How the Democratic Frontrunners Compare on Health Care

By Katrina vanden Heuvel, TheNation.com. Posted December 3, 2007.

With Iowa one month away, the almost obsessive horserace coverage is in full swing and, as it has for much of campaign, it shortchanges the substance of the serious and urgent issues in dispute.

Take the fight between Hillary Clinton and Barack Obama over whose healthcare plan would cover more people or cost less. The substance of that battle received about two sentences in today's Washington Post front page story out of Iowa. But here's the real problem (because we all know horserace coverage is what we're going to get at this stage in this endless campaign)....Even if the Post or the Times devoted a full story analyzing the leading candidates' healthcare proposals, how much attention would the two papers give to alternatives offered by someone like Congressman Dennis Kucinich--the only candidate supporting a truly universal, Medicare for all, healthcare plan that, according to recent polls, has majority support? I suspect very little. In our downsized politics of excluded alternatives, media polices the parameters of what's considered "realistic" when it comes to many choices, including healthcare reform.

That's why a recent analysis of the mainstream candidates' healthcare proposals is so valuable. Released by Healthcare-NOW, an organization committed to universal single payer reform, it's a useful guide for voters who want to understand the full range of choices they should be seeking in this campaign. It's not that all of the leading candidates' proposals aren't advances over what we have now, but as voters and citizens we could demand more. And it will require an independent progressive movement to push truly universal healthcare reform onto the next president's agenda.

Check out the analysis below, prepared by Len Rodberg, Research Director, New York Metro Chapter, Physicians for a National Health Program, September 25, 2007. Presented to the New York Chapter of Healthcare-NOW on November 6, 2007.

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The Mainstream Democratic Candidate' Proposals for Universal Healthcare

The mainstream Democratic candidates for President -- John Edwards, Barack Obama, Hillary Clinton -- have each put forward their proposals for "affordable quality health coverage for all." The three Democrats' proposals, while purporting to provide "universal health care", will not actually achieve this goal:

None of these plans offers a realistic way of containing the rising cost of health care. All will add additional funds to an already too-costly system. None will truly provide universal access to care.

Only a single payer national health insurance program can actually achieve affordable, workable universal access to health care.

The three proposals share a set of common elements:

The private insurance system would remain in place, with no fundamental change in the way it operates. Those who currently have insurance would not experience any change in how they are insured or the coverage they have.

Large employers would be required to provide insurance for their employees or (in the case of Edwards and Obama) pay into a fund to subsidize insurance for their employees.

Everyone (for Edwards and Clinton) or children (for Obama) would be required to have insurance, either through their employer or purchased on their own (an "individual mandate"). Income-related subsidies would be provided through the tax system.

Insurers would be required to offer coverage to everyone ("guaranteed issue") without limits on pre-existing conditions, and without "large premium differences based on age, gender, or occupation" (from Clinton's plan).

All would make available a "choice" of private insurance plans, as well as a public insurance option modeled on Medicare. (They use the language of the insurance industry -- and Hillary Clinton uses it in the name of her plan itself, the "American Health Choices Plan" -- suggesting that what consumers want is a choice of plan.)

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Katrina vanden Heuvel is editor of The Nation.

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