2008 Democratic candidates on health care

I know where the 2008 Republican presidential candidates stand on the issue of health care (they put it at the bottom of the list), but what about the Democrats? Do they concur with voters who see it as our number one domestic issue? After checking their various campaign websites, I can say they've definitely put a lot of thought into the issue and given it priority status.

First up is Bill Richardson and his plan as described at a recent health care forum:

New Mexico Governor Bill Richardson said the "cornerstone" of his plan is to allow all Americans and business to be able to purchase the same coverage that members of Congress have, while offering "help" for those will low incomes. He also argued for an expansion of Medicare to cover those 55 and older, and a "cooperative relationship" between individuals, businesses and states "catalyzed by the government." Without naming Edwards, he argued that additional sources of revenue are not necessary, saying increased efficiency, preventative care and an exit from Iraq will provide enough revenue to expand coverage. But it wasn't clear if Richardson was pledging to achieve universal coverage.

Additionally, from Joseph Paduda's blog, "Richardson appears to be pushing for the elimination of Medicare Advantage and other private-insurer based Medicare programs." That's a plus since these plans cost on average 19% more than traditional Medicare, but he's also promoting tax breaks for lower-income Americans to help them buy health insurance. Several Republican candidates mentioned tax breaks too, but I don't see how that will help poor people buy health coverage unless the government advances them the money up front.

Mike Gravel solves that problem with vouchers.

Former Alaska senator Mike Gravel proposed a single-payer system of sorts, but under his system each American would get a health care voucher that they would use to purchase their choice of five or six private insurance plans. “Everyone gets the same product. If you want more than the product you’ve got, you pay for it,” he said. Gravel said he would not expand Medicare or Medicaid unless “we don’t see the private insurance companies shape up.”

Gravel's voucher idea is interesting, but I don't see the private insurance companies shaping up, and I don't see Gravel winning the primary either.

On to the next candidate, Hillary Clinton, best remembered for championing universal health care long before anyone else would even touch the subject. Here's a brief description of her plan from a recent speech:

There are three parts to my approach. First, lowering costs for everyone. Second, improving quality for everyone. Third, insuring everyone. [...]

My plan will offer individuals and small businesses market access to larger insurance pools that will lower costs and end insurance company discrimination against people with pre-existing conditions. As part of a plan for universal coverage, which I will discuss in detail in the coming months, we would create large insurance pools that lower administrative costs for small businesses and individuals by spreading the risk. In a system of universal coverage insurance companies cannot as easily shift costs through cherry picking and other means.

Clinton would also push legislation to provide respite care for caregivers of elderly and disabled Americans, something I approve of and believe is desperately needed. However, from a recent health care debate, she said "it would take her two terms to get a universal health care system in place." That's unacceptable to me. The number of uninsured is at crisis levels and Americans can't wait that long.

I'm not totally sold on her plan to create large insurance pools either. I no longer trust corporate America to put people before profits, and the fact that Clinton received hundreds of thousands of dollars in campaign contributions from insurance companies for her 2006 re-election in the Senate disturbs me too.

John Edwards has also been pushing universal coverage for sometime now, and he has the most comprehensive and detailed position on health care to date. Here's a brief description from The Nation:

Edwards' plan, first unveiled earlier this year, calls for an expansion of both public and private health plans, forces employers to either provide health care or pay into a fund that does, mandates individuals to buy insurance and offers government subsidies for families with incomes of up to $80k who can't afford it.

He also has plans [pdf] to expand the infrastructure for long-term care, offer respite care and support to families caring for loved ones, and improve the wages, training and working conditions for aides, which definitely scores brownie points with me.

Edwards also gets more points for his honesty and candidness. When asked at a recent health care debate about the transitional costs to a new system, he said "it would cost $90 to $120 billion a year, which he would pay for by rolling back President Bush's tax cuts for those making more than $200,000." This honesty won't hurt Edwards since polling shows that voters are willing to pay higher taxes in order to solve our health care crisis.

Moving along to Barack Obama, you can read about his plan on his website, but here's a short synopsis from CommonSense:

If you don't have health insurance through your employer, you will be enrolled into a new, comprehensive public health insurance plan that emphasizes prevention, chronic care management and quality care. The benefits will be similar to those available today to every federal employee.

This plan will enjoy the great efficiencies we see in public plans like Medicare but, if you still cannot afford it, you will receive a subsidy to pay for it. Of course, you can choose private insurance if you prefer but the private plans will have to compete on a level playing field with the public plan—without the extra payments that tip the scales in favor of private Medicare Advantage plans today.

Employers who do not offer meaningful coverage or a meaningful contribution to the cost of quality health coverage for their employees will be required to pay a percentage of payroll to the plan and their employees will be enrolled. Any employer can decide it no longer wishes to administer insurance and can offer insurance through the exchange. Self-employed Americans will find it easy to enroll as well at no disadvantage. Children will be covered and no one can be denied health insurance because of a preexisting condition or illness. [...]

Much of that tracks what Edwards has offered, and in fact, Obama offered that Edwards' plan is "very credible."When asked if additional tax revenue is needed, Obama did not dismiss the possibility, saying we need to "do whatever it takes" but noted there is much savings to be reaped with a more efficient system. He also said he would need to "put some money on the front end in creating a new system" and then "get those savings on the back end," emphasizing that "those savings [should] go into the pockets of families, and not just insurance companies or drug companies."

Obama only recently posted his plan on his website and it does sound very similar to Edwards'. He does get points from me though for mentioning there would be no extra payments to private Medicare Advantage type plans. (Taxpayers have been fleeced enough by the private sector under the Bush administration.)

Chris Dodd also has a plan to fix health care on his campaign website, although it doesn't appear as though he'll be a contender. Here's a brief synopsis of his plan from CommonSense:

Connecticut Sen. Christopher Dodd said his plan was based on four principles: universality (“everyone participates, everyone benefits,” prevention, extend Medicaid to more families, and improving the use of technology. He referenced his leadership in getting the Family Medical Leave Act written into the law as proof of his commitment to working families and to the health care issue. [...]

As did some of the other candidates, Dodd said that all Americans should be able to get the same type of health care plan as members of Congress.

That type of plan has already been introduced. The Kennedy-Dingell Medicare-For-All plan offers the uninsured a choice to use Medicare or the federal employees health plan, the same plan members of Congress and the president currently enjoy, but I agree with Dodd that all Americans should be able to get it.

That brings me to Dennis Kucinich. He's the only presidential candidate with a plan for a universal single payer, not for profit health care system. The National Health Insurance Bill (HR 676) is being sponsored by Congressman John Conyers and Kucinich, along with the backing of Physician's for a National Health Program. Click the links to read more, but here's a brief description from CommonSense:

Ohio Rep. Dennis Kucinich used the forum to continue his vigorous pitch for a single-payer health care system, arguing that the plans of the other major candidates were too dependent on insurance companies and others with a profit motive that was antithetical to the notion of universal, nondiscriminatory care. To critics who raise the fear that a totally government-run system would end up rationing care to control costs, Kucinich said that insurance companies already ration care. He also scoffed at the argument that private-sector competition would reduce costs, saying that the opposite has been the case in health care.

I like HR 676 (and the Medicare-For-All plan) and I agree with all of Kucinich's points, but I don't think he has a chance of winning the nomination either, so that leaves me undecided about who I'm backing in the primary. I want to vote for the person I think has the best chance of winning the White House AND delivering on health care, but I also want that person to be someone who is interested in delivering every dime possible toward providing care, not delivering for the investors. Who would you vote for?