Wall Street Journal Examines Democratic Presidential Candidates' Plans And The 'Ghost' Of Single-Payer

Main Category: Health Insurance / Medical Insurance
Article Date: 28 Jan 2008 - 8:00 PDT

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"Democrats backing universal health care long favored a single-payer system," and, although most Democratic presidential candidates have announced proposals to expand health insurance to all U.S. residents by "building on the employer-based system," the "ghost of single-payer past looms large," the Wall Street Journal reports.

Sen. Hillary Rodham Clinton (D-N.Y.) earlier this week criticized Sen. Barack Obama (D-Ill.) for shifting his support from a single-payer health care system to his current proposal, which would require health insurance only for children and would build on the employer-sponsored system. In response, Obama denied that he supported the implementation of a single-payer health care system. He said, "What I said was that if I were starting form scratch, if we didn't have a system in which employers typically provided health care, I would probably go with a single-payer system."

The exchange "showed how politically sensitive the idea of a single-payer system remains," the Journal reports. According to the Journal, when Democratic candidates say "something too kind" about a single-payer health care system, "there's a Republican around the corner ready to brand you a socialist," and, when they say "something too harsh," they "alienate many on the left wing of the party."

David Nexon, a senior executive vice president with AdvaMed and former adviser to Sen. Edward Kennedy (D-Mass.), said of health care reform proposals, "There are a lot of different ways of skinning this cat." He added, "The key is to get one that can pass and provides decent-quality, affordable coverage to everyone, not the one that is the perfect system in the eye of whatever beholder it is" (Meckler, Wall Street Journal, 1/25).

Webcast of forums featuring a number of the major presidential candidates discussing health care are available online. The forums were organized by Families USA and the Federation of American Hospitals. The Kaiser Family Foundation hosted the forums in its Barbara Jordan Conference Center in Washington, D.C. Webcasts provided by kaisernetwork.org are available on a dedicated Web site, http://presidentialforums.health08.org.

Edwards on Health Care
Former Sen. John Edwards (D-N.C.) on Thursday in an interview in Patrick, S.C., said that his health care proposal, which would allow U.S. residents to pay to participate in public health plans modeled on Medicare, could develop into a single-payer health care system and that he would not oppose such a development, the New York Times reports.

He said that, under his proposal, residents would decide "which works best" -- private or public health plans. He added, "It could continue to be divided," but "it could go in one direction or the other, and one of the directions is obviously government or single-payer. And I'm not opposed to that."

According to the Times, in the event that public health plans can offer health insurance at lower prices than private plans, the federal government "theoretically" could become the "de facto insurer for the nation." Edwards said, "There is nothing back-door about it," adding, "It's right through the front door. We're going to let America decide what health care system works for them" (Sack, New York Times, 1/25).

AMA Addresses Issue of the Uninsured
American Medical Association President-elect Nancy Nielsen on Thursday at the Economic Club of Florida said the group has visited states with early presidential caucuses or primaries to "raise concerns among candidates and voters" by "becoming part of the voice for the uninsured," the Tallahassee Democrat reports. The issue of the uninsured is "worsening," she said, adding, "Doing nothing is not an option."

AMA supports a proposal that would provide tax credits to help uninsured U.S. residents purchase health insurance and would eliminate federal tax exclusions for coverage. In addition, the proposal would seek to provide all residents with a choice of portable health plans. AMA does not seek to eliminate the employer-sponsored health insurance system, Nielsen said.

She said, "We need to work together to find a uniquely American solution. ... What we know is that uninsured people live sicker and die younger." She added, "This is not about doctor income" (Liner, Tallahassee Democrat, 1/25).

Editorial
Democratic presidential candidates are "careful" not to use the phrase "socialized medicine" when discussing their health care plans, but "make no mistake, three of the party's remaining hopefuls advocate changes that would push us closer to precisely such a system," the Las Vegas Review-Journal writes in an editorial. Clinton, Obama and Edwards "all agree that the government should essentially expand Medicare to give every American a choice of enrolling in the federal program," according to the editorial. These candidates "should be forced to address" concerns that government-run insurance would "crowd out competitive private plans" by offering less-expensive, taxpayer-subsidized coverage, and that the cost of such a plan would "far surpass" savings achieved by reducing the number of uninsured individuals (Las Vegas Review-Journal, 1/25).

Letter to the Editor
Republican presidential candidate and former Arkansas Gov. Mike Huckabee's reference to the work performed by caregivers as "'emptying a bedpan' was insensitive and insulting, leaving the impression that [caregivers' work] is unimportant and ... unworthy of respect," Lin Salasberry, a certified nursing assistant from Iowa, and 10 other caregivers write in a Des Moines Register letter to the editor. The letter continues that Iowa caregivers last month sent a letter to Huckabee asking him to explain the statement and inviting him to "walk a day in the shoes of a professional caregiver," but "no response has been received." The caregivers write that they hope "Huckabee and other candidates understand that there are more than three million professional caregivers in America who are concerned about his words and failure to respond" (Salasberry, Des Moines Register, 1/25).

Opinion Pieces
"The sad state of health care is one of the leading issues in the presidential campaigns," because the U.S. health system "is a national disgrace," Thomas Preston, a physician, writes in a Seattle Post-Intelligencer opinion piece. "The owners, investors and employees of Big Pharma and device or instrument suppliers reap billions in profits through the present form of insurance," so "transformation ... will never come from within the industry," according to Preston. He adds, "The electorate must insist on change through the political process." Preston adds, "To succeed, politicians must begin with consensus to eliminate financial self-interest from health care decision-making, guarantee health insurance for everyone and restore independence in evaluation of treatments" (Preston, Seattle Post-Intelligencer, 1/22).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.