Nurses, Clinicians Talk About Primary Candidates' Healthcare Plans

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Web resources:

• Primary 2008 Presidential Candidates' Health Plan Summaries

(Zoom zoom main street)

The Avis Goodwin Community Healthcare Center sits on the main street in the center in Rochester.

The non-profit relies on private and government grants to keep its doors open to patients from all walks of life.

(Dental Sounds)

Inside the clinic, a dentist drills into the molars of an uncomplaining 8-year-old.

(Dentist's drill and voices)

Out in the lobby, Sandra Lane waits for her son to come back from his visit.

He’s covered by the State Children's Health Insurance Program - or SCHIP.
But Lane, who works for a small optics firm, doesn’t have her own health insurance.

“It's very frustrating for me because I've always worked my husband and I have both worked very very hard all of our lives and to not have health insurance uhm is frustrating to us the last program I looked at was to the tune of $1,800 dollars a month for a family of three and that's far beyond our budget.”

So it's not a surprise that Lane will have healthcare in mind when she votes in the presidential primary.

“I've been a fan of Hillary's for a very long time and when I heard she was running I got quite excited. Uhm I haven't made a final decision yet, but I'm really leaning towards Hillary Clinton - basically for her program for healthcare.”

And that sentiment follows the results of a national Kaiser Foundation poll.

It found that over a third of Democrats feel that Hillary Clinton focuses more on healthcare issues than do other candidates.

And more Democrats said that Clinton’s healthcare views were closer to their own than those of other candidates.

Clinton’s healthcare plan does call for universal coverage.

“Americans will have access to the same choices that members of Congress do and if we get more people into this congressional plan that offers what I call the health choices menu…ah The cost of coverage will drop because the more people that can bargain for the coverage the lower the coverage costs will be.”

Most of the Democratic candidates promise to cover all Americans -- one way or another.

And many of them propose paying for it, at least in part, by rescinding President Bush’s tax cuts.

John Edwards was first to release his plan.

“I will walk out on the white house lawn and say to America ‘We Need Universal Healthcare.’ I’ll explain why – to cover everybody and bring down costs for everybody.”

And others followed, including Barack Obama:

“I believe that by the end of my first term we will have universal healthcare system instituted in this country.”

And Chris Dodd:

“I believe in a very universal program here where every single American is included.”

Plans proposed by Bill Richardson, Mike Gravel, and Joe Biden also include universal coverage.

But Dennis Kucinich stands alone as the only candidate calling for a universal single-payer system financed by the government – but delivered privately.

He says that private insurance companies play a significant role in driving healthcare costs up.

“What other candidates are talking about is universal health for insurance companies to have the government subsidize insurance companies. I’m saying that’s wrong I’m saying that its time for not for profit system where you get the insurance companies out of the equation.”

The various plans are similar in many ways, but there are some key differences.

Clinton's healthcare plan would allow people to choose between government and private plans – regardless of whether they already have insurance.

Obama and Edwards, on the other hand, would limit government options to those who don’t have access to other insurance policies.

Edwards, Chris Dodd, Bill Richardson and Clinton call for individual mandates – requiring all Americans to enroll in a health plan to bring costs down.

Obama, who estimates that his plan will cost nearly $40 billion less than those proposed by Clinton and Edwards, would mandate coverage only for children.

And all the Democrats promise to bring healthcare costs down.

Some propose tax credits and subsidies for people who buy their own insurance.

Other proposals include use of electronic medical records, preventative care incentives, taxing employers who don’t offer coverage – and expansion of Medicaid, SCHIP and Medicare.

And most say they’d allow the federal government to negotiate with drug companies.

Certainly – there are more similarities than differences.

But Jannell Levine, the only registered nurse at the Avis Healthcare Center in Rochester, points out that insured patients also struggle to get the care they need.

She says she spends too much time on the telephone with insurers trying to get procedures authorized for patients who think they are covered for them.

“Oh a lot of time. A lot on the phone sometimes as much as an hour for a prior authorization, which when we have patients in and out all day with 60 to 70 phone calls in a day plus doing refills and shots and immunizations..I mean having time to do these prior authorizations by itself is challenging never mind actually getting the authorization.”

Levine is leaning toward a vote for Clinton.

She feels that the senator is more likely to push reforms through - including those that make it easier for patients to get the care they need.

Most of the candidates list various insurance industry reform measures in their plans.

Edwards and Clinton say they’ll require insurers to spend more on patient care and less on administration.

And most of the Democratic candidates promise that insurers won’t be allowed to discriminate against people with pre-existing conditions.

Still, patient advocate Megan Atkins feels that the issues don’t stop at insurance reform and universal coverage.

She says even with Medicare, some seniors go without essential services.

“When people get older especially since they haven't been receiving dental care they often come in when they need dentures and dentures are running at $600-$700 dollars -- and they can't afford that.”

And one of the clinic’s social workers, Pam Parks, says that the situation is dire for low income patients who need to see mental health specialists.

“You know people with schizophrenia they have nowhere to go there are a few mental health centers around, but it's self-pay, it's insurance, and a lot of them don't have it so they're now on the streets, they're being arrested, and jails are handling that problem and they're not equipped to handle that either.”

Parks plans to vote for Hillary Clinton.

She feels the senator has done more homework on issues such as mental health.

But Atkins, the patient advocate, thinks that Obama has proven his commitment to the same issues.

So he has her vote.

For NHPR News, I'm Dianne Finch.