Kaiser Daily Health Policy Report Features Recent Developments Related to Health Care in Presidential Election

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

• Challenges for next president: The next president, regardless of whether Democratic presidential nominee Sen. Barack Obama (Ill.) or Republican presidential nominee Sen. John McCain (Ariz.) wins the election, will face a number of challenges with the implementation of health care and other proposals because of the recently enacted $700 billion bailout for Wall Street firms, the Dallas Morning News reports. The next president may have to address Medicare issues, according to the paper. However, other issues such as health care reform might have to "go on the back burner," says Leon Panetta, a chief of staff to former President Clinton (Gillman, Dallas Morning News, 11/2).
  
  
• Health care as election issue: Forty-two percent of U.S. adults believe that their health care costs would increase under an Obama administration, and 61% believe that their costs would increase under a McCain administration, according to a recent USA Today/Gallup poll, USA Today reports. The poll, conducted between Oct. 31 and Nov. 2, includes responses from 3,050 adults and has a margin of error of plus or minus two percentage points (Page, USA Today, 11/2).
  
  
• Historically Republican states: Both Obama and McCain recently have campaigned on health care issues in states that historically have supported Republican presidential candidates, McClatchy/Kansas City Star reports. Obama recently campaigned on health care issues in Virginia, which has not voted for a Democratic presidential candidate since 1964 (Talev/Douglas, McClatchy/Kansas City Star, 11/2).
  
  
• Role for Clinton: Advisers to Sen. Hillary Rodham Clinton (D-N.Y.) have said that she might take a lead role on the Obama health care proposal in the event that he wins the election, the New York Times reports. However, her role in large part will depend on the role of Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.), given his experience and seniority on the issue (Healy, New York Times, 11/3).
  
  
• Small businesses: Health care is the second-most important election issue for small businesses, surpassed only by the economy, according to the National Small Business Association, the Chicago Tribune reports. The National Federation of Independent Business also reports that health care has remained a top concern for small businesses for the past 20 years (Meyer, Chicago Tribune, 11/3).
  
  
• Special-needs children: Some families with special-needs children believe that they have a "potential first friend in the White House, someone poised to bring better schooling, more Medicaid financing and greater attention to their cause," in Republican vice presidential nominee Alaska Gov. Sarah Palin, the Times reports. Her son Trig has Down syndrome (Bosman, New York Times, 11/3).
  
  
• Women: Palin in a recent interview with the Wall Street Journal said that women would benefit more under a McCain administration, in part because of his health care proposal, the Journal reports. She said that women "want to be able to afford good health care for our families," adding that "McCain's plan ... will allow us to make our own decisions, to be able to afford health care, to erase these state lines that prohibit a competitive environment to purchase a good health care package." Palin added, "That's an issue that is important to women" (Strassel, Wall Street Journal, 11/1). In related news, McClatchy/Raleigh News & Observer on Saturday examined the effect that the Obama and McCain health care and other proposals would have on women (Recio, McClatchy/Raleigh News & Observer, 11/1).

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

• The Baltimore Sun on Sunday compared the Obama and McCain proposals on health care, embryonic stem cell research and other issues (Baltimore Sun, 11/2).
  
  
• The Detroit Free Press on Sunday examined the effect that the Obama and McCain health care proposals would have on employers, consumers and employees (Detroit Free Press, 11/2).
  
  
• The Morning News on Sunday examined a number of the Obama and McCain proposals on health care and other issues. According to the Morning News, health care "provides one of the sharpest contrasts between the candidates," and costs "are a major issue for voters, particularly with a shaky economy and job market" (Dallas Morning News, 11/2).
  
  
• The News & Observer on Saturday examined the effect that the Obama and McCain health care proposals would have on businesses (Stock/Bell, Raleigh News & Observer, 11/1).

Opinion Pieces

• Robyn Blumner, St. Petersburg Times: "McCain promises to be the next Social Darwinist-in-chief" and would "manacle government, ensuring that it does not have the revenues" for public health insurance and other programs, columnist Blumner writes. According to Blumner, McCain "claims that he will eliminate the nation's soaring budget deficits by the end of his first term and that he won't raise taxes on the middle class beyond taxing the value of their health insurance, which means gutting the government is his only course." Blumner adds, "Which smacks more of the 'evils' of socialized government: taking part ownership in a raft of banks, essentially partially nationalizing the banking sector," which McCain supported, or "creating an affordable public health insurance program as an alternative for Americans who don't get health coverage at work," which Obama supports? (Blumner, St. Petersburg Times, 11/2).
  
  
• Mike Thomas, Orlando Sentinel: McCain and Obama "would take us in completely opposite directions" on health care, but "I must opt for McCain's" proposal, Sentinel columnist Thomas writes. According to Thomas, "McCain would empower individuals but then leaves them at the mercy of what could be a mercilessly unregulated market." Meanwhile, Obama "would empower the government," and "as we've seen with Medicare, the program and costs grow out of control" and force lawmakers to "blow the budget to bits and then try to save themselves by squeezing the docs and hospitals," Thomas writes. The McCain proposal "is a better starting point" because over time the tax credits that he would provide "could be tweaked in a way to greatly expand coverage," Thomas writes, adding, "It offers the only hope of holding down costs." He concludes, "And if it doesn't work, and we get spending and the national debt under control, bring on Obama's plan," but "if we start with that, there will be no turning back" (Thomas, Orlando Sentinel, 11/2).
  
  
• John McCain, Wall Street Journal: "I will not impose 'one-size-fits-all' health care on families and small businesses through expensive mandates and fines," McCain writes in a Journal opinion piece. He adds, "I will bring down the skyrocketing cost of health care with competition and choice" and "reform the insurance market to be fair." In addition, McCain writes that he would "allow you to keep the same health plan if you change jobs or choose to stay home" (McCain, Wall Street Journal, 11/3).
  
  
• Barack Obama, Wall Street Journal: "When it comes to health care, we don't have to choose between a government-run system and the unaffordable one we have now," Obama writes in a Journal opinion piece. He writes, "My opponent's plan would make you pay taxes on your health care benefits for the first time in history," adding, "My plan will make health care affordable and accessible for every American." Obama writes, "If you already have health insurance, the only change you'll see under my plan is lower premiums," adding, "If you don't, you'll be able to get the same kind of plan that members of Congress get for themselves" (Obama, Wall Street Journal, 11/3).

Letters to the Editor

• Marcia Angell, New York Times: Times columnist David Brooks last month wrote that McCain "has a good health care plan that was never fully explained," but the proposal is a "disastrous plan that most experts agree would destroy the tax-exempt employment-based insurance system and leave employees on their own to shop for whatever private insurance they could afford," Angell, a senior lecturer in social medicine at Harvard Medical School and a former editor of the New England Journal of Medicine, writes in a Times letter to the editor. According to Angell, the "average current cost of decent private plans is more than double" the amount of the tax credits that McCain proposes and "is very likely to increase rapidly over the next four years." In addition, although "McCain claims that individuals should be able to shop for insurance bargains, which would bring the cost of premiums down," experts who understand "how the private health insurance industry operates would know that this is not a workable idea," Angell writes. She concludes, "The McCain plan would very probably increase ... the ranks of the uninsured and the underinsured" (Angell, New York Times, 11/1).
  
  
• John Clymer, Washington Post: "One of the most promising places to start in health care reform is where there is consensus between the two parties," and for "the first time, prevention is a core element of both the Republican and Democratic platforms and is at the heart of both candidates' plans to control costs," Partnership for Prevention President Clymer writes in a Post letter to the editor. According to Clymer, Obama and McCain "both have talked about reforming the health care system to better cover and support prevention of chronic illnesses." He concludes, "We can no longer abide failure in Washington. To make progress in health care, we must focus on 'the art of the possible'" (Clymer, Washington Post, 11/3).

Broadcast Coverage
American Public Media's "Marketplace" on Thursday profiled a voter who has problems with payment of her medical bills and examined the effect that the Obama and McCain health care proposals would have on her situation (Karson, "Marketplace," American Public Media, 10/31).

CNN's "Ballot Bowl 2008" on Saturday compared the Obama and McCain health care proposals. The segment includes comments from Obama and McCain (Malveaux, "Ballot Bowl 2008," CNN, 11/1). A transcript of the program is available online.

NPR's "All Things Considered" on Thursday examined the effect that the Obama and McCain proposals on family leave, sick leave, elder care and other issues would have on working families (Jaffe, "All Things Considered," NPR, 10/31).