The Presidential Candidates on Health Care

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The 2008 Presidential Candidates on Health Care

WASHINGTON (By Farhana Hossain, NYTimes) July 6, 2007 — Presidential candidates in both parties are promising to overhaul the nation's health care system and cover more — if not all — of the nation's uninsured. In 2005, 44.8 million people — 15.3 percent of the population — were without health insurance, according to estimates released by the Census Bureau in March. The leading Democrats are competing among themselves over who has the better plan to control costs and approach universal coverage. The Republicans, for the most part, are promising to expand coverage without increasing the role of the federal government, and reduce cost through tax incentives. Most of the candidates have not presented a detailed outline of their health care plans, but here is what they have said so far.
DEMOCRATS	PROPOSAL TO EXPAND COVERAGE	PAYING FOR ADDITIONAL COSTS

Joseph R. Biden Jr. Democrat	IMMEDIATELY INSURE EVERYONE UNDER 18 I would move immediately to insure all children under age 18, modernize medical records and provide catastrophic health insurance to lift the burden on the 46 million people who can’t afford coverage. -- Las Vegas Sun, March 23, 2007 WORK WITH STATES TO MOVE TOWARDS UNIVERSAL COVERAGE I think the thing that will get us to total health coverage — health insurance for everybody the quickest — is to do what we did on welfare reform. What we did was we allowed the states considerable flexibility and leeway in reorganizing the system and we underwrote the cost of the poor states in doing it to get work programs going. Do the same exact thing with health care. You have a dozen states, including big ones, that are now passing legislation requiring universal insurance, just like liability insurance. Once you get to a critical mass of 30 to 35 states, you've established a national consensus. … Cherry-pick those elements of the plans. Maybe even give them localized flavor rather than one simple standard that exists that require that there be total complete coverage across the board. -- In New Hampshire, April 14, 2007	END WAR IN IRAQ; ROLL BACK PRESIDENT BUSH'S TAX CUTS FOR THE HIGHEST EARNERS The first two things we could do and we could do it without having to fundamentally change anything other than the president's unneeded tax cut for people making an average of $1.43 million dollars a year in the top one percent. -- In Nevada, April 2007 Eliminate the break for investment on dividends, which is $195 billion. … For $26 billion a year, I can insure every single solitary child under the age of 18 in the United States. … You need start-up dollars. The place I'd start off with is somewhere over $220 billion a year by the tax cuts and ending the war. -- On NBC's "Meet the Press," April 2007



Hillary Rodham Clinton Democrat	HAS PLEDGED TO ENSURE EVERYONE; DETAILS OF THE PLAN TO COME There are three parts to my approach. First, lowering costs for everyone. Second, improving quality for everyone. Third, insuring everyone. -- At George Washington University, May 24, 2007 I think we will move toward requiring employers to participate, the way Massachusetts does, or the way California is considering, and if you don't insure your employees, then you're going to have to pay some kind of a per employee amount into a fund so that everybody can be given insurance. But we're also going to make it possible for us to lower cost. And the reason I haven't sent out a plan and said, 'Well here's exactly what I think we should do,' is because during this campaign, I want the ideas that people have. -- On ABC's "Good Morning America," March 26, 2007	DOES NOT WANT TO PUT MONEY INTO THE SYSTEM WITHOUT CONTROLLING COST FIRST "I hate to put more money into our national health care system until we get the cost down and we have a better system… We've got to get the cost under control. Why would we put more money into a dysfunctional system? . -- On ABC's "Good Morning America," March 26, 2007 HAS OUTLINED A SEVEN-POINT PLAN TO CONTROL COST • Ensure better preventative care • Modernize record-keeping • Streamline care for the chronically ill • Create large insurance pools • Start a "Best Practices Institute" to finance research • Control prescription drug costs • Revise medical malpractice system -- At George Washington University, May 24, 2007



Chris Dodd Democrat	HAS PLEDGED UNIVERSAL HEALTH CARE, SUBSIDIZED BY EMPLOYERS AND THE GOVERNMENT Everyone participates, everyone benefits. All the stakeholders -- individuals, employers, the government -- are involved in coming up with a system here that would make it possible to reduce those numbers of 47 million of our fellow citizens who have no health care to make sure they'll be included. … • Second is prevention alone. Minimum we try to do is see to it to reduce the cost by stopping people from getting ill in the first place. … • Thirdly is building upon the good things we've done already: Forty years of Medicaid and Medicare. I would extend Medicaid to poorer families, 100 percent of poverty; the ones with children, 300 percent of poverty. … • Last is the fourth principle, dealing with technology. … Some $80 or $90 billion could be saved, not to mention the morbidity rates by doing a far better job and utilizing the technology that exists today. -- Presidential Forum on Health Care, March 27, 2007	END WAR IN IRAQ; ROLL BACK PRESIDENT BUSH'S TAX CUTS FOR THE HIGHEST EARNERS If you get rid of these permanent tax cuts to the top one percent of income earners, get the war ended in Iraq that we're spending $2 million a week, $8 million a month, we can provide the resources to really move in this direction. So I would make it a top priority in my administration. I wouldn't want to put a time frame on it because I think it's too important, but for us to get there as soon as possible. -- Presidential Forum on Health Care, March 27, 2007



John Edwards Democrat	REQUIRE EVERYONE TO GET INSURANCE, SUBSIDIZED BY EMPLOYERS AND THE GOVERNMENT What we're going to do is cover every single American, including the 47 million who don't have coverage. We're going to bring down costs for everybody. And for most Americans, we're going to help them pay the cost. It's based on a concept of shared responsibility. In the case of employers, we're going to ask them to do more to either insure all their employees or to contribute to their being insured. The government will help subsidize the health care and create health care markets so we have more competition and deal with issues like preventative care, mental health care, to make sure those kind of things -- chronic care -- are, in fact, being done. And then, finally, for individuals, we're going to make sure they have insurance. They have to have insurance so that everybody has health insurance. -- On NBC's "Meet the Press," Feb. 4, 2007 DETAILED PLAN	ROLL BACK PRESIDENT BUSH'S TAX CUTS FOR THE HIGHEST EARNERS The tax cuts that George Bush gave to people who make over $200,000 a year will have to go away to pay for my health care plan. My universal health care plan costs 90- to $120 billion a year. I do not believe, having spent a lot of time on this, that you can achieve universal health care without--without finding a revenue source, and that's my revenue source. -- Face the Nation, Feb.25, 2007



Mike Gravel Democrat	ISSUE VOUCHERS TO EVERYONE BASED ON THEIR PROJECTED NEEDS Under the plan we would issue vouchers to every single American. And the vouchers, you don't pay for them, they're issued to you. You sign up every year for them. And the vouchers will have a very modest co-pay, a very modest deductible, but that's it. Everybody gets the same product universally in the United States of America. And then if you want more than the product you got, you pay for it. … The vouchers are set up for risk on an individual basis, not on a collective this fits all, because if you're young, you probably don't have a cost of more than $3,000. When you're my age, it could be $150,000-$180,000 in one year. … One of the facets of the plan would be to keep in place Medicare and Medicaid and phase them out over time. Because plans to put everybody on Medicare aren't going to fly financially and just can't be met. -- Presidential Forum on Health Care, March 24, 2007	FEDERAL GOVERNMENT WITH TAXPAYER'S MONEY; CONTROL COST BY MODERNIZING RECORDS All Americans pay for it regardless of the system you have now but the system you're going to get, single-payer Health Care Voucher plan. … There's no magic in this whole process. Somebody is going to pay. You know who pays, it's the average American, one way or the other, particularly under our present system. And so to want to trash the business community and trash our tax system, which is already corrupt, with greater corruption as a way to solve the problem is a nonstarter. … The way the plan is designed, it won't raise costs, because the 30 percent that they're talking about is paper cost. If you took that and put it into some real costs in health care, we'd cover everybody without raising any costs. -- Presidential Forum on Health Care, March 24, 2007



Dennis Kucinich Democrat	ESTABLISH MEDICARE FOR ALL A not-for-profit health care system is not only possible, but H.R. 676, a bill that I introduced, and a number of Congressmen, the Conyers-Kucinich bill, actually establishes Medicare for all, a single-payer system and it's a not-for-profit system. It's time we ended this thought that health care is a privilege. It is a basic right, and it's time to end this control that insurance companies have not only over health care but over our political system. … I'm talking about a real deal for the American people, a universal single-payer not-for-profit Medicare for all. -- Presidential Forum on Health Care, March 24, 2007	REMOVE COSTS RELATED TO PRIVATE INSURERS At least 30% of the $3.2 trillion spent annually for health care in the United States goes to the for-profit system, while 50 million Americans, many of them working, are without health insurance. About $660 billion goes for corporate profits, executive salaries, stock options, advertising, marketing, and the cost of paperwork. If we took all that money and we put it into a public health system, a national health care plan, we would have enough money to cover everything for everyone. -- House floor, July 12, 2006 IMPLEMENT TAXES FOR THE HIGHEST EARNERS AND A PAYROLL TAX (B) Increasing personal income taxes on the top 5 percent income earners. (C) Instituting a modest and progressive excise tax on payroll and self-employment income. (D) Instituting a small tax on stock and bond transactions. -- H.R. 676



Barack Obama Democrat	REQUIRE CHILDREN TO GET INSURANCE; AIMS FOR UNIVERSAL COVERAGE The main disagreement with John [Edwards] and I is John believes that we have to have mandatory insurance for everyone in order to have universal health care. My belief is that most families want health care but they can't afford it. And so my emphasis is on driving down the costs, taking on the insurance companies, making sure that they are limited in the ability to extract profits and deny coverage -- that we make sure the drug companies have to do what's right by their patients instead of simply hoarding their profits. If we do those things then I believe that we can drive down the costs for families. In fact, we've got very conservative, credible estimates that say we can save families that do have health insurance about a thousand dollars a year, and we can also make sure that we provide coverage for everybody else. And we do provide mandatory health care for children. -- CNN debate for Democratic candidates, June 3, 2007 DETAILED PLAN	ROLL BACK PRESIDENT BUSH'S TAX CUTS FOR PEOPLE EARNING OVER $250,000 To help pay for all this, we will ask all but the smallest businesses who don’t make a meaningful contribution today to the health care coverage of their employees to do so by supporting this new plan. And we’ll also allow the temporary Bush tax cuts for the wealthiest Americans to expire. -- University of Iowa, May 29, 2007



Bill Richardson Democrat	REQUIRE EVERYONE TO GET INSURANCE, SUBSIDIZED BY EMPLOYERS AND THE GOVERNMENT No. 1, my plan is mandatory. You do have everybody sharing -- the employer, the employee, you have the state and the federal government. Secondly, I believe that we can have a plan where if you were satisfied with your health care plan, you can keep it. No new bureaucracy. But in addition to that, you focus on prevention. You allow everybody to get the Congressional plan that every member here has.You bring Medicare 55 and over. -- CNN debate for Democratic candidates, June 3, 2007 Our main responsibility should be to insure all children under five. We've done that in New Mexico and we should do that nationally. Secondly, we should insure all working adults, all working families. The third phase would be the chronically unemployed. The way you do that is by improving efficiencies and costs. The way you do that is not have Medicare and Medicaid covering seniors and disabled, it should be one. We should expand the S-Chip [State Children's Health Insurance Program] to cover children. -- A.F.S.C.M.E. forum, Feb. 21, 2007	FORM PARTNERSHIP WITH HEALTH CARE COMMUNITY I would not increase taxes. I believe that, if anything, Democrats have been viewed — our solution is always to increase taxes, and we shouldn't. … I don't think the solution of the Democratic Party should always be to either spend more or tax more. I believe if we have partnerships between hospitals, between communities, between the state, the federal government, and you give flexibility to the states, we can have universal health care. -- A.F.S.C.M.E. forum, Feb. 21, 2007



REPUBLICANS	DETAILS OF THEIR PLANS	PAYING FOR ADDITIONAL COSTS

Sam Brownback Republican	ADVOCATES MARKET-BASED HEALTH CARE; ESTABLISH REGULATORY COMPETITION AMONG STATES We need high-quality, affordable health care for everyone. … We must address our health care problems with market-based solutions, not government-run health care. -- Announcing his candidacy, Jan. 20, 2007 Our health care system will thrive with increased consumer choice, consumer control and real competition. I believe it is important that we have price transparency within our health care system. … Consumers should be able to choose the from health care coverage plans that are tailored to fit their families' needs and values. Accordingly, individuals should be allowed to purchase health insurance across state lines. … I will continue to work at the forefront to create a consumer-centered, not government-centered, health care model that offer both affordable coverage choices and put the consumer in the driver's seat. -- Campaign Web site MORE DETAILS	NOT AVAILABLE



James Gilmore Republican	HAS NOT ADDRESSED THE ISSUE OF HEALTH CARE IN RECENT APPEARANCES; HIS CAMPAIGN WEB SITE DOES NOT ADDRESS THE ISSUE His actions on health care as the governor of Virginia, from 1998 to 2002, can be found here.	NOT AVAILABLE



Rudy Giuliani Republican	ADVOCATES MARKET-BASED HEALTH CARE; MAKE PRIVATE INSURANCE AFFORDABLE THROUGH TAX DEDUCTIONS What I would do is change the whole model that we have for health insurance in this country. The problem with our health insurance is it’s government- and employer-dominated. People don’t make individual choices. It’s your health; you should own your health insurance. We should be giving you a major tax deduction — $15,000 for a family — so you can buy your own health insurance. If you buy health insurance for $8,000 or $9,000, you’ll save $5,000 or $6,000 in tax-free money. Then we should have a health savings account in which you can put some money aside to pay for your ordinary medical expenses. Health insurance should become like homeowners insurance or like car insurance. -- CNN debate for Republican candidates, June 5, 2007	HAS NOT ADDRESSED HOW HE WOULD PAY FOR THE TAX DEDUCTIONS; HAS SAID THAT A FREE-MARKET WOULD BRING DOWN COSTS We need 100 million Americans making different decisions that will bring down the cost of health insurance, it will bring down the cost of prescription medicines. Free-market principles are the only things that reduce cost and improve quality. -- CNN debate for Republican candidates, June 5, 2007



Mike Huckabee Republican	ADVOCATES MARKET-BASED HEALTH CARE; MAKE PRIVATE INSURANCE AFFORDABLE THROUGH TAX DEDUCTIONS AND COST CONTROL MEASURES We don’t need universal health care mandated by federal edict or funded through ever-higher taxes. We do need to get serious about preventive health care instead of chasing more and more dollars to treat chronic disease, which currently gobbles up 80% of our health care costs, and yet is often avoidable. The result is that we’ll be able to deliver better care where and when it’s needed. I advocate policies that will encourage the private sector to seek innovative ways to bring down costs and improve the free market for health care services. … I also value the states’ role as laboratories for new market-based approaches, and I will encourage those efforts. -- Campaign Web site	IMPLEMENT COST CONTROL MEASURES We can make health care more affordable by reforming medical liability; adopting electronic record keeping; making health insurance more portable from one job to another; expanding health savings accounts to everyone, not just those with high deductibles; and making health insurance tax deductible for individuals and families as it now is for businesses. Low-income families would get tax credits instead of deductions. -- Campaign Web site



Duncan Hunter Republican	ADVOCATES MARKET-BASED HEALTH CARE; OPPOSED TO GOVERNMENT-SUBSIDIZED UNIVERSAL HEALTH CARE I am not for universal health care. If everything is paid for by the government, you'll have companies trying to get in and trying to overcharge. And you’ll lose what I call a consumer interest, in keeping the cost of health care down. -- WMUR-TV, April 13, 2007 LET AMERICANS SHOP FOR INSURANCE ACROSS STATE LINES We need to be able to buy our health care insurance across state lines. Right now the same single policy that can be purchased in Long Beach for $73 costs $334 in New Jersey. The states lock up the insurance industry. They won't let Americans buy across state lines just like they do everything else. If we're able to do that, we're going to bring down the cost of health insurance. -- CNN debate for Republican candidates, June 5, 2007	NOT AVAILABLE



John McCain Republican	HAS PLEDGED AFFORDABLE HEALTH CARE FOR EVERY AMERICAN WITHOUT A FEDERAL MANDATE; EXPECTED TO RELEASE A DETAILED PLAN THIS SUMMER I think that we can make health care affordable and available without a mandate. Six of the eight million children that haven’t taken advantage of the S-Chip is because they just haven’t signed up. Community health centers need to be expanded. There’s a whole variety of things that we can do before we mandate health care for every American. One of the problems we have is that there’s a lot of healthy Americans that say, ‘I just don’t want health insurance.’ … I'm going to have a plan that every American can take advantage of and afford. … We're working on it. We've been working on it for a long time. It's a very tough issue, but I know many of the elements right now - tax incentives for people of low incomes so that they can afford health care, community health centers, expand the S-Chip, put health care online, help medical malpractice reform, make health savings accounts more available. I mean, there's a long list of steps that we must take in order to make health care available and affordable. -- On ABC's "This Week," June 10, 2007	SAYS UNIVERSAL HEALTH CARE IS POSSIBLE WITHOUT A TAX INCREASE I'm certainly not interested in raising people's taxes, as many of the Democrats are interested in doing. I'm absolutely opposed to that. -- On "This Week," June 10, 2007



Ron Paul Republican	ADVOCATES MARKET-BASED HEALTH CARE; OPPOSED TO FEDERAL MANDATE It’s time to rethink the whole system. The rise of HMOs has created a harmful collusion between politicians, drug companies, and organized medicine that raises the price of health care by stifling competition between providers. And all this in favor of moving us towards universal health care! … I believe strongly that patients are better served by having an element of choice in the matter, which is why I support letting the free-market determine health care costs. This won’t happen, however, until we unravel the HMO web and change the tax code to allow individuals to fully deduct health care costs from their taxes, as employers can. -- Muckraker Report, June 28, 2007	WANTS TO MAKE HEALTH CARE MORE AFFORDABLE WITHOUT TAX INCREASE Congress needs to craft innovative legislation that makes health care more affordable without raising taxes or increasing the deficit. It also needs to repeal bad laws that keep health care costs higher than necessary. -- LewRockwell.com, August 23, 2006



Mitt Romney Republican	ENCOURAGE STATES TO DEVELOP MARKET-BASED HEALTH CARE PROGRAMS; OPPOSED TO A NATIONAL VERSION OF THE PLAN HE SUPPORTED FOR MASSACHUSSETS AS GOVERNOR OF THE STATE, REQUIRING EVERYONE TO GET INSURANCE I like the idea of letting states have some flexibility to develop their own programs to get more and more people insured. We found a way to get everybody in our state, Massachusetts, insured. I like the plan. I think it's one of the best things we did in my administration. It's not perfect. We will learn from it. But the idea is for people who can afford insurance make sure they get their premiums down by taking mandates off insurance companies. Let the insurance companies offer true market-based products. And then for people who can't afford insurance, help them buy their own private policy. Don't put them on Medicaid. Get them private insurance. Get everybody in the system. It's a bit like bringing work to welfare. Bring personal responsibility to health care. Get the government out of the health care business for those 45 million uninsured, and let individuals own their own policies. -- On Fox News' "On the Record," April 23, 2007	SAYS UNIVERSAL HEALTH CARE IS POSSIBLE WITHOUT A TAX INCREASE It’s a conservative idea insisting that individuals have responsibility for their own health care. I think it appeals to people on both sides of the aisle: insurance for everyone without a tax increase. -- USA Today, July 5, 2005



Tom Tancredo Republican	ADVOCATES MARKET-BASED HEALTH CARE; WOULD NOT RULE OUT FEDERAL SUBSIDIES FOR THE NEEDY As for the uninsured: as many as 25 percent of them are illegal aliens and should be deported or encouraged to leave. For citizens and legal residents who are employed by businesses which cannot afford coverage, I favor association health plans which band small businesses together to access lower-cost insurance. For those out of work, state governments should be the primary source of relief, although I would not rule out federal incentives or limited subsidies to make sure families who have fallen on hard times are not without coverage. -- Campaign Web site	PROPOSES IMMIGRATION REFORM TO CURB COST The two major problems are the high cost of care and the number of uninsured. Tort reform and immigration enforcement would save the system billions and drive down costs. In California alone, illegal immigrants cost the system $800 million annually and have forced 84 hospitals to close. As for the uninsured: as many as 25 percent of them are illegal aliens and should be deported or encouraged to leave. -- Campaign Web site



Tommy Thompson Republican	MAKE HEALTH CARE MORE AFFORDABLE AND ACCESSIBLE WITHOUT FEDERAL MANDATE We must build a system that is affordable and accessible for everyone. And we can do this without government-run health care that robs our great nation of its ingenuity in developing new cures and treatments for deadly diseases. And we can do it only when we take some common-sense steps to bring our health care system into the 21st century. … We must use the private sector and public sector to provide health insurance for all. -- Iowa, April 2007 We've got to completely transform the health care system, make it a wellness system, and make it a prevention system. ...We have 125 million Americans that have one or more chronic illnesses. In order to change this we have to educate the American people about tobacco, about diabetes, about cardiovascular [diseases] and about obesity. You do that, you'll be able to change health care. -- CNN debate for Republican candidates, June 5, 2007	IMPLEMENT MEASURES TO CONTROL COSTS AND SAVE MONEY Twenty five percent of Americans use two-thirds of the cost of health care. If you manage those diseases, you can reduce that down to 50 percent and save lots of money. … Information technology -- electronic medical records, a patient bill of rights, and be able to have E-prescribing, and if you do that, you're going to be able to save billions of dollars. If you just go paperless, ladies and gentlemen, you will save 10 percent of the cost of health . -- CNN debate for Republican candidates, June 5, 2007