The Politics of Healthcare

By: Dan Weiman for Body1

There are now only three viable candidates for the presidency, Democrats Hillary Clinton and Barack Obama, and Republican John McCain. As has been the case for the last 20 years, the regulation of healthcare will play a big role in how voters pick their candidate for president. There are currently 47 million uninsured Americans. Because these people do not have health insurance, emergency room visits are often the only way they can receive healthcare. The cost of an emergency room visit is often very high, and can not only bankrupt the patient, but also costs hospitals millions of dollars per year in uncollected fees.

The current conditions in the healthcare industry have led the Democratic candidates to call the situation a full-blown crisis, while the Republican candidate John McCain has emphasized concern for the rising cost of healthcare. All three have laid out detailed plans for how to reform the industry to correct some of the problems within the system and to lower the overall cost to the country and to individuals.

Being from the same side of the aisle, it is natural that Hillary Clinton and Barack Obama have similar views on the steps that should be taken in order to reform healthcare. Both plan to create a new pool of revenue for healthcare primarily by repealing the Bush tax cuts and taxing employers that do not provide healthcare for their employees. The income brought in would then go to a healthcare pool that would provide expansion of public health programs such as Medicaid, Medicare, S-CHIP, and the Federal Employee Health Benefits Program, which is the plan that members of Congress are offered. To counteract some of the cost to employers, there would be tax cuts for small businesses that offered their employees insurance. For residents that make more money than would qualify for Medicaid or S-CHIP, both plans include subsidies and tax credits to help with the high cost of premiums.

Both candidates call their plans “Universal Health Care,” but what exactly does that mean? Both plans would call for laws banning insurance companies from denying clients coverage due to pre-existing conditions. Advocates of the plans argue that those with chronic illnesses have extreme difficulty finding a private insurance company that will cover them. Others complain that the criteria private insurance companies use for a pre-existing condition is so rigorous that even those that are relatively healthy could have problems with their insurance company.

Where Sen. Clinton argues that her plan is in fact more “universal” is in her mandated coverage law. Along with all of the reforms her plan offers, she contrasts with Obama in that her plan mandates that everyone in country have a form of health insurance. In other words, those that do not qualify for Medicaid or Medicare would have to purchase a health insurance plan, whether it is from the private sector or the government. Sen. Clinton argues that this is necessary in order to cut down on unnecessary emergency room costs that can reverberate throughout the entire healthcare system.

Sen. Obama’s healthcare plan does not include a mandate for everyone, but does require that children have health insurance. Sen. Obama claims that his plan will actually lower the cost of healthcare a bit more than Clinton’s and thus healthcare will be available and more affordable to anyone who chooses to purchase it. Much has been made by the candidates over this difference in their respective plans, but in truth their plans are actually almost entirely similar with the exception of this one caveat.

Although differing fundamentally on how to reform the healthcare industry, the Republican candidate Sen. John McCain agrees that the rising cost of healthcare is a problem the country must face. Like Sens. Obama and Clinton, McCain believes preventative medicine can save the country money spent for healthcare costs. However, McCain does not advocate government programs or expanding government coverage; instead, he believes that families should be encouraged to teach their children about health risks.

Fundamentally, McCain believes costs can be brought down through increased national competition of private insurance companies as well as citizen initiatives. Instead of the tax cuts that Sens. Clinton and Obama offer for businesses that provide health insurance, McCain is in favor of giving a $2,500 tax credit for individuals and $5,000 credit for families to purchase their own health insurance independent of their employer. Sen. McCain’s plan does not offer any expansion of government funds for Medicaid or any additional government programs that are designed to supplement low-income earners who cannot afford health insurance. McCain’s principles are grounded in a fiscally-conservative philosophy, which means that government involvement and spending would be minimal.

Whoever is elected president will not simply be able to implement his or her plan without opposition. If Sen. McCain is elected, the Democratic congress will likely press him for more spending and government regulation in trying to fix what many see as a broken healthcare system. If one of the Democrats is elected, not only will they face opposition from the congressional minority Republicans, but there will also be questions among Democrats over whether Sen. Clinton’s plan for a mandate is feasible, or conversely if Sen. Obama’s lack of mandate is fiscally prudent. Whatever the outcome of the election, healthcare will likely remain a point of political controversy which will be in constant evolution.

Last updated: 07-Mar-08