Democratic Presidential Candidate Obama Reaches Number of Delegates Needed To Secure Nomination

Democratic presidential candidate Sen. Barack Obama (Ill.) on Tuesday secured an adequate number of delegates to become the presumptive nominee, the Washington Post reports (Balz/Kornblut, Washington Post, 6/4). Obama also won the Montana Democratic primary with 57% of the vote, compared with 41% for opponent Sen. Hillary Rodham Clinton (D-N.Y.).

Clinton won the South Dakota primary with 55% of the vote, compared with 45% for Obama (CNN.com, 6/4). In a speech to supporters, Clinton said she would continue her efforts to expand health insurance to all U.S. residents. She said, "It is a fight I will continue until every single American has health insurance. No exceptions and no excuses" (Kuhnhenn/Fouhy, AP/Houston Chronicle, 6/3). ). In a rally last night, Obama said, "And you can rest assured that when we finally win the battle for universal health care in this country -- and we will win that fight -- [Clinton] will be central to that victory" (CNN.com, 6/4).

According to an exit poll, 15% of Montana Democratic primary voters cited health care as their most important issue in the election, compared with 49% who cited the economy and 31% who cited the war in Iraq. Fifty-three percent of Montana Democratic primary voters who cited health care supported Obama, and 44% favored Clinton, the poll found.

In South Dakota, an exit poll found that 15% of Democratic primary voters cited health care as their most important issue in the election, compared with 56% who cited the economy and 26% who cited the war in Iraq. Among South Dakota Democratic primary voters who cited health care, 63% supported Clinton, and 37% favored Obama, the poll found.

The exit polls, conducted by Edison Media Research and Mitofsky International, included responses from 1,312 Democratic primary voters in Montana and 1,166 voters in South Dakota (CNN.com, 6/4).

Economists Discuss Health Care Proposals
A panel of economists on Tuesday at a briefing hosted by the Alliance for Health Reform and the Robert Wood Johnson Foundation discussed the health care proposals of the major presidential candidates, CQ HealthBeat reports. According to the panel, the proposals could address some problems with the health care system, although their effects on costs remain undetermined.

Uwe Reinhardt, an economics professor at Princeton University, said, "Most of us would favor (some of the stipulations of the presidential health care proposals), but, if you give us a truth serum, most of us would say that whether it saves dollars per year is not so clear." He added that the proposals would not address some of the major causes of increased health care costs.

Mark McClellan of the Brookings Institution said that reporters should continue to ask candidates about their proposals to finance their health care plans. According to McClellan, although Obama and Clinton have proposed to eliminate tax cuts proposed by President Bush and approved by Congress for households with annual incomes greater than $200,000 to help finance their health care plans, that proposal would not provide significant funds because the cuts will expire in early 2009.

McClellan said that presumptive Republican nominee Sen. John McCain (Ariz.) has offered a more realistic estimate of the cost and plan to finance his health care proposal than Obama and Clinton have offered for their plans. "This is the first time I can remember a Republican candidate not proposing anything new as far as subsidies," McClellan said. In addition, Reinhardt called McCain the "true radical in this among these three" because of his proposal to replace a "sacred" tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families for the purchase of private coverage (Cooley, CQ HealthBeat, 6/4).

A webcast of the forum is available online at kaisernetwork.org.

Opinion Pieces
Summaries of several opinion pieces related to health care in the presidential election appear below.

• Bruce Bodaken, San Francisco Chronicle: Efforts to expand health insurance to all residents of California and Massachusetts "indicate a changing dynamic in which health plans can be a valuable ally of coverage expansion advocates," and "federal policymakers would be making a big mistake if they wrote off the health insurance industry in those deliberations," Blue Shield of California CEO and Chair Bodaken writes in a Chronicle opinion piece. Bodaken writes that health insurers supported the state efforts because "we recognize better than anyone the inconvenient truth that the system as it exists today is failing" and because "state policymakers adopted a cooperative approach that acknowledges our legitimate concerns." He concludes, "If we start the debate in a defensive crouch, we might just end it flat on our backs," but, "if we extend a hand of cooperation, it is likely to be grasped" (Bodaken, San Francisco Chronicle, 6/4).
  
  
• Marie Cocco, Indianapolis Star: "More than halfway through a political season" in which "public concern about America's porous, confusing and costly health insurance system" has "consistently emerged" as a main concern for voters, "this is what we can expect when the next president takes office next year: not so much," syndicated columnist Cocco writes in a Star opinion piece. Neither Obama nor McCain has "pledged to cover all of the 47 million uninsured Americans," and neither has proposed to make health care "more fair and equitable by putting everyone in a pool in which risks are shared" among all residents, Cocco writes. She concludes that, "if Obama wins" the presidential election, Democrats "will have squandered the best opportunity in more than a decade to take a bold leap toward the universal coverage Democrats have promised since the presidency of Harry Truman" (Cocco, Indianapolis Star, 5/31).
  
  
• John Gage, Arizona Daily Star: "With 1.6 million American heroes returning from Iraq and Afghanistan, never has it been more urgent to strengthen the veterans' health care system," but McCain, a veteran who "should be leading the charge," is "doing the opposite," Daily Star columnist Gage writes. McCain has voted against increased funds for health care for veterans from 2004 to 2007, Gage adds. In addition, a proposal by McCain to "abandon the Veterans Health Administration" and provide veterans with a card that allows them to receive treatment from private health care providers would result in a "disaster," Gage writes. According to Gage, the proposal would "direct veterans outside the VHA (and often into HMOs), where they will face worse care and (along with taxpayers) higher costs." He writes, "Any candidate who is serious about supporting our veterans should build on the VHA's innovations and achievements, end underfunding and understaffing, and expand its capacity to meet the new demand" (Gage, Arizona Daily Star, 6/3).
  
  
• Paula Hall, Seattle Post-Intelligencer: "Election day is not the end game" for the health care and other proposals of the presidential candidates because the "real change we want and need will come only when we hold elected leaders accountable to the standards and promises they make on the campaign trail," guest columnist Hall writes in a Post-Intelligencer opinion piece. She writes, "You wouldn't invest in the stock market and then ignore the returns. It's the same concept with politicians. If we do not continue our phone calls, lobby-day visits and our collective actions, we can't expect to see our government rebuild the middle class, secure affordable health care for all and ensure all workers have the freedom to unite for a voice on the job" (Hall, Seattle Post-Intelligencer, 6/2).
  
  
• David Hill, The Hill: "The boardroom of Big Tobacco must be abuzz these days over the prospect of the Oval Office again becoming a smoke-filled room," as Obama "may be their next (or last) best hope to make smoking fashionable again," Hill, director of polling firm Hill Research Consultants, writes in an opinion piece in The Hill. "I'd imagine everyone with children would be horrified" by a president who smokes, Hill writes, adding, "It's bound to be demoralizing" to NIH, CDC and groups that seek to reduce smoking rates. Hill adds that, because "minorities and lower-income voters are some of the toughest sales when it comes to tobacco-control ballot measures, like for higher cigarette taxes," these "last holdouts from the common sense of smoking cessation may resist more than ever" in the event that Obama wins the presidential election and "persists in sneaking smokes." He concludes, "I won't speculate as to whether Obama is still smoking behind closed doors or hopelessly addicted to those substitute nicotine lozenges," but neither "is acceptable in a president" (Hill, The Hill, 6/3).