Clinton, Obama Continue To Spar Over Health Care Plans

Leading Democratic presidential candidates continued to focus on health care issues and "the question of how 'universal' a coverage plan must be," the Los Angeles Times reports. Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.) have proposed plans that would require all individuals to obtain health insurance, while Sen. Barack Obama (D-Ill.) has proposed such a requirement only for children (Wallsten/Zaldivar, Los Angeles Times, 12/1).

On Saturday at two forums held in Des Moines, Iowa, Clinton said of her health care proposal, "We have to have more cost-effective and higher-quality health care for everyone; I don't want to leave anyone uncovered." In response to a question about the participation of private health insurers under her proposal, Clinton said, "My plan also regulates insurance companies," adding, "They can no longer do business unless they were willing to drastically change the way they treat people." She also criticized Obama for his claims that his health care proposal would provide "universal" health insurance despite the lack of requirement that all residents obtain coverage (Glover, AP/Minneapolis Star-Tribune, 12/2).

She said of his proposal, "It went from universal when I wasn't there to comprehensive when I was on the same stage," adding, "It's obvious that he doesn't want to face up to the very position he took because every time he changes his posture on it, he uses different words to describe it" (Earle, New York Post, 12/3). On Sunday, Clinton told reporters in Cedar Rapids, Iowa, that "you can't get a straight answer" from Obama on health care (Kornblut, Washington Post, 12/3). Patti Solis Doyle, Clinton's campaign manager, called on Obama to stop running a television ad that says his plan would "cover everyone." Doyle said Obama's plan would leave about 15 million of the uninsured uncovered.

On Friday at the fall meeting of the Democratic National Committee in Tyson's Corner, Va., Obama said that his health care proposal would seek to reduce costs and would prove more effective in efforts to expand health insurance than the Clinton plan. According to Obama, "I have put forth a universal health care plan that will do more to cut the cost of health care than any other proposal in this race. If you can't afford health insurance right now, you will be able to afford it when I'm president." He added "Anyone who tells you otherwise is more interested in scoring political points than actually solving the problem." Obama said, "Sen. Clinton is arguing that the only way to get every American covered is if you force every American to buy health care," adding that a lack of detail in the Clinton plan regarding enforcement of the requirement suggests that her criticism of his health care plan "is more of a political point that she's trying to make than a real point" (Los Angeles Times, 12/1).

Democratic Presidential Candidate Clinton Would Consider Garnishing Wages To Enforce Health Insurance Mandate, Advisers Say
Policy advisers for Clinton on Saturday said that she would consider a proposal to garnish the wages of some U.S. residents who can afford health insurance but do not obtain coverage, the Long Island Newsday reports. Under her health care proposal, Clinton would require all residents to obtain health insurance, with subsidized and no-cost coverage provided to those who qualify. Neera Tanden, a policy adviser for Clinton, in a conference call with reporters said that Clinton would consider a proposal to have employers "automatically enroll employees" in health insurance and withhold "parts of their salaries to pay for it." According to Tanden, "these are reasonable steps to enforce a mandate" (Thrush, Long Island Newsday, 12/1).

Edwards Faces Skepticism on Health Care Promise
Former Sen. John Edwards (D-N.C.) on Sunday "faced sharp voter skepticism" over whether he could fulfill his promise to revoke the health insurance of lawmakers in the event that they do not pass legislation to expand coverage to all residents, the Times reports. Edwards acknowledged that he could not take such action unilaterally but said that he would propose legislation to require lawmakers to vote on a bill to expand health insurance to all residents or lose their own coverage.

Edwards said, "I want to see a Republican senator or congressman take the position that they're going to defend their health care and vote against health care for their constituents," adding, "I will make sure every voter in their state knows they are protecting themselves against the interests of the people that they represent. I'm telling you, this will work."

In addition, he criticized Clinton for the involvement of health insurers and pharmaceutical companies in her health care proposal. He said, "If you're sitting at a table negotiating with drug companies about universal health care, you've already lost. It's not the job of the president of the United States to negotiate away what the American people need because these people have money" (Martelle, Los Angeles Times, 12/3).

Clinton Faces Criticism Over Health Care Documents
Clinton is "taking heat" over the release of correspondence between her and her husband, former President Bill Clinton, during their development of a health care reform proposal in the 1990s, the AP/Minneapolis Star Tribune reports. Hillary Clinton said, "My husband has not withheld a single document." She added that the National Archives, which has authority over the documents, "is moving as rapidly as the Archives moves." Bill Clinton said, "I'm not trying to cover anything up" (Sidoti, AP/Minneapolis Star Tribune, 12/3).

Huckabee Takes More Populist Position on Health Care
Populist positions on health care and other domestic issues differentiate former Arkansas Gov. Mike Huckabee (R) from other Republican candidates, USA Today reports. In his campaign, Huckabee has promoted the importance of preventive care and has cited his own loss of 110 pounds, which he has said has allowed him to survive type 2 diabetes (Page, USA Today, 12/3). As Arkansas governor, Huckabee "tapped a deep vein of populism" through his support of SCHIP and his criticism of a proposal from a state lawmaker to deny health care and other public services to undocumented immigrants, the Times reports (Fausset, Los Angeles Times, 12/2).

Opinion Pieces

• Merrill Matthews, Wall Street Journal: Allegations by Clinton that health insurers spend $50 billion annually to avoid payment of claims "raise real questions about Sen. Clinton's grasp of the facts" and are "part of a broader effort by the left to disparage the private-sector health insurance industry as wasteful and inefficient, meanwhile claiming that there would be great savings if the government covered more people," Matthews, executive director of the Council for Affordable Health Insurance and a resident scholar for the Institute for Policy Innovation, writes in a Journal opinion piece. Government "regulation is one of the primary causes of high health insurance costs," and states that have the most coverage mandates "have significantly higher premiums than the less-regulated states," he writes. According to Matthews, the "best way to get past third-party claims adjudication is to move toward a system where patients, in consultation with physicians, do most of the monitoring themselves." He adds, "That is what does happen when people use health insurance only for major expenses, paying smaller bills out of a tax-free" health savings account or health reimbursement account (Matthews, Wall Street Journal, 12/1).
  
  
• George Will, Washington Post: "Edwards' health care proposal involves un-Jeffersonian bossiness" in his requirement that all residents obtain preventive care, Post columnist Will writes. In addition, in a television advertisement launched in Iowa, Edwards "brandishes his mailed fist at Congress, to which he vows to say: 'If you don't pass universal health care by July of 2009, in six months, I'm going to use my power as president to take your health care away from you,'" Will writes. "What power enables presidents to 'take' health care from people who have it by statute?" Will writes, adding, "This is the Democrats' riposte to the grandiosity of the current president's notion of executive prerogatives?" (Will, Washington Post, 12/2).

Broadcast Coverage
CBS' "Face the Nation" on Sunday included a discussion with David Axelrod, chief strategist for the Obama campaign, and Howard Wolfson, communications director for the Clinton campaign, about the health care proposals of the candidates and other issues (Schieffer, "Face the Nation," CBS, 12/2). Video of the segment is available online.

NPR's "All Things Considered" on Saturday reported on criticism from Clinton about the Obama health care proposal and criticism from Obama about the Clinton and Edwards plans. The segment includes comments from Clinton and Jonathon Oberlander, an associate professor in the Department of Social Medicine at the University of North Carolina (Rovner, "All Things Considered," NPR, 12/1). Audio of the segment is available online.