining 3% of the population be required to purchase insurance, or lured into it by rate decreases and subsidies? Reich's position is that the answer depends on who you think comprises that 3%.

Comparing Senators Clinton and Obama he shows us the difference in views on this topic. Senator Clinton's position is that the 3% are youthful and in good health, which means they would lower the overall cost of health care as their payments subsidize others. Senator Obama's position is that many of them simply cannot afford coverage even with subsidized premiums. His belief is that they would either ignore the mandate or simply be unable to afford it. To Mr. Reich's credit his conclusion after comparing them is cautious and well reasoned. Like much of the current discussion on the topic it also casts an eye towards Massachusetts:

Who's correct? It's hard to know. So far, the Massachusetts experiment suggests Mr. Obama. Massachusetts is the only state to require that every resident purchase health insurance. The penalty for failing to do so could reach $4,000 next year, but the state has already exempted almost 20% of its current uninsured from the requirement. Massachusetts is concerned they can't afford a policy, even with subsidies similar to those in all the Democratic plans. So far, about 50% of Massachusetts's uninsured have complied with the mandate.

He closes with a call to action for Democrats, encouraging them to "stop leading with their chins," in counterproductive arguments over mandates and begin building momentum for large scale and desperately needed change. Change that they all already agree upon.

SOURCE: "The Road to Universal Coverage" 01/09/08
photo courtesy of Kevin Dooley, used under this Creative Commons license

Electronic Medical Records: The $77 Billion Solution

Reform of the American health care system is a huge part of the current political discourse. A major aspect of that reform as proposed by George Halvorson in his book Health Care Reform Now! is widespread adoption of Electronic Medical Records (EMR's or EHR's).

EMRs are making news on both the east coast and west coast this week. On the east coast Senator Hillary Clinton pressed for EMRs in response to a question from the crowd in a New Hampshire appearance.

C|net news blogger Anne Broache provides a sound bite from Sen. Clinton's comments:

"We go online to buy things from Mongolia, we go online to do our banking, but we can't go online in a secure, encrypted, confidential way to get access to our medical records," she lamented.

Diana Manos, Senior Editor of Healthcare IT News also covers the story:

The adoption of EHRs [electronic health records] is not new to Clinton, who has included them as a kingpin to her presidential healthcare platform from the start. Gearing up for New Hampshire's primary next Tuesday, Clinton told voters that moving to electronic records from paper could save an estimated $77 billion in healthcare costs.

Last May at George Washington University, Clinton said that moving healthcare from paper to electronic records is among several key ways the country could cut runaway healthcare spending by one third.

The other side of the U.S. brings more news about EMRs. Reuters offers a press release about Cisco Systems joining the effort to create the country's largest health information exchange service:

"Cisco recognized early on the importance of transforming the health care
system through electronic health records and information sharing," said Nick
Augustinos, Cisco Internet Business Solutions Group Director. "Through
collaboration with CalRHIO and other technology leaders, we believe California
will lead the nation in creating a statewide health information exchange
system that not only supports clinicians, but also helps consumers make better
health care choices."

Cisco partners with HP, Perot Systems Corporation, and Medicity, Inc. as partners in this effort. The final objective is to enable EMRs to be shared in a confidential manner among health care providers across the state of California as well as through the National Health Information Network (which is currently under development).

Before EMRs grabbed the attention of the U.S. Presidential contenders, healthcare delivery systems were already moving toward shared electronic records. Prompted by individual states or by financial self-interest, health care providers and employers have decided not to wait for federal legislation. Now that the politicians are climbing on board, it's hard to imagine a future that does not include easy access to medical records over the Internet.

SOURCE: "Clinton presses for electronic medical records" 01/04/08
SOURCE: "Clinton: Time to digitize all Americans' medical records" 01/04/08
SOURCE: "Cisco Joins CalRHIO Effort to Build Country's Largest Statewide Health Information..." 01/07/08
photo courtesy of Kevin Zollman, used under this Creative Commons license

Mandates II: Clinton vs. Obama

Aggressive, increasingly so. That is how staff reporter John McCormick of the Chicago Tribune describes U.S. Sen. Hillary Clinton this morning. In an interview her campaign offered the Tribune she takes off her verbal kid gloves for a direct attack on competing U.S. presidential candidate Sen. Barak Obama. The main topic of this attack? Mandated health care, an issue we also covered in yesterday's post.

Mr. McCormick provides commentary on the clash:

The two Democratic candidates have been sparring in recent days over health care, with Clinton charging that Obama's health plan would not offer true universal coverage because he would not require all Americans to buy into a plan as she would. Obama has countered that his proposal offers guaranteed access at lower costs.

"One of the things Sen. Obama takes credit for as a state senator is a health-care task force that looked into the question of how do you provide universal health care in Illinois," Clinton said. "[That report] was clear: If you want universal health care you have to have a mandate."

Although the task force did recommend a mandate, it also suggested exemptions to penalties for Illinois residents who couldn't buy insurance or get it from an employer. When Gov. Rod Blagojevich unveiled his health-reform proposal earlier this year, he ultimately stopped short of such a requirement.

He goes on to chronicle many of the back and forth accusations and the constant re-framing of this discussion that has occurred between the two candidates. Obama's campaign points out that Sen. Clinton was against mandates in the '90s when last she made headlines with health care reform. Clinton's campaign denies it. The really interesting new statement arising from the Tribune interview is this one:

Clinton said she is puzzled by Obama's approach.

"Sen. Obama [is] now criticizing a mandate, when he has one in his own plan, when he helped to set up a task force that says there has to be a mandate," she said. "And there are lots of ways to do it, through default enrollment, through going to schools, workplaces to enroll people."

The question of who will win this battle of words and policies will be resolved soon, and then it will be time for the presidential race itself. I wonder what sort of things will enter the health care debate over the course of Election Year? I am sure that more comments like this one (also from the Tribune interview) should be expected:

"I have for months tried to stay positively on the issues, to talk about what I will do as president, to set forth my credentials and experience, the strengths that I think I bring to the position," she said.

"But I have been attacked pretty regularly by my two leading opponents, and it's gone on for months. So, at some point, as we get toward the end of these campaigns, you have to stand up and rebut what people are saying and put out the contrasts, and that is what I intend to do."

SOURCE: "Clinton Hits Obama on Health Care" 11/28/07
photo courtesy of borman818 remixed and used under this Creative Commons license

Obama, Clinton Square Off on Mandates

Political columnists everywhere have been having a field day as U.S. Presidential hopefuls Sen. Hillary Rodham Clinton of New York and Sen. Barack Obama of Illinois spar on the issue of health care reform. Both of the candidates have pledged to achieve universal health coverage, Clinton stressing a mandate (requiring the purchase of health insurance much as we do with automobile coverage) and Obama pressing affordability as the main issue.

Mike Dorning at the Baltimore Sun shares Sen. Obama's comments at a Littleton, NH event:

"Sen. Clinton still hasn't explained what this mandate is: What's she going to do if somebody doesn't purchase health care? Is she going to fine them? Is she going to garnish their wages?" Obama said.

"One of the problems with her approach is that she hasn't been straight with the American people about how she's going to impose this mandate. And without an enforcement mechanism, there is no mandate. It's just a political talking point," he continued...

Shortly after Obama spoke, his campaign sent out a memo noting that in Massachusetts, the only state so far to require residents to buy health insurance, hundreds of thousands of people have not purchased insurance despite a fine levied on those who fail to do so through their tax returns.

As the only Democratic candidate who does not support a mandate Obama has good reason to keep a close eye on the Massachusetts plan (originally set in place by Republican Presidential hopeful Mitt Romney, who does not now support a national insurance mandate). According to this morning's New York Times article by Kevin Sack, implementing mandated coverage may not be quite as easy as it seems.

More than 200,000 previously uninsured residents have enrolled, but state officials estimate that at least that number, and perhaps twice as many, have not.

Those managing the enrollment effort say it has exceeded expectations. In particular, state-subsidized insurance packages offered to low-income residents have been so popular that the program’s spending may exceed its budget by nearly $150 million.

But the reluctance of so many to enroll, along with the possible exemption of 60,000 residents who cannot afford premiums, has raised questions about whether even a mandate can guarantee truly universal coverage.

Additional concerns have been generated by projections that the state’s insurers plan to raise rates 10 percent to 12 percent next year, twice this year’s national average. That would undercut the plan’s secondary goal of slowing the increase in health costs.

He goes on to share each of the Democratic frontrunners' views on the subject of mandated health care:

“The sad reality is that the uninsured don’t just struggle with costs themselves, they impose costs on the rest of us,” Mrs. Clinton said in September. “It’s a hidden tax: the high cost of emergency room visits that could have been prevented by a much less expensive doctor’s appointment, the cost of unpaid medical bills that lead insurance companies to raise rates on the rest of us.”

Mr. Edwards echoed those remarks a week later. “The reason the mandate is necessary is because you cannot have universal health care without it,” he said. “Does not exist, and anyone who pretends it is, is not being straight.”

Senator Barack Obama of Illinois sees it a different way. He argues there is danger in mandating coverage before it is clear it can be affordable for those at the margins. While Mr. Obama does not rule out a mandate down the road, his emphasis is on reducing costs and providing generous government subsidies to those who need them. He would mandate coverage for children.

Mr. Sack's article then looks at the penalty system set in place by the Massachusetts plan for those who refuse to get coverage. This year, state residents who do not purchase insurance will lose their tax exemption (approximately $200), next year that penalty will rise to half the cost of the least expensive insurance policy available (with a probable minimum of $1,000). In his interviews he finds that many were not purchasing insurance because they either did not feel the need for it or because the penalty was not yet high enough to force them to do so.

“At 27, it’s not like I’m thinking, ‘Oh, man, what if I need an operation down the line?’ ” said Samuel B. Hagan of Lenox, a courier who remains uninsured. “Furthest thing from my head.”

John E. McDonough, executive director of Health Care for All, an advocacy group based here, said he found it breathtaking that political leaders were calling for an individual mandate well before there was any way to measure the success of the Massachusetts experiment.

"As goes Massachusetts, so goes the Nation?" The pitfalls and successes of that state's health plan will figure largely in future dialog on the subject.


SOURCE: "Obama challenges Clinton on health care" updated
SOURCE: "Massachusetts Faces a Test on Health Care" 11/25/07
photo courtesy of patriarcha12, remixed and used under this Creative Commons license

Hillary Clinton vs. Barack Obama on Health Care

With less than a year to go before the United States decides who will be the country's new chief executive the debates are starting to get heated. Last night's debate among candidates for the Democratic Party's presidential nomination was a perfect case in point. Senator Hillary Rodham Clinton faced off against Senator Barack Obama. The subject of health care reform proved, to no one's surprise, to be the hot button issue.

Michael Cooper of the New York Times reports:

The crux of their dispute centers on their overall approaches to health care.

Mrs. Clinton's plan would require all Americans to get coverage and would provide subsidies to make it more affordable. Mr. Obama's plan would require only children to have coverage; his plan would require employers to provide coverage or contribute to a new public program that would make insurance more affordable to people not covered by their jobs or by the government.

“The only difference between Senator Clinton's health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated - forced - them to get health care,” Mr. Obama said. “That's not what I'm seeing around Nevada. What I see are people who would love to have health care. They desperately want it. But the problem is they can't afford it.”

Aswini Anburajan adds the following on MSNBC's First Read:

Obama has pledged, repeatedly, on the stump to pass universal healthcare by the end of his first term in office. He promises to do so through a mixture of bravado, “If Harry and Louise get up on TV, I'll dip into my campaign fund and run my own ads saying Harry and Louise are wrong;” and by running an open process in which every party will have a seat at the table.

The main quantitative difference between the three main Democratic front runners, Clinton, Obama, and Edwards, is that only Senator Obama's plan does not mandate care (requiring coverage) for everyone. In the debate and on the stump he has questioned the ability of government to enforce such a mandate. Mr. Cooper's article quotes him as saying of Senator Clinton's approach, "She states that she wants to mandate health care coverage, but she's not garnishing people's wages to make sure that they have it.”

From here on out things should continue to heat up in the various debates. Check back with us often as we keep our fingers on the pulse of health care reform!


SOURCE: "It Was Clinton vs. Obama on Health Care" 11/16/07
SOURCE: "What's Obama's Health care Position?" 11/15/07
photo courtesy of swanksalot on Flickr, used under this Creative Commons license

Just The Facts, Please

Health care today is a massive issue. A quick glance at any news-oriented media (including this blog) will show the topic being addressed from every angle as a variety of facts, pseudo facts, and pure polemic fight for that all important mindshare -- yours.

The catchphrases and keywords of the discussion are bandied about everywhere: Hillary Care, socialized medicine, single payer plan, SCHIP, government insurance and many others. How is the average American to make any clear sense of this media barrage?

Thanks to the pioneering efforts of Annenberg Political Fact Check from the Annenberg Public Policy Center (APPC) of the University of Pennsylvania, we have a few options available today. A pioneer in presenting non-partisan fact checking online, the APPC accepts no funding from individuals, political campaigns, businesses, unions or lobbying organizations. It also boasts a large team of researchers and journalists to assist in cutting through the rhetoric.

PolitFact, a project from the St. Petersburg Times and Congressional Quarterly, and its "Truth-O-Meter," is another site which checks the veracity of campaign videos and candidates. Particularly useful when the health care issue comes up. It is always interesting to see the myriad ways in which the same numbers can be presented by different sides.

Then there is the new kid on the block: The Washington Post. In early September the Post launched its new Fact Checker feature, helmed by distinguished staff writer Michael Dobbs and research wizard Alice Crites, the backbone of the Post's investigative department for most of the last ten years. During that decade Crites has worked on three Pulitzer-winning series. Personally I like the fact they use "Pinocchios" to rate the magnitude of factual distortion.

Let's take a look at the Fact Checker this morning, where accusations of socialized medicine levied at Senator Hillary Clinton are dissected:

According to MIT economics professor Jonathan Gruber, who advised Romney on his health care reform law and has also advised Clinton, the Massachusetts law has a lot in common with the Clinton plan. Both plans mandate universal health care coverage and subsidize health care for people on low incomes. The main difference is that Clinton's proposal permits people to switch to a Medicare-type plan and increases taxes at higher income levels.

Contrary to claims by Romney and other Republicans, the Clinton plan does not force Americans to accept "government insurance." It offers people a choice. If they are happy with their present health plan, they can keep it. Otherwise, they can switch to the plans offered to members of Congress, or a government-run plan similar to Medicare.

The column goes into great detail providing quotes and sources, as well as detailing the lack thereof. It concludes with "The Pinocchio Test."

The claim that "Hillary care" is tantamount to "socialized medicine" does not stand up to serious examination. The Clinton health care plan has more in common with the Massachusetts plan signed into law by Governor Mitt Romney than the British National Health system. We award three Pinocchios to Romney.

I wonder if anyone will win the coveted "Geppetto Checkmark," the sign denoting a complete lack of factual distortion?

SOURCE: "'Hillary Care' and 'Socialized Medicine'" 10/24/07
photo courtesy of Marc Nozell, used under its Creative Commons license

Clinton Care Chaos

The media and blogosphere are abuzz about what many are calling "HillaryCare 2.0." The presidential hopeful laid out her approach to health care reform yesterday in Iowa. It was shortly afterwards that her new ad debuted.

The attacks and analyses began immediately, with a frequent refrain being about Clinton's stance on the insurance companies. Clinton makes many references to not allowing the insurance companies to control health care prices. That adversarial tone is seemingly quite at odds with the way her plan is being assessed in some quarters. This excerpt from The Nation is a good example:

The Clinton plan maintains the current system of for-profit, insurance-industry defined health care delivery. The only real change is that, in return for minimal requirements regarding coverage of those with preexisting conditions, the government would pump hundreds of billions in federal dollars into the accounts of some of the country's wealthiest corporations. The plan's tax credit scheme would buy some more coverage for low-income families, which is good, but it would do so at a cost so immense that, ultimately, Clinton's plan will be as tough a sell as the failed 1993 "Hillarycare" proposal.

America is ready for health care reform.

But it is not ready for more bureaucracy, more expense and more revenue for insurance companies.

Criticism abounds from all sides of the debate with both Republicans and her fellow Democrats rushing to add their own critiques. Does this avalanche of criticism denote a defensive posture amongst her detractors?

ABC News summarizes the reactions from other candidates and comments on the overall state of the playing field:

Clinton's plan is "European-style socialized medicine" (Mitt Romney); straight out of Michael Moore's "Sicko" (Rudy Giuliani); an "imitation" advanced by a flawed saleswoman (John Edwards); inadequate and advanced by a flawed saleswoman (Barack Obama -- but how would he cover more people without requiring coverage?); and automatically bad because Clinton herself "set back our ability to move toward universal health care immeasurably" back in 1994 (a very aggressive Chris Dodd).

All the attention is a form of flattery; just about any other candidate would have had himself hospitalized (maybe even in Cuba) to be attacked like this when he offered his plan. The obsession with "Hillarycare 2.0" speaks to the control that Clinton exerts over the entire field, as the one person who at this moment looks like she has the best shot of being elected president (and who represents the match-up the Republican base craves the most).

SOURCE: "Clinton's Prescription for Another Health Care Reform Failure" 09/17/07
SOURCE: "Hillary '07 Battles Hillary '93" 09/18/07
photo courtesy of valentinapowers on Flickr.

A Populist Prescription from Barack Obama

Health care is the subject on everybody's lips, especially those running for office. Members of both major political parties have laid out their platforms on this issue as they either campaign for office or prepare to do so, but there is dissent within each party as well. Barack Obama created quite a stir yesterday with his reaction to comments on Hillary Clinton's failed attempt at reform back in 1993. The Associated Press provides a relevant quote from his Sac City, Iowa, appearance:

"It was a closed process and not everybody understood what was taking place, so when the insurance companies and the drug companies started running those 'Harry and Louise' ads, nobody really knew what was what. That's why the American people have to be involved."

After Clinton's plan was proposed, special interest groups ran the commercials, featuring a fictional couple worrying about losing their ability to pick their own doctors and warning that the government would take control of the health care system. Support for the health care expansion evaporated and the effort was eventually dropped.

Obama said the lesson to be learned was to involve the American people in the effort. Without political support, no health care expansion can be approved, he said.

Obama then followed the announcement of his more populist approach with the statement that he would announce outlines of a health care reform package in his first 100 days as President. The details of this package would then be drafted by a bi-partisan commission. Alec McGillis at The Washington Post takes note of the tactical change this represents within the overall debate:

The remarks were a new twist on the health care debate that has played a dominant role so far in the Democratic race -- until now, most of the candidates have focused on the differences between their plans, not how they would go about actually getting reform enacted. The comments also represented a variation on a theme that Obama first introduced in an interview with The Washington Post last month -- that he would be in a better position to unite the country than would Clinton, given her polarizing reputation among many voters. And it is a rebuttal of sorts to the argument Clinton has been making on the trail in recent days -- that she, unlike Obama, has the experience to know how to work within the system to get things done. In Clinton's highest-profile bid for reform, Obama is reminding voters, the system won.

SOURCE: "Obama Vows Open Health Reform Process " 09/05/07
SOURCE: "Obama Draws Clinton Contrast" 09/05/07
photo courtesy of SEIU International on Flickr remixed and used under this Creative Commons license

Market Reform Key to Health Care Reform?

In today's Boston Herald, Dr. Lawrence A. Hunter, a senior fellow at the Institute for Policy Innovation, critiques health care reform plans that involve market reform.

Hunter criticizes "market-based health plans," such as those proposed by 2008 Presidential candidates Sen. Hillary Clinton, Massachusetts Gov. Mitt Romney, and Sen. Barack Obama, and former Sen. John Edwards.

In both parties, politicians have proposed to "curb," "harness" or "reform" the market to "fix" America’s health care system. However, lawmakers continue to ignore the underlying problem with today’s health care system. Because of government intervention in the marketplace, there’s a vast gap between the demand for health care and its supply.

Hunter discusses troubles he believes are already apparent in Massachusetts' state-based health care reform and compares these to potential reform on the national level. He also goes on to point out specific problems he sees with the candidates' plans.

John Edwards' plan hides this tax hike by forcing businesses to "either cover their employees or help finance their health insurance," and Obama has promised to "require employers to make a meaningful contribution to the health coverage of their employees." Romney’s plan assessed new taxes on those who chose not to buy health insurance and small business owners who wouldn’t play along - proving there is no such thing as voluntary socialism, even when designed by a so-called conservative.

SOURCE: "Market Reform Most Unhealthy: Gov’t Meddling Sickens System" 07/30/07