The Health Care Connundrum

Health care is shaping up to be the most important issue in the United States for the first time since the early 1990s in the coming election. It is an issue that all the Democratic candidates have been addressing here in Iowa and one that they will continue to address until the caucuses. A recent New York Times poll gives a lot of perspective about how the candidates are and should be addressing the issue. According to the poll, 90% of Americans think our health care system needs either fundamental changes or to be completely rebuilt and a disproportionate percentage of Americans, 62%, trust Democrats to improve the health care system. One may think this is an easy chance for Democratic candidates to push a massive reform like a single payer health care system but popular opinion about health care reform is much more complex than it seems.

64% of Americans think the government should guarantee health care for all Americans, which is an increase of 10% since 1996 and by a 2 to 1 margin, Americans think its worth paying higher taxes so everyone can have health insurance. When asked on the details of health care plans, Americans favor a single payer solution over the current model by a margin of 47 to 38 percent. However there is a big gap between how people percieve health care in general in the U.S. and their own individual health care coverage. While 57% of Americans are somewhat or very dissatisfied with the state of health care in the United States, only 20% of Americans are somewhat or very dissatisfied with their own health care. This trend also holds with the cost of health care. A whopping 81% of Americans are somewhat or very dissatisfied with the cost of healthcare in the U.S. but only a bare majority, 53%, are dissatisified with the cost of their own health care.

Only one candidate has introduced a health care plan so far, John Edwards. His health care plan tries to balance the concerns expressed in the poll of universal coverage without affecting people who already have health insurance. Unfortunately, it comes across as a little complex as a result. The poll results belied this. People who expressed an opinion about it favored the plan by a margin of over 2 to 1. However, nearly half of all poll respondents were unsure, which is a sure sign that it confused a lot of people.

This deftly illustrates the problems that candidates face. When like John Edwards, or Bill Clinton in his first term, they fix our dysfunctional health care system while taking into account the relative satisfaction that individuals feel about their personal health care plans, the result is confusion. However, if you try to set up a single payer plan, it makes people afraid that they will lose their health care. The result gives a candidate two difficult choices between what type of health care plan to propose. John Edwards has already picked one option and it will be interesting to see what the other candidates do.

Add comment March 1st, 2007

John Edwards’s Health Care Plan

In the midst of the stupidity over bloggers and the stupidity over his house, it’s worth noting that John Edwards presented a pretty significant and detailed heath care plan last week. The plan, which was analyzed in detail by Jonathan Cohn at the New Republic, provides universal health care but does so through the use of tax credits to create and fund entities for groups of peopuyle to purchase insurance called “health markets” as well as through an “individual mandate” which is a requirement that everyone b insured. It also allows Medicare to compete with private insurers to provide coverage to people through health markets. It is a complex plan that would be funded by rolling back the Bush tax cuts. Although it has the advantage of “giving people who have insurance something they lack now–more security and more choice–without taking away their coverage,” the complexity this engenders makes it difficult to sell. As Cohn notes “grafting universal coverage onto an already complicated system inevitably means drawing up a complicated plan. That’s not particularly helpful in the current media environment.”

The alternative is a straightforward single payer system like that in a bill before Congress, HR 676, that was introduced by John Conyers (and co-sponsored by Dave Loebsack.) This is the system used in the rest of the western world, which leads to significantly lower health care costs than what we have. A single payer plan would be much more effective but is considered less politically feasible. As a result, it is doubtful that any other serious candidate will advocate for it (as opposed to hopeless publicity seekers). However, it is still possible. The national debate on health care is moving increasingly towards a single payer solution. Edwards, by introducing his plan, laid down his marker but, as the debate develops, other candidates who either seek to flank him on the left or merely keep up with the national debate may introduce single payer plans similar to HR 676. In meantime, we will just have to wait and see what their policy teams cook up.

Barack Obama pledged in his annoucement yesterday that “we will have universal health care in America by the end of the next president’s first term.” However, he hasn’t unveiled his plan yet. In the meantime, John Edwards has been the first candidate to unveil a detailed health care plan. It may not be perfect but it is definitely worthy of respect.

1 comment February 11th, 2007