Candidates Split on Health Care Coverage

March 14, 2008 — Should everyone in America have access to health
insurance? If so, should you be required to get it?
Beneath all the complexities, the presidential health care debate really
boils down to those two big questions. And how you feel about the answers might
tell you a lot about which candidate you think can solve the nation’s mounting
health care problems.
As for question one, Democratic candidates Hillary Clinton and Barack Obama
both answer “yes.” Each has a plan leading to “universal health
care,” a system in which everyone has medical coverage. For McCain, the
answer is both “yes” and “no.”
McCain says everyone should have access to coverage in principle, but his
plan doesn’t guarantee it and won’t try to. He believes that market-based
forces can work to bring down health care costs so that eventually people can
afford to buy it.
But before you think it’s just Clinton and Obamavs. McCain when it
comes to health care, think of question two. Clinton says that making sure
everyone is covered is a critical ingredient to reforming the way insurance
companies cover health care. That’s why she says that everyone should be
required to get coverage.
Obama agrees, but only up to a point. He says parents should be required to
make sure their kids are covered. Then once insurance reforms help bring down
costs, everyone else will eventually have to get coverage too.
Obama has attacked Clinton for calling for an insurance mandate. While that
is often a dirty word in politics, Clinton and her advisors say it’s
necessary.
“It’s important from the start to make sure that coverage is
universal,” says Katherine Hayes, a vice president at Jennings Policy
Strategies, which advises Clinton’s campaign on heath issues.
Unless everyone has coverage, insurance companies can still seek out the
healthiest people to cover. That leaves older and sicker people — the ones who
need coverage the most — out of the loop, Hayes said at a Capitol Hill forum
on the candidates’ health plans sponsored by the Alliance for Health
Reform.
The practice is called “cherry-picking,” and both Clinton and Obama
say it needs to be done away with.
“Both call for individuals to acquire coverage when it becomes
affordable,” says Gregg Bloche, a professor of law at Georgetown University
and an advisory to Obama’s campaign.
But Obama wants to give reforms time to work before requiring coverage. Both
he and Clinton want to form purchasing pools to make insurance cheaper, and to
work to decentralize health care from hospitals and traditional clinics so that
it’s easier to access.
They both also want to provide tax credits to help small businesses buy
coverage for workers, and provide subsidies to help people get coverage if they
can’t afford it themselves.