Health care reform: Proposals similar, but candidates differ on approach
Insurance, access, costs among Iowans' top concerns
By Fred Love, Journal Des Moines Bureau | Posted: Monday, September 22, 2008
DES MOINES -- Presidential candidates John McCain and Barack Obama have made some big promises on health care throughout their respective campaigns.
Both have vowed to expand health insurance access to millions of uninsured Americans.
They've promised to stem the rising costs of health care and cut prescription drug prices.
But they don't see eye to eye on how it should be accomplished.
On the issue of medical insurance, for instance, Obama wants to establish a nationalized health plan, whereas McCain's strategy relies on tax credits and market forces.
About 241,000 Iowans don't have health insurance, according to Iowa for Health Care, a health care reform advocacy group.
That puts Iowa in good standing when compared with other states, said Bruce Koeppl, state director for AARP, an advocacy group for older Americans.
But there's still room for improvement, Koeppl said.
Access to treatment has grown as a concern among rural Iowans, especially on the subject of accessibility to doctors, he said.
"It's different because in Iowa, if you live out in rural Iowa, the number of doctors is shrinking, so accessibility just means you have to travel farther," he said.
He also said medical costs have steadily risen in Iowa for the past few decades, chewing up a greater portion of the average Iowan's income.
An AARP study conducted this summer found that swing voters in Iowa rank health care among their top concerns.
The survey, which targeted voters who said they had either not made up their minds or leaned only slightly toward a candidate, found that 52 percent of those interviewed wanted to hear more from the candidates on their health care plans.
Dr. George Weiner, a professor of internal medicine at the University of Iowa, praised Obama, a Democrat, for his emphasis on insuring all Americans.
Weiner said Obama's plan to guarantee all Americans access to a nationalized plan would keep citizens from falling through the cracks.
Obama would grant subsidies to Americans who couldn't otherwise afford to pay for the national plan, and Weiner said that would help a significant portion of the estimated 47 million uninsured Americans, some of whom have jobs but still can't afford insurance.
He said Obama's strategy would also grant those uninsured citizens access to preventive care that could save tax dollars in the long run by detecting medical problems early.
Weiner said Obama's promise to update information technology in the medical realm would streamline health care by improving communication between doctors and patients and preventing doctors from prescribing medications that may not react well with those prescribed by other doctors.
"If we invest up front by insuring and giving preventive care, that would be a huge advantage," he said.
Dr. Christi Taylor, who practices internal medicine in West Des Moines, said McCain, the Republican nominee, wants to put patients in control of the health care they receive but that Obama's policy gives too much responsibility to the government.
McCain's plan would grant $2,500 tax credits to individuals and $5,000 tax credits to families to buy private health coverage.
Critics have said that the tax credits wouldn't cover the costs of an insurance plan for many Americans, but Taylor said the plan would likely pay for basic coverage while also keeping health care costs in check by emphasizing competition among private insurance providers.
She also applauded McCain's support of tort reform to protect physicians from frivolous lawsuits.
She said doctors often order unnecessary tests or studies for patients to protect themselves from lawsuits but that reforming the tort system would eliminate the need for such unwarranted tests.
"Without tort reform we'll never be able to control the costs of medicine, and McCain realizes that's necessary," she said.
Charlie Wishman, an organizer for Iowa Citizen Action Network, said the current U.S. health care system has reached a point of crisis as costs have risen and more citizens are uninsured.
Wishman said the next president will likely face a polarized and thorny environment on health care reform, and he called for quick and decisive action.
"Whoever does get elected, it is vitally important that they take this up, and they need to take it up in the first hundred days," he said. "It's that much of a crisis."
Fred Love can be reached at (515) 243-0138 or fred.love@lee.net.
Candidate Health Care Quiz
Click here to take the quiz.
What they promise
Medicare/Medicaid
McCain: Would push to reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination.
Obama: Expand availability of Medicaid to more Americans and protect Medicare recipients from fraudulent claims by marketers and drug plan agents.
SCHIP
Obama: Expand availability of the federal State Children's Health Insurance Program and mandate coverage for children
McCain: Approved of President Bush's veto of a bill last year that sought to expand SCHIP availability because of the costs involved.
Health Insurance
McCain: Citizens would receive a direct refundable tax credit of $2,500 for individuals and $5,000 for families to help pay for an insurance plan. Families would be able to choose the insurance provider.
Obama: National health plan available to all Americans. Individuals and families in need of financial assistance would receive a federal subsidy to buy into the new public plan or buy a private health care plan.
Tort Reform
McCain: Push for reform of tort laws to protect physicians from frivolous lawsuits to bring down health care costs.
Obama: Strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and promote new models for addressing physician errors to reduce the need for malpractice suits.
Prescription drug costs
McCain: Stimulate greater competition in our drug markets through safe reimportation of drugs and faster introduction of generic drugs.
Obama: Would allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama would also repeal the ban that prevents the government from negotiating with drug companies.
Both have vowed to expand health insurance access to millions of uninsured Americans.
They've promised to stem the rising costs of health care and cut prescription drug prices.
But they don't see eye to eye on how it should be accomplished.
On the issue of medical insurance, for instance, Obama wants to establish a nationalized health plan, whereas McCain's strategy relies on tax credits and market forces.
About 241,000 Iowans don't have health insurance, according to Iowa for Health Care, a health care reform advocacy group.
That puts Iowa in good standing when compared with other states, said Bruce Koeppl, state director for AARP, an advocacy group for older Americans.
But there's still room for improvement, Koeppl said.
Access to treatment has grown as a concern among rural Iowans, especially on the subject of accessibility to doctors, he said.
"It's different because in Iowa, if you live out in rural Iowa, the number of doctors is shrinking, so accessibility just means you have to travel farther," he said.
He also said medical costs have steadily risen in Iowa for the past few decades, chewing up a greater portion of the average Iowan's income.
An AARP study conducted this summer found that swing voters in Iowa rank health care among their top concerns.
The survey, which targeted voters who said they had either not made up their minds or leaned only slightly toward a candidate, found that 52 percent of those interviewed wanted to hear more from the candidates on their health care plans.
Dr. George Weiner, a professor of internal medicine at the University of Iowa, praised Obama, a Democrat, for his emphasis on insuring all Americans.
Weiner said Obama's plan to guarantee all Americans access to a nationalized plan would keep citizens from falling through the cracks.
Obama would grant subsidies to Americans who couldn't otherwise afford to pay for the national plan, and Weiner said that would help a significant portion of the estimated 47 million uninsured Americans, some of whom have jobs but still can't afford insurance.
He said Obama's strategy would also grant those uninsured citizens access to preventive care that could save tax dollars in the long run by detecting medical problems early.
Weiner said Obama's promise to update information technology in the medical realm would streamline health care by improving communication between doctors and patients and preventing doctors from prescribing medications that may not react well with those prescribed by other doctors.
"If we invest up front by insuring and giving preventive care, that would be a huge advantage," he said.
Dr. Christi Taylor, who practices internal medicine in West Des Moines, said McCain, the Republican nominee, wants to put patients in control of the health care they receive but that Obama's policy gives too much responsibility to the government.
McCain's plan would grant $2,500 tax credits to individuals and $5,000 tax credits to families to buy private health coverage.
Critics have said that the tax credits wouldn't cover the costs of an insurance plan for many Americans, but Taylor said the plan would likely pay for basic coverage while also keeping health care costs in check by emphasizing competition among private insurance providers.
She also applauded McCain's support of tort reform to protect physicians from frivolous lawsuits.
She said doctors often order unnecessary tests or studies for patients to protect themselves from lawsuits but that reforming the tort system would eliminate the need for such unwarranted tests.
"Without tort reform we'll never be able to control the costs of medicine, and McCain realizes that's necessary," she said.
Charlie Wishman, an organizer for Iowa Citizen Action Network, said the current U.S. health care system has reached a point of crisis as costs have risen and more citizens are uninsured.
Wishman said the next president will likely face a polarized and thorny environment on health care reform, and he called for quick and decisive action.
"Whoever does get elected, it is vitally important that they take this up, and they need to take it up in the first hundred days," he said. "It's that much of a crisis."
Fred Love can be reached at (515) 243-0138 or fred.love@lee.net.
Candidate Health Care Quiz
Click here to take the quiz.
What they promise
Medicare/Medicaid
McCain: Would push to reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination.
Obama: Expand availability of Medicaid to more Americans and protect Medicare recipients from fraudulent claims by marketers and drug plan agents.
SCHIP
Obama: Expand availability of the federal State Children's Health Insurance Program and mandate coverage for children
McCain: Approved of President Bush's veto of a bill last year that sought to expand SCHIP availability because of the costs involved.
Health Insurance
McCain: Citizens would receive a direct refundable tax credit of $2,500 for individuals and $5,000 for families to help pay for an insurance plan. Families would be able to choose the insurance provider.
Obama: National health plan available to all Americans. Individuals and families in need of financial assistance would receive a federal subsidy to buy into the new public plan or buy a private health care plan.
Tort Reform
McCain: Push for reform of tort laws to protect physicians from frivolous lawsuits to bring down health care costs.
Obama: Strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and promote new models for addressing physician errors to reduce the need for malpractice suits.
Prescription drug costs
McCain: Stimulate greater competition in our drug markets through safe reimportation of drugs and faster introduction of generic drugs.
Obama: Would allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama would also repeal the ban that prevents the government from negotiating with drug companies.
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jim wrote on Sep 22, 2008 10:02 AM:
X-SSC wrote on Sep 22, 2008 8:22 AM: