Democrats Seize on Health in Split From Republicans (Update1)
By Aliza Marcus
March 26 (Bloomberg) -- All the Democrats running for president agree the U.S. government should ensure that every American has medical coverage. Now they need a consensus on the price tag and how to pay for it.
Hillary Clinton, Barack Obama, John Edwards and four other candidates, speaking at a health-care forum in Las Vegas over the weekend, promised to extend health coverage and control costs. They weren't unanimous about how much it would cost or where the funds would come from.
The candidates' early comments suggest the Democrats see that promising health benefits for every American may help them gain an edge on the Republicans, analysts said. President George W. Bush, in office since 2001, and Republicans seeking to succeed him have failed to gain traction with proposals to offer tax credits to help individuals buy insurance.
``This is a subject that the Democrats will grab for themselves,'' said Stuart Altman, a professor of health policy at Brandeis University in Waltham, Massachusetts. ``It's one of the defining separations between the two parties.''
About 15 percent of Americans don't have insurance, saddling hospitals and state government with the bills when they show up for treatment in emergency rooms. People who have coverage and employers that pay for it worry that costs are rising at more than twice the rate of inflation, polls show. U.S. health spending reached $2.1 trillion last year, 16 percent of the economy.
As a result, an issue that was a peripheral concern in recent national campaigns is re-emerging, said Kenneth Thorpe, a professor of health policy at Emory University in Atlanta.
`Bolder' Than Before
``Their positions on health care are more comprehensive and bolder than four years ago,'' said Thorpe, referring to the Democrats. ``Four years ago, you wouldn't have heard support for universal coverage.''
The leading candidates, Senator Clinton of New York, Senator Obama of Illinois and former Senator Edwards of North Carolina, said revamping the health-care system will require change from everyone involved.
Employers will have to ``pay or play,'' as Obama, 45, put it during the event March 24 at the University of Nevada at Las Vegas. Businesses will have to offer insurance coverage or contribute to a fund to help workers buy it, all three candidates said.
Once the government guarantees that insurance is available, everyone should be required to have it, Edwards and Clinton said.
``So if your employer doesn't provide insurance, if you are not covered by a government plan, then you have to be in the system,'' Clinton, 59, said. ``An individual mandate is actually an individual responsibility policy.''
Repealing Tax Cuts
Edwards, 53, the only candidate with a detailed plan so far, emphasized that he would pay for expanding health coverage by revoking Bush's tax cuts for people earning more than $200,000 a year. Edwards estimated that covering everyone in America would cost the government as much as $120 billion more annually.
``It's not possible to do this without raising taxes,'' Edwards said.
Obama and Clinton weren't willing to say how they would finance their ideas. Obama said a plan he will soon present would save money by ``making the system more efficient'' and providing better preventative care.
``What we really need to look at is how we can save money over the long run,'' Clinton said.
Health-Care Industry Reaction
The willingness of the Democrats to make health care a central campaign theme is encouraging, said Chip Kahn, president of the Federation of American Hospitals, which represents investor-owned hospitals.
The hospital organization released a report last month estimating that universal coverage would cost the government about $115 billion a year.
``We want everyone at the table, knowing at the end of the day people are going to have to give something,'' said Kahn in a telephone interview today.
Insurance companies are also ready to join in discussions, said Karen Ignagni, President of America's Health Insurance Plans, the largest industry group.
Clinton's comments at the forum about insurance providers were unwarranted, Ignagni said. Clinton said insurance companies make a lot of money while denying benefits to people who have coverage.
``We are happy to engage on what we have accomplished and contributed to the system,'' Ignagni said in a telephone interview.
Republican Candidates
Although the Republican candidates were invited to the forum in Las Vegas, none attended. The event was sponsored by the 1.8 million-member Service Employees International Union, which usually backs Democratic candidates, and by the advocacy arm of the Center for American Progress, a Washington-based policy group headed by John Podesta, who was chief of staff to former President Bill Clinton.
Republican presidential candidates will come under pressure to offer health care plans, said Thorpe of Emory University.
``Health care is one of the biggest policy concerns,'' Thorpe said. ``And it's not just the uninsured who care. It's business, it's unions. The Republican candidates are not only slow on this, but I think it's a mistake to ignore a major domestic concern.''
To contact the reporter on this story: Aliza Marcus in Washington at amarcus8@bloomberg.net
Last Updated: March 26, 2007 13:00 EDT |
