Kaiser Daily Health Policy Report Highlights Coverage of Recent Developments Related to Health Care in the Presidential Election

Summaries of several recent developments related to health care issues in the presidential election appear below.

• Economic Policy Institute report: The health care proposal announced by Republican presidential nominee Sen. John McCain (Ariz.) would prompt many employers to drop health insurance for employees, according to a report released recently by EPI, the Charleston Gazette reports. The proposal 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 to purchase coverage through their employers or the individual market. According to the report, as many as 27 million of the 165 million U.S. residents who have employer-sponsored health insurance would lose their coverage under the proposal. In the report, authors Josh Bivens and Elise Gould wrote that, although the current employer-sponsored health insurance system "is far from perfect, it does pool and spread risk." They added, "Kicking away the foundations of this system should only be done if there is a well-crafted alternative" (Nyden, Charleston Gazette, 10/20).
  
  The report is available online.
  
  
• Health care as issue for McCain: "One of the great untold stories of this race so far is just how much McCain is being damaged on health care" in part because of advertisements from the campaign of Democratic presidential nominee Sen. Barack Obama (Ill.) "blasting" his proposal and a lack of ads to respond to the criticism, The Politico reports. According to The Politico, although the McCain campaign has "denounced Obama's claims through the media, ... the shots have been unanswered on the air." In addition, "many voters now are concerned about what will happen to their health care were McCain to be president," as polls have found that about half of voters believe McCain would "make the right decisions on health care," The Politico reports. "Further, there is anecdotal evidence that Obama's paid media onslaught has gotten people thinking about health care," according to The Politico (Martin, The Politico, 10/20).
  
  
• Health care as issue for Illinois voters: Fourteen percent of registered voters in Illinois cite affordable health care as their top election issue, second to the economy (cited by 57%), according to a poll conducted recently by the Chicago Tribune, the Tribune reports. For the poll, pollsters surveyed 500 registered voters in Illinois to determine their top election issues and the influence of those concerns on their support for presidential candidates (Pearson, Chicago Tribune, 10/21).
  
  The poll is available online (.pdf).
  
  
• Prospects for next Congress: Republicans have begun to warn that the election could result in an Obama presidency and larger majorities for Democrats in Congress, a development that could "steer the country toward a government-run health system," among other concerns, the San Francisco Chronicle reports (Coile, San Francisco Chronicle, 10/21).
  
  
• Rural voters: Obama during his campaign has sought to appeal to rural voters on the economy and health care, two issues of significant importance to that demographic, the Chronicle reports. According to HHS, almost 18% of rural U.S. residents lacked health insurance in 2007 (Garofoli, San Francisco Chronicle, 10/21).

Examination of Health Care Proposals
Two newspapers recently examined the Obama and McCain health care proposals. Summaries appear below.

• The AP/Arizona Daily Star on Monday compared the views of the major presidential candidates on health care, embryonic stem cell research and a number of other issues (Woodward, AP/Arizona Daily Star, 10/20).
  
  
• The Los Angeles Times on Tuesday examined how the McCain health care proposal would rely on the private market to expand health insurance and how the Obama plan would expand government programs (Hiltzik/Girion, Los Angeles Times, 10/21).

Editorials
Summaries of several recent editorials that addressed health care issues in the presidential election appear below.

• Des Moines Register: Both Obama and McCain "have some good ideas" about health care, but Obama has the "better plan for reforming the entire system," according to a Register editorial. The editorial states, "Each candidate has at least one good idea," but "reforming health care will require lots of good ideas," as a "workable plan must address the needs of working Americans struggling to pay expensive premiums, employers saddled with the cost of coverage and those without insurance." As an alternative to the Obama and McCain proposals, the editorial proposes "offering all Americans the option of buying into a uniform government program similar to Medicare." The editorial states, "Under a so-called single-payer system, people still choose their own doctors, and services are delivered by private-sector clinics and hospitals." In addition, the proposal "could be financed similar to Medicare, through a combination of participants' premiums and tax dollars," and "could save money by eliminating administrative costs and pooling everyone together to leverage down costs." The editorial concludes, "Given the economic realities the next president and Congress will face, such a plan could be phased in. ... Everyone would pay taxes to fund it. And everyone, eventually, would be covered" (Des Moines Register, 10/18).
  
  
• Houston Chronicle: U.S. residents should elect Obama president in part because his "health care plan mandates health insurance for all American children, an issue of vital importance" to several counties in Texas with high rates of uninsured children, a Chronicle editorial states. The editorial states, "By contrast, the proposal by McCain to offer a tax credit to Americans to purchase insurance while taxing health benefits for the first time will further discourage small-business owners from providing employee health insurance" (Houston Chronicle, 10/18).
  
  
• Orlando Sentinel: U.S. residents should elect Obama president in part because he has a "better plan than the Arizona senator for expanding health care coverage," a Sentinel editorial states. "Obama would focus on the problem -- uninsured Americans -- while strengthening the current system of employer-based care," the editorial states, adding, "Mr. McCain would unravel that system" (Orlando Sentinel, 10/19).
  
  
• Philadelphia Inquirer: "On every issue important to America, Barack Obama offers a plan that would pull this nation from the precipice built by bad Bush decisions," an Inquirer editorial states. According to the editorial, "Obama would provide health insurance to more Americans" and would "subsidize premiums for the working poor, mostly paid for by repealing the Bush tax cuts but also by requiring businesses that don't provide medical benefits to contribute." The editorial adds, "McCain's idea to provide medical tax credits of $2,500 per person and $5,000 for families would come at a hefty cost, ending the tax break given workers whose health care is paid for them at work" (Philadelphia Inquirer, 10/19).
  
  
• Raleigh News & Observer: "Obama is exactly what the nation needs at a time when the hills are steep and the winds against us are stiff" in part because of his "pledge to realize universal health care," a News & Observer editorial states. Meanwhile, the McCain health care proposal "is a narrow idea" that "fails to reckon with health care's actual costs," the editorial states, adding, "And leaving the system in the hands of the insurance and drug companies that now control it would mean that millions of people with health problems would not be able to buy insurance at any price" (Raleigh News & Observer, 10/19).
  
  
• Wilmington News Journal: The McCain health care proposal would "essentially wipe out the tax exemption for employer-based insurance benefits," and although the Obama campaign has "used the seeming novelty of the proposal to attack Sen. McCain's proposal as a wild-eyed invention," the "idea has been around for years," a News Journal editorial states. According to the editorial, both "liberal and conservative economists have endorsed one version or another," and "it is an issue that will not go away, no matter who is elected." The current employer-sponsored health insurance system "is under assault from all sides," the editorial states, adding, "Change is coming, one way or another." The editorial concludes, "So why isn't this back story in the foreground? Why aren't the candidates and the press putting it in front of the voters?" (Wilmington News Journal, 10/19).

Opinion Pieces
Summaries of several recent opinion pieces that addressed health care issues in the presidential election appear below.

• Jay Bookman/Cynthia Tucker, Atlanta Journal-Constitution: U.S. residents should elect Obama president in part because he "is better equipped" than McCain to address health care, Bookman and Tucker, both members of the Journal-Constitution editorial board, write in an opinion piece. They write that the Obama health care proposal "requires a comprehensive approach, including financial assistance to help small businesses buy insurance for their employees," and also would "require large employers that do not offer health insurance to help their workers with the cost of buying insurance on their own" (Bookman/Tucker, Atlanta Journal-Constitution, 10/19).
  
  
• Alicia Caldwell, Denver Post: "Solving the nation's health care crisis has ranked high on the priority list for many politicians over the years," but "the sheer number of failed efforts is a testament to just how difficult the problem is to solve," Post columnist Caldwell writes. According to Caldwell, the McCain health care proposal would "give employers financial incentives to drop health coverage for employees and leave them struggling to find equivalent insurance at a cost commensurate to what they had been paying." Meanwhile, the Obama proposal "would put government in the position of subsidizing health coverage for people who would have difficulties affording it, and the potential costs are concerning," according to Caldwell. She writes, "The worsening economic climate and the taxpayer funds committed to bailing out the financial sector are likely to have profound effects on the resources available to tackle health care reform," adding, "While the costs of tackling health care reform have always been steep, the events of recent weeks may have made that proposition even more difficult" (Caldwell, Denver Post, 10/17).
  
  
• Paul Krugman, New York Times: McCain has made Samuel Wurzelbacher, "aka Joe the Plumber -- who had confronted Barack Obama on the campaign trail, alleging that the Democratic candidate would raise his taxes -- the centerpiece of his attack on Mr. Obama's economic proposals," Times columnist Krugman writes. "But what's really happening to the plumbers of Ohio, and to working Americans in general?" he asks. According to Krugman, "They aren't making a lot of money" and have "been having growing trouble getting health insurance, especially if, like many craftsmen, they work for small firms." He writes that the "typical plumber would pay lower, not higher, taxes under an Obama administration and would have a much better chance of getting health insurance" (Krugman, New York Times, 10/20).
  
  
• Andrew Romano, Newsweek's "Stumper": "Neither candidate has spent a ton of time talking about the issue," but Obama "has flooded national TV markets with a series of (not always accurate) ads that characterize McCain's market-based plan as 'radical' and accuse him of planning 'drastic cuts to Medicare,'" Romano, a Newsweek associate editor and political blogger, writes in an opinion piece in Newsweek's "Stumper" blog. However, "McCain hasn't ponied up for a response," which might "be why 54% of voters surveyed earlier this month by the New York Times and CBS News said they weren't confident McCain would 'make the right decisions on health care,'" Romano writes. "Only 10% said they were 'very confident' he would," Romano adds. "Ultimately, the new cash disparity" between the Obama and McCain campaigns "gives Obama a major messaging advantage," according to Romano (Romano, "Stumper," Newsweek, 10/20).
  
  
• Douglas Holtz-Eakin, Orlando Sentinel: "Medicare benefits are safe" under the McCain health care proposal, despite recent statements made to that effect by Obama, McCain senior policy adviser and former Congressional Budget Office director Holtz-Eakin writes in a Sentinel opinion piece. He writes, "Apparently, Sen. Obama is against eliminating Medicare fraud that allows criminals to make millions by charging for fake procedures, payment reforms that will provide coordinated and more effective care for our seniors, and new treatment models that will better manage chronic-care diseases," all of which are "among the reforms that Sen. McCain has proposed for Medicare." According to Holtz-Eakin, although an ad released recently by the Obama campaign "misleadingly accuses John McCain of taxing health insurance for the first time, leading to the largest middle-class tax increase in history," the "tax code will subsidize -- not tax -- health insurance both before and after the McCain reforms." He adds, "It is true that the reform will make that subsidy more fair -- providing the same help to rich and poor regardless of the source of their insurance ... which is why even Sen. Obama's own economic policy adviser has advocated for a refundable tax credit like the one proposed by Sen. McCain." In addition, he writes that "Obama's plan will cause almost 50 million Americans to lose the health coverage they currently have" and "has been estimated to cost more than $240 billion annually -- a financial burden of more than $3,000 per American family." He adds, "When the kids and employees are forced into the government-run plan, America will be closer to the government-run, single-payer health-care system Barack Obama has said he wished America had" (Holtz-Eakin, Orlando Sentinel, 10/21).
  
  
• Bruce Josten, The Politico: "For all its faults, American health care does many things right," but the system "costs too much, covers too few, is rarely efficient, is often negligent, and focuses too much on treatment and not enough on prevention," Josten, executive vice president for government affairs at the U.S. Chamber of Commerce, writes in an opinion piece in The Politico. In response to the problems, Josten recommends the implementation of wellness and disease-management programs, as well as health care information technology; expansion of the employer-sponsored health insurance system; and revision of the medical liability system. "Our health care system does have many problems, but a single solution doesn't exist to solve them all," Josten writes, adding, "We need a multifaceted program of wellness and prevention, transparency, technology and consumer responsibility to cover more people and provide superior care at a lower cost." Health care is a "critical issue of obvious concern to every American," he writes (Josten, The Politico, 10/20).
  
  
• Igor Volsky, The Politico: Policymakers who "ignore the link between economic and health care policy and divorce the health care crisis from the current financial meltdown run the risk of further eroding our economy" because the "health care crisis and the financial crisis exacerbate the economic health of individual Americans and U.S. companies," Volsky, a health care researcher at the Center for American Progress Action Fund and a blogger at "The Wonk Room," writes in an opinion piece in The Politico. "Unless the next president addresses growing health care costs and improves access to affordable health care, American businesses and families will continue to suffer," Volsky writes, adding, "That's why increasing access to affordable health care while simultaneously addressing cost containment is the bailout this economy requires." He writes, "The next president can't afford to support the same kind of deregulatory policies that created today's sweeping financial crisis" and "must expand health care coverage, improve the value of the present system and ease the burden of high health care costs by spreading the costs of coverage." Volsky concludes that, "to fix the economy, the next president must use the presidential bully pulpit to address the health care crisis" (Volsky, The Politico, 10/20).
  
  
• John Harkey, Tennessean: "Most people haven't heard much about Sen. John McCain's health care plan, and given the events on Wall Street, that is probably a good thing for McCain," Harkey, a health care sector consultant and former publisher of The Harkey Report, writes in a Tennessean opinion piece. Harkey writes, "Deregulation is not a word McCain is talking about right now, yet his health plan has deregulation as its core emphasis." He adds, "The non-group market" that McCain proposes "requires your health to be vetted to determine your insurance risk," but the "tax credits he proposes are insufficient alone to purchase the typical comprehensive group policy, ... so there will be a tendency among financially stretched individuals and families to 'buy down' to a cheaper policy." Harkey concludes, "Those who now have group policies with their more solid protections may want to take a closer look at the McCain plan, and wonder, as they contemplate the damage inflicted by Wall Street on their retirement funds, if now is the time to give up the relative safety of federally regulated, employer-sponsored group coverage and gamble on the risks in a deregulated group or non-group market" (Harkey, Tennessean, 10/21).

Broadcast Coverage

• NBC's "Nightly News" on Monday compared the Obama and McCain proposals for Medicare. The segment includes comments from Obama, McCain and political analyst Susan MacManus (Potter, "Nightly News," NBC, 10/20).
  
  
• NPR's "Day to Day" on Monday examined how the economy has shifted attention from health care in the presidential election. The segment includes comments from Trudy Lieberman, head of the Health and Medicine Reporting Concentration at the City University of New York Graduate School of Journalism ("Day to Day," NPR, 10/20).
  
  
• PBS' "NewsHour with Jim Lehrer" on Friday reported on how Obama and McCain have promoted their health care proposals in swing states. The segment includes comments from Obama, Biden, McCain and Republican vice presidential nominee Alaska Gov. Sarah Palin (Suarez, "NewsHour with Jim Lehrer," PBS, 10/17).