New York Times Examines Coming General Election Debate On Health Care, Lack Of Discussion About Reducing Medicare, Medicaid Costs

Main Category: Health Insurance / Medical Insurance
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 04 Mar 2008 - 9:00 PDT

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A debate about "whether universal coverage should even be a national priority" will replace the current "skirmish" over the "mechanics of universal health coverage" when the general election campaign begins, the New York Times reports.

Presumptive Republican nominee Sen. John McCain (Ariz.) has announced a health care proposal that focuses on "cost containment over assuring coverage for all," the Times reports. According to the Times, Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) "have not ignored the cost side of the health care equation," but "anyone paying attention to the Democratic campaign over the last two months could be excused for thinking that universal coverage is the candidates' fundamental concern."

Experts have raised concerns that the general election campaign could prompt a "debate that pits coverage against cost," which they maintain "would be regrettable" because the federal government "must fight on all fronts simultaneously to have any chance at meaningful change," the Times reports (Sack, New York Times, 3/2).

Separately, the Times looks at how Clinton and Obama have highlighted their proposals to expand health insurance to more U.S. residents, but they have said "little" about the "more immediate challenge" of "how to tame the soaring costs of Medicare and Medicaid."

Medicare and Medicaid cost a combined $627 billion last year and accounted for 23% of all federal spending. In 10 years, Medicare and Medicaid will cost about twice as much and account for 30% of all federal spending, according to the Congressional Budget Office. In addition, Medicare trustees estimate that the Part A hospital trust fund will become insolvent in 11 years.

According to the Times, neither Democratic candidate has said, "in any detail, how they would slow the growth of Medicare and Medicaid or what they think about the main policy options" -- such as "rationing care, raising taxes, cutting payments to providers or requiring beneficiaries to pay more." In addition, neither Democratic candidate has said "how they would overcome the health care industry lobby, which has blocked proposals for even modest reductions in Medicare payment rates," the Times reports.

The Times reports that Medicare and Medicaid spending tend "to increase in tandem with health spending generally" and that both Clinton and Obama have said that their health care proposals would reduce costs. Clinton has said that her proposal would save more than $50 billion annually through "efficiency reforms" to the health care system, and Obama has said that his plan would result in "tremendous savings" through increased efficiency.

According to the Times, McCain has described Medicare as a "fiscal train wreck" and opposed the Medicare prescription drug benefit in 2003 because it added to the cost of the program (Pear, New York Times, 3/3).

Clinton Vulnerable on Health Care?
The Republican nominee, in the event that Clinton wins the Democratic nomination, likely will use her failed effort to implement health care reform in the 1990s to "rile up the Republican base," the Raleigh News & Observer reports. According to the News & Observer, the Republican nominee likely will cite the effort as a "bloated, complicated, government-run step toward socialized medicine" and an indication that Clinton "loves big government."

Neil Newhouse, a partner at Republican polling firm Public Opinion Strategies, said, "We would go after her health care plan. It would be socialized medicine, Canada" and "fining people who don't have health care" (Douglas, Raleigh News & Observer, 3/2).

Rx Industry Contributions
The pharmaceutical industry has increased campaign contributions to Democratic candidates in the current election cycle, a change from recent years, the Philadelphia Inquirer reports. In the current election cycle, Democratic candidates have received 51% of campaign contributions from the pharmaceutical industry, and Republicans have received 49%, according to the Center for Responsive Politics. Among presidential candidates, Clinton ranks first in campaign contributions from the pharmaceutical industry, and McCain ranks fifth.

Uwe Reinhardt, a health economics professor at Princeton University, said, "It's quite clear the industry bets on candidates like they bet on horses." Reinhardt added, "They never bet their ideology as much as they bet who is going to be in the White House. I would view these (contributions) as betting odds. It's as cold as that." A lobbyist for an unnamed large pharmaceutical company said, "As a company, we steer completely clear of being involved in any presidential politics. We've worked with all administrations" (Stark, Philadelphia Inquirer, 3/2).

Opinion Pieces
Summaries of two opinion pieces related to health care in the presidential election appear below.

• David Francis, Christian Science Monitor: A "change in the United States health care system has become an economic necessity" for "advocates of health care reform," in part because many companies "want to get rid of their health care costs," Monitor economics columnist Francis writes. McCain "calls for dozens of reforms to bring down costs and make expenditures more effective in health results," but his proposals "don't fully embrace the uninsured," Francis writes. He adds that Clinton and Obama "are more ambitious" in their proposals. None of the candidates has proposed a single-payer health care system, but that "may be in part political expediency, considering what is possible," Francis writes (Francis, Christian Science Monitor, 3/3).
  
  
• Tommy Thompson: New York Times: Republican candidates "are not focusing enough on how government can be administered more efficiently and successfully ... in the health care arena," former HHS Secretary Tommy Thompson writes in a Times opinion piece. He writes, "Just as we have marshaled forces to put a man on the moon and to stop the growth of communism in the world, we should make it a priority to find cures for ... devastating diseases," such as "breast cancer, prostate cancer and colon cancer." He adds that Republicans should address problems with FDA, "not only in food safety but in many other areas as well." In addition, Republicans should "look at how we can incorporate medical diplomacy into our foreign policy and thus enhance respect for America around the world," according to Thompson. He writes, "Our party has definite positions" on health care, "but it would seem that the news media have assumed Republicans are not focused on it" (Thompson, New York Times, 3/2).

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