The Democratic presidential candidates rolled out their healthcare reform plans months ago. But the healthcare system is so complex that voters are having a hard time sorting through the advantages and disadvantages of the different proposals. New Hampshire Public Radio?s Raquel Maria Dillon reports.
New Hampshire Democrats consistently list healthcare as one of their top campaign issues. And the candidates have responded by plugging their healthcare proposals every chance they get.
Emory University health policy professor Ken Thorpe says most of the Democrats take an incremental approach.
THORPE :18 what these programs are doing is saying we know that healthcare costs a lot and we want to reduce costs. The programs then are focusing on existing plans -- Medicaid, Chip ? not reinventing the wheel, there?s nothing really new here. They?re using those as vehicles for the federal government to expand coverage.
As a physician, former Governor Howard Dean early on put healthcare at the center of his campaign. On the campaign stump, he talks a lot about his record of expanding coverage in Vermont and his early-childhood development program called ?Success by Six.?
DEAN :20 if we can do that in a small rural state, surely the most powerful nation on the face of the earth can join the British, the French, the Germans, Japanese, Irish, Italians, Israelis, Canadians, Danes, Dutch, Swedes, Norwegians, even in Costa Rica they have a health insurance benefit. And we should too! FADE APPLAUSE
Dean says his program would cost 932 billion dollars over the next 10 years and cover 30 million Americans.
Massachusetts Senator John Kerry wants to let individuals buy into the Federal Employees Health Benefit Program. He also includes several cost control measures in his healthcare plan.
KERRY :23 I take every catastrophic case off your backs. if the federal government is paying for every case $50K or more. All of a sudden, everybody?s premiums have been lowered because the risk they?re paying for is capped. By capping that risk I lower the premiums by $1000 or more.
Kerry hopes to insure 27 million Americans, including almost all children, for a cost of almost 900 billion dollars over the next decade.
Connecticut Senator Joe Lieberman wants to establish a new federal research institute called the Center for Cures to explore new treatments for chronic diseases. His healthcare plan he says would expand existing programs to cover 32 million people for 750 billion dollars.
Retired General Wesley Clark offered his plan to doctors and healthcare workers at the Dartmouth-Hitchcock Medical Center a couple weeks ago.
CLARK :10 one of the more important steps we can take to bring medicine in America into the 21st century is to reorient our healthcare system toward value, accountability, and prevention.
Clark would mandate coverage for all children and college students and provide tax credits to needy families. He says his plan would cover 32 million people who were previously uninsured and cost almost 700 billion dollars over the next ten years.
North Carolina Senator John Edwards? plan would also require parents to insure their children, and give tax credits to families who aren?t able to. It would cost almost 600 billion dollars and cover 22 million previously uninsured individuals.
Health policy expert Ken Thorpe says many of the candidates? proposals focus on vulnerable populations where early prevention can make a difference.
THORPE :22 there are 11M children without health insurance. Two of candidates would actually mandate that parents would have to provide insurance for them. That?s Clark and Edwards. Sen. Lieberman also has a proposal that would enroll all kids in country into health insurance plan as well.
Most candidates also talk about negotiating with pharmaceutical companies for cheaper prescription drugs and increase the number of people going into nursing to relieve shortages at hospitals and clinics.
Analysts note that under the Dean, Kerry, or Lieberman plans, there?s an option to further expand programs to cover all of the estimated 40 million uninsured Americans ? if there?s enough money.
Thorpe says Ohio Congressman Dennis Kucinich takes an entirely different approach. Kucinich calls for universal healthcare coverage based on the Canadian model.
KUCINICH :16 private for-profit healthcare is pricing people out of the care they need. For example in NH, Anthem purchased Blue Cross-Blue Shield for $15B. That money came right from their subscribers and they turned around and raised their rates.
Implementing that the program would cost an estimated 200 billion dollars in fiscal year 2005. Kucinich would fund his plan by increasing the payroll tax to almost 8% over several years. But he says a single-payer plan would save money with lower administrative costs.
The cost of these plans ranges from 6 to 900 million dollars. Thorpe says most of them look to the same pot of money to pay for it.
THORPE :18 collectively the democrats have said that they want to make substantial investments in reforming our healthcare system. And they would do that by repealing all or part of the tax cuts that have been put on the table. they would not enact some of the tax cuts that have already be voted on, or they would simply repeal them.
Healthcare advocates say any new proposal is an improvement on the status quo. Ellen Golombeck is executive director of Americans for Healthcare.
GOLOMBECK :15 if we don?t do something more and more people will become uninsured. Pressure on state budgets will become insurmountable as Medicaid costs continue to climb as people become uninsured. This is kind of a snowball rolling downhill.
Sorting out the healthcare plans is complicated. To make it easier several non-partisan organizations have published side-by-side comparisons. You can find website links on New Hampshire Public Radio?s website nhpr.org.
For NHPR News, I?m RMD.
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