Presidential Nominees Discuss Health Care, Economy, Other Issues at Debate

Democratic presidential nominee Sen. Barack Obama (Ill.) and Republican presidential nominee Sen. John McCain (Ariz.) on Tuesday during a debate at Belmont University in Nashville, Tenn., discussed their proposals for health care, the economy and other issues, the Wall Street Journal reports (Meckler/Cooper, Wall Street Journal, 10/8).

McCain Comments
"I want to give every American a $5,000 refundable tax credit," McCain said of his health care proposal, which would replace an income 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 who purchase of coverage through their employers or the individual market. "They can take it anywhere, across state lines. Why not? Don't we go across state lines when we purchase other things in America?" (AP/Kansas City Star, 10/7).

He criticized part of the Obama proposal that would require employers to offer health insurance or pay a percentage of their payrolls into a federal fund to provide coverage, with an exemption for small businesses (Kiely/Jackson, USA Today, 10/8). In addition, he said that the proposal would fine parents who do not obtain health insurance for their children and that Obama has not announced the amount of such fines (AP/Rocky Mountain News, 10/7). Obama "starts saying, government will do this and government will do that, and then government will, and he'll impose mandates," McCain said. He added, "If you're a small-business person and you don't insure your employees, Sen. Obama will fine you. Will fine you. That's remarkable. If you're a parent and you're struggling to get health insurance for your children, Sen. Obama will fine you" (AP/Kansas City Star, 10/7).

Obama Comments
Obama said of his plan, "If you've got a health care plan that you like, you can keep it," adding, "All I'm going to do is help you to lower the premiums on it." He said, "Small businesses are not going to have a mandate. What we're going to give you is a 50% tax credit to help provide health care for those that you need. Now, it's true that I say that you are going to have to make sure that your child has health care" (AP/Kansas City Star, 10/7).

Obama said that the McCain proposal would prompt employers to drop coverage for workers (USA Today, 10/8). He also criticized part of the proposal that would allow the purchase of health insurance across state lines (AP/Rocky Mountain News, 10/7). Obama said, "The reason that it's a problem to go shopping state by state, you know what insurance companies will do? They will find a state ... where there are no requirements for you to get cancer screenings, where there are no requirements for you to have to get pre-existing conditions, and they will all set up shop there" (AP/Kansas City Star, 10/7). Obama added that McCain "voted against the expansion" of SCHIP (AP/Rocky Mountain News, 10/7).

In response to a question about whether health care is a privilege, a right or a responsibility, Obama said that he considers health care a right for all U.S. residents. McCain said that he considers health care is a responsibility but does not support government mandates (Schmall, "Trailwatch," Forbes, 10/7).

Accuracy of Statements Examined
The AP/Boston Globe and the New York Times, among other newspapers, on Wednesday examined the accuracy of statements on health care and other issues that Obama and McCain made during the debate. According to the AP/Globe, both Obama and McCain "stretched facts, sometimes past the breaking point ... and misrepresented each other's position on health care" (Kuhnhenn/Woodward, AP/Boston Globe, 10/7). Both Obama and McCain "mischaracterized elements of their opponent's health care proposals and may have oversold their own," the Times reports (Sack, New York Times, 10/8).

Editorial
Obama during Tuesday's debate "showed again ... that he sure is comfortable with the status quo on health care" and "continued his recent assaults on John McCain's health reform even though it is precisely the kind of plan that someone of Mr. Obama's professed convictions ought to support," a Wall Street Journal editorial states. Obama says McCain's plan "would amount to 'taxing your health care benefits for the first time in history,' which is a wild distortion," according to the editorial. "His point seems to be that because companies wouldn't have to pay for health care, they could raise wages and thus taxes would also increase for workers on those higher incomes," the Journal states. However, "[a]ll in all, workers would come out ahead with the McCain plan," and it is "fairer that the status quo, which subsidizes the most expensive employer (and union) insurance plans," the editorial states. The Journal writes that the "Obama plan is all about expanding government health care," but the "inevitable result as spending explodes would be price controls and rationing." The editorial concludes, "On choice, portability, quality and especially equity, the McCain health plan is far superior to Mr. Obama's," adding, "The Democrat is merely offering Canada on the installment plan" (Wall Street Journal, 10/8).

Opinion Pieces

• Stuart Butler, New York Times' "Campaign Stops": Butler, vice president for domestic policy at the Heritage Foundation, writes in a Times' "Campaign Stops" opinion piece that he agrees "with the need to restructure insurance to ensure that all Americans have access to affordable coverage," adding, "Retargeting today's inequitable and regressive tax breaks for health care, which Mr. McCain wants to do and Mr. Obama doesn't is needed to help the low-paid and uninsured. But insurance reform is also needed." Butler continues that he supports "exchanges at the state level, not at the national level" because "getting the details of the design right is no easy task and state-level experimentation would be an ideal way to do that" (Butler, "Campaign Stops," New York Times, 10/7).
  
  
• Ezekiel Emanuel, New York Times' "Campaign Stops": McCain "wants to open up the health insurance market to 'vigorous nationwide competition,'" Emanuel, chair of the department of bioethics at NIH, writes in a Times' "Campaign Stops" opinion piece. However, he adds that such an approach "suffers from three major defects": insurers charge in relation to a person's health, individual health insurance policies "typically cover less than employer-based insurance and usually have higher deductibles" and copayments, and "insurers' administrative costs in the individual market are substantially higher because, when the sales are to each individual separately, there is more underwriting and no economies of scale." According to Emanuel, "One way to solve these problems is to have 'insurance exchange' in which a variety of insurers would offer the same benefits at a fixed price and have to take all comers, while being paid more if they enrolled sicker patients (risk adjustment)." He writes, "One of the key ways the insurance exchanges can work to reduce costs is to have a basic package, and, if people want more services, they could decide whether to buy them" (Emanuel, "Campaign Stops," New York Times, 10/8).
  
  
• Arthur Garson, Christian Science Monitor: "The next president, whoever that is, should start" overhauling the U.S. health care system "by appointing a group made up of those responsible for wasting our dollars" through inefficiencies -- including health care providers, insurers and pharmaceutical companies, as well as members of Congress and the administration -- "to examine ways to save and then implement them," Garson -- executive vice president, provost and former dean of the School of Medicine at the University of Virginia -- writes in a Monitor opinion piece. According to Garson, "It could take five years to generate savings, so we have no time to lose." He concludes, "When we save this money and figure ways to apply it to the uninsured, we will have a long-term superwin: better competitiveness and health care for all" (Garson, Christian Science Monitor, 10/8).
  
  
• Michael Gerson, Washington Post: Contrary to the claims made by Obama and Biden, McCain's tax credit proposal "would help all individuals and families purchase coverage" and "result in a significant tax cut for nearly everyone," Post columnist Gerson writes. He continues that McCain's plan "goes to the root of the problem -- a system that depends mainly on businesses to provide health coverage," which "leaves many workers afraid to change jobs, ... discriminates against the self-employed and places unique burdens on small businesses." According to Gerson, to provide a "genuine alternative [to Obama's proposal], Republicans should ... make the ownership of private health insurance an entitlement." Gerson concludes, "Universal Medicare is a frightening prospect," but it may be "unavoidable unless Republicans can counter the rallying cry 'health care for everyone' with a simple and superior alternative: 'Health insurance for everyone'" (Gerson, Washington Post, 10/8).
  
  
• Adrienne Washington, Washington Times: Neither Obama's nor McCain's health care plan "comes cheap, though they certainly cost less than the $700 billion-plus government bailout for Wall Street, Washington Times columnist Washington writes. She adds, "Voters want to know what the next president plans to do about rising health costs and the inaccessibility of quality health care," and people should "[p]ay attention" when the candidates discuss their health care plans because the proposals "are decidedly different" (Washington, Washington Times, 10/8).

Broadcast Coverage

• ABC's "World News" on Tuesday included debate analysis conducted by ABC Chief Washington Correspondent George Stephanopoulos that included comments about health care (Stephanopoulos, "World News," ABC, 10/7).
  
  
• CBS' "Evening News" on Tuesday included an analysis of the effect that the Obama and McCain health care proposals would have on small businesses. The segment includes comments from small-business owners and their customers (Hughes, "Evening News," CBS, 10/7).
  
  
• NBC's "Nightly News" on Tuesday included a debate analysis conducted by NBC political analyst Mike Murphy and Democratic strategist Bob Shrum (Williams, "Nightly News," NBC, 10/7).
  
  
• NPR's "Morning Edition" on Wednesday included coverage of the debate (Liasson, "Morning Edition," NPR, 10/8).
  
  
• NPR's "Talk of the Nation" on Tuesday included a discussion about what three NPR reporters hoped that Obama and McCain would discuss during the debate. The reporters included congressional correspondent David Welna, health policy correspondent Julie Rovner and education correspondent Claudio Sanchez ("Talk of the Nation," NPR, 10/7).
  
  
• WAMU's "The Diane Rehm Show" on Tuesday included a discussion about the Obama and McCain health care proposals. The segment includes comments from Leonard Burman, a senior fellow at the Urban Institute and director of the Tax Policy Center; Rovner; and John Sheils of the Lewin Group (Rehm, "The Diane Rehm Show," WAMU, 10/7).
  
  
• WBUR's "Here and Now" on Tuesday included an analysis of the Obama and McCain health care proposals. The segment includes comments from Trudy Lieberman, director of the Health and Medical Reporting Program at the Graduate School of Journalism at the City University of New York ("Here and Now," WBUR, 10/7).