Newsweek Examines Whether Preventive Care Programs Proposed By Major Presidential Candidates Can Reduce Costs

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance;  Public Health
Article Date: 03 Sep 2008 - 6:00 PDT

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Newsweek on Monday examined whether preventive care programs proposed by Democratic presidential nominee Sen. Barack Obama (Ill.) and presumptive Republican presidential nominee Sen. John McCain (Ariz.) would reduce health care costs. According to both candidates, preventive care "makes for healthier patients and lower health care costs," but a study recently published in the New England Journal of Medicine found that such programs "usually result in higher payouts, not lower ones," Newsweek reports.

Newsweek interviewed two of the authors of the study, Peter Neumann and Joshua Cohen, both health policy researchers at Tufts Medical Center. Neumann said that politicians promote preventive care programs because they allow them to "talk about health care without talking about cutting payments or limiting choices." He added, "The blanket statement that prevention will save money and improve health is too simplistic. Sometimes it saves money, sometimes it doesn't." In addition, Neumann said that the most effective preventive care programs target high-risk populations (Carmichael, Newsweek, 9/1).

McCain Names Vice Presidential Candidate
McCain on Friday during a rally in Dayton, Ohio, announced that he has selected Alaska Gov. Sarah Palin (R) as his vice presidential candidate, the Chicago Tribune reports (Zuckman, Chicago Tribune, 8/30). Palin supports increased competition in the private health insurance market, which she believes will reduce health care costs and the need for government subsidies (Atlanta Journal-Constitution, 8/30). In addition, Palin supports proposals that would provide consumers with more information about the price of medical services, as well as incentives for employers to provide employees with health insurance based on the private market. In the past, she has said that consumers should take more responsibility for their own health (New York Times graphic, 8/30).

Editorial, Opinion Pieces
Summaries of an editorial and several opinion pieces that address health care issues in the presidential election appear below.

• Raleigh News & Observer: Obama has said that he would "boost health insurance availability for all" and finance the proposal with "higher taxes on the wealthy ... with employers who didn't provide health coverage plans paying into a national fund to help the uninsured," but "it will be difficult for Obama to make good on all of his promises" because of the federal budget deficit, a News & Observer editorial states. According to the editorial, "Obama's goals are lofty and the means to his ends may be difficult to attain," but "high aspirations have always been part of presidential campaigns." The editorial adds that "he at least is ready to grapple with problems, the answers to which have long been delayed, such as energy and oil dependence and health care" (Raleigh News & Observer, 8/30).
  
  
• Oliver Fein, Philadelphia Inquirer: The latest report from the Census Bureau found that more than 45 million U.S. residents were without health insurance at some point last year, an issue that "has surfaced during the presidential campaign," Fein, associate dean and professor of clinical medicine and public health at Weill Cornell Medical College in New York and president-elect of Physicians for a National Health Program, writes in an Inquirer opinion piece. Fein writes that the McCain health care proposal "would undermine employer-sponsored health plans and push millions, including some with chronic illnesses, onto the individual insurance market," a "sure-fire formula for increasing the number of uninsured and uninsurable adults." Meanwhile, the "frequency of chronic illness among the uninsured also poses challenges for individual mandate proposals, including those associated with Sen. Barack Obama," Fein writes. He adds, "While Obama's plan includes a requirement that insurance companies accept anyone who applies for coverage and sets up a new public plan to provide another coverage option, several states that have adopted this kind of model (Massachusetts being the most recent example) have invariably abandoned them, citing uncontrollable costs." According to Fein, the "plight of the uninsured and uninsurable shows how the for-profit, private health insurance model of financing health care has outlived its usefulness" and indicates the need to "move to a single-payer national health insurance program" (Fein, Philadelphia Inquirer, 8/31).
  
  
• Scott Gottlieb, Wall Street Journal: The U.S. health care system "would be in better shape today if more of our political class didn't fall prey to old suspicions that economic reasoning only worsens clinical outcomes," Gottlieb, a physician and resident fellow at the American Enterprise Institute, writes in a Journal opinion piece. According to Gottlieb, the Obama health care proposals would "create a federally run health care plan that would take patients out of private insurance and into a centrally planned health care program" and implement the "kinds of prescriptive mandates on covered services that have been a hindrance to community health clinics." He adds, "Yes, Mr. Obama has pointed to public and private clinics as a way to extend coverage, and he recently co-sponsored the Senate's 'Access for All America Act' that aims to expand support for the clinics." However, Gottlieb writes, the "bill contains the usual fare of requirements thrust from Washington onto local health care providers" (Gottlieb, Wall Street Journal, 9/2).
  
  
• Colbert King, Washington Post: The possibility that some voters who supported former Democratic presidential candidate Sen. Hillary Rodham Clinton (N.Y.), "angered by her defeat" in the primaries, might vote for McCain in the general election "makes about as much sense as swallowing hemlock," as "nothing in McCain's record" indicates that he supports her positions on health care and other issues, Post columnist King writes. He writes, "While Clinton was fighting for Medicare prescription drug coverage, McCain consistently voted against it, at least 28 times." In addition, Clinton "has been a tireless fighter for universal health care," King writes, adding, "McCain, on the other hand, has a plan that will jack up health care costs and leave some Americans with no health care coverage at all" (King, Washington Post, 8/30).
  
  
• Robert Samuelson, Newsweek: "By all rights, we should be having a fierce debate over the role of government" in health care and other issues in the presidential campaign, but "instead, and not surprisingly, we have a bidding war between candidates to see who can promise the most appealing package of new spending programs and tax cuts," columnist Samuelson writes in a Newsweek opinion piece. He adds, "Barack Obama and John McCain emit pleasing slogans and programs that, as often as not, are disconnected from the country's actual problems," such as spending on Social Security, Medicare and Medicaid (Samuelson, Newsweek, 9/1).

Broadcast Coverage
NPR's "On The Media" on Friday reported on the new national television advertising campaign that features "Harry and Louise" and seeks to promote health care in the presidential election (Mogul, "On The Media," NPR, 8/29).

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.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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