Democratic candidates on health care
The following table summarizes the basic elements of a plan that would provide affordable, portable, universal health insurance to all Americans, and indicates whether the candidate's proposals include that element.
(1) Obama's plan is mandatory for children only
(2) Dodd's plan calls for "automatic enrollment"
(3) Biden's plan to reduce exclusions is incentive based
Gravel also has a plan that involves "vouchers" paid for with a "national sales tax" that would cover everyone, but it is short on details and you have to sit through a rambling YouTube video to even get that much info.
While Kucinich is considered a "fringe" candidate, his is the only plan that includes all the elements, and his is the only plan that has actually been introduced into Congress (HR676).
Kucinich's proposal (which is to basically end traditional health insurance and open Medicare up to all Americans) is also the only plan that would remove employer-provided insurance from the equation, and for that reason is the only fully portable plan. While the others offer alternatives to employer-provided insurance, they focus on perpetuating the current system of employer-provided health insurance, which by definition is not portable if you change jobs or lose your job.
There is also a distinction between "universal coverage" and "universal access". Only Kucinich's plan and the other plans that are mandatory would provide universal "coverage". Plans such as Obama's and Biden's would provide universal "access."
Contrary to scary propaganda disseminated over conservative "news" and talk radio channels, none of the Democratic candidate's proposals involve "socialized medicine", and none take away any choice of providers (unless you are in an HMO or PPO plan v. a fee for service plan, which is exactly the same as it is now). The top-tier candidates all let you keep your current insurance if you prefer, and offer more options for the unemployed, the self-employed, low-income families, and the uninsured.
Following are summaries of the Clinton, Edwards, and Obama proposals:
Hillary Clinton:
Clinton's "America Health Choices" plan (modeled after Edwards' plan) would let you keep your current employer-provided or individual health insurance, or opt-in to the Federal Employee Health Benefit Program (FEHBP) which is the same plan offered to members of Congress, or let you purchase insurance from a menu of private plans or a new public plan modeled after Medicare.
Clinton's plan would establish uniform "insurance rules across states and markets," to ensure that "no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums." Under the Clinton plan, enrolling in one of the health insurance offerings is mandatory for all citizens.
Clinton would require employers to help finance the system, with large employers required to provide health insurance or contribute to the cost of coverage and small employers receiving tax credits to continue or start health insurance plans. Medicaid and SCHIP would be "fixed" to ensure that low-income, uninsured are covered.
Working families would receive refundable tax credits to help pay for health insurance, and the tax credits would be designed so that premiums would not exceed a fixed percentage of income. Tax credits would be paid for by eliminating the Bush tax cuts for the wealthy. Clinton's plan would also provide tax credits for retiree health benefit plans.
Clinton proposes to improve the quality of health care and control costs through preventive medicine, better use of information technology, eliminating overpayments, funding for independent research into the effectiveness of treatments, and allowing Medicare to negotiate prescription drug prices,
John Edwards:
Edwards' proposal focuses on employer-provided health insurance, saying "Businesses have a responsibility to support their employees' health." The Edwards and Clinton plans are similar, except that Edwards does not offer buy-in to the Federal Employee Health Benefit Program. There would be regional "Health Care Markets" purchasing pools offering a menu of competing plans, with at least one public plan modeled after Medicare. Edwards would make health insurance mandatory once all these offerings are in place.
Edwards' plan also focuses on improving the quality of healthcare, with emphasis on "evidence based medicine", best practices, information technology, public-private research partnerships, and reducing medical errors.
Edwards also proposes to reward higher quality health care by paying higher rates to plans and providers that deliver the best health care, and to penalize plans that "fail to meet critical, easily quantifiable goals."
Edwards would create a "Consumer Reports" for health care to "help Americans evaluate hospitals' effectiveness in treating injuries and diseases." Edwards would also fund programs to eliminate health disparities among low-income and minority populations.
Barack Obama:
Obama's plan is similar to Clinton's and Edwards' except it would only be mandatory for children to enroll. It would establish a public program similar to the Federal Employee Health Benefit Program for those without access to insurance through their employer or a public assistance program such as Medicaid. There would be subsidies for low-income families and individuals who do not qualify for Medicaid or SCHIP. Medicaid and SCHIP eligibility would be expanded. There are also several proposals for overall improvement in public health.
A "National Health Insurance Exchange" would allow anyone to "enroll in the new public plan or purchase an approved private plan, and income-based sliding scale subsidies will be provided for people and families who need it."
Employers who do not provide health insurance would be required to contribute a percentage of payroll to help fund the national plan.
Obama would improve quality and lower costs by requiring data collection and reporting for providers who participate in the public plan, promoting patient safety, promoting best practices, providing incentives for higher quality health care, supporting disease management programs, coordinating and integrating care, promoting better use of information technology, and requiring full transparency regarding costs. Obama would also offset employer health care plans for costs related to catastrophic illness or injury as long as employers use the money to maintain lower premiums.
Obama would also increase competition through the National Health Insurance Exchange, and would "force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration" in markets that are not competitive. Obama would also allow drug reimportation, increase the use of generics, and allow Medicare to negotiate prescription drug prices.
Obama's plan also mentions "medical malpractice reform." He proposes to "strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance" and to "promote new models for addressing physician errors that improve patient safety, strengthen the doctor-patient relationship, and reduce the need for malpractice suits."
Conclusion
Clinton, Edwards, and Obama all propose essentially the same thing. They all focus on employer-provided insurance as the primary source of health care, they all expand or at least "fix" (in Clinton's case) Medicaid and SCHIP, they all propose a new national health care plan with access to portable, private plans for anyone, and they all propose a variety of measures to improve quality of health care and control costs.
The Dodd and Richardson proposals are similar. Richardson would also lower the eligibility age for Medicare to 55. Biden would also expand Medicare to cover those 55 and over, expand SCHIP, allow buy in to the Federal Employee Health Benefit Program, and also establish a "reinsurance" program to cover catastrophic costs if insurers agree to not exclude anyone from coverage.
You can review the other Democratic candidate's positions on health care here:
• Dennis Kucinich
• Chris Dodd
• Bill Richardson
• Joe Biden
| Clinton | Obama | Edwards | Richardson | Dodd | Biden | Kucinich | |
| Universal | • | • | • | • | |||
| Single payer | • | ||||||
| Mandatory | • | (1) | • | • | (2) | • | |
| Fully portable | • | ||||||
| No exclusions | • | • | • | • | • | (3) | • |
| Subsidized | • | • | • | • | • | • | • |
(1) Obama's plan is mandatory for children only
(2) Dodd's plan calls for "automatic enrollment"
(3) Biden's plan to reduce exclusions is incentive based
Gravel also has a plan that involves "vouchers" paid for with a "national sales tax" that would cover everyone, but it is short on details and you have to sit through a rambling YouTube video to even get that much info.
While Kucinich is considered a "fringe" candidate, his is the only plan that includes all the elements, and his is the only plan that has actually been introduced into Congress (HR676).
Kucinich's proposal (which is to basically end traditional health insurance and open Medicare up to all Americans) is also the only plan that would remove employer-provided insurance from the equation, and for that reason is the only fully portable plan. While the others offer alternatives to employer-provided insurance, they focus on perpetuating the current system of employer-provided health insurance, which by definition is not portable if you change jobs or lose your job.
There is also a distinction between "universal coverage" and "universal access". Only Kucinich's plan and the other plans that are mandatory would provide universal "coverage". Plans such as Obama's and Biden's would provide universal "access."
Contrary to scary propaganda disseminated over conservative "news" and talk radio channels, none of the Democratic candidate's proposals involve "socialized medicine", and none take away any choice of providers (unless you are in an HMO or PPO plan v. a fee for service plan, which is exactly the same as it is now). The top-tier candidates all let you keep your current insurance if you prefer, and offer more options for the unemployed, the self-employed, low-income families, and the uninsured.
Following are summaries of the Clinton, Edwards, and Obama proposals:
Hillary Clinton:
Clinton's "America Health Choices" plan (modeled after Edwards' plan) would let you keep your current employer-provided or individual health insurance, or opt-in to the Federal Employee Health Benefit Program (FEHBP) which is the same plan offered to members of Congress, or let you purchase insurance from a menu of private plans or a new public plan modeled after Medicare.
Clinton's plan would establish uniform "insurance rules across states and markets," to ensure that "no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums." Under the Clinton plan, enrolling in one of the health insurance offerings is mandatory for all citizens.
Clinton would require employers to help finance the system, with large employers required to provide health insurance or contribute to the cost of coverage and small employers receiving tax credits to continue or start health insurance plans. Medicaid and SCHIP would be "fixed" to ensure that low-income, uninsured are covered.
Working families would receive refundable tax credits to help pay for health insurance, and the tax credits would be designed so that premiums would not exceed a fixed percentage of income. Tax credits would be paid for by eliminating the Bush tax cuts for the wealthy. Clinton's plan would also provide tax credits for retiree health benefit plans.
Clinton proposes to improve the quality of health care and control costs through preventive medicine, better use of information technology, eliminating overpayments, funding for independent research into the effectiveness of treatments, and allowing Medicare to negotiate prescription drug prices,
John Edwards:
Edwards' proposal focuses on employer-provided health insurance, saying "Businesses have a responsibility to support their employees' health." The Edwards and Clinton plans are similar, except that Edwards does not offer buy-in to the Federal Employee Health Benefit Program. There would be regional "Health Care Markets" purchasing pools offering a menu of competing plans, with at least one public plan modeled after Medicare. Edwards would make health insurance mandatory once all these offerings are in place.
Edwards' plan also focuses on improving the quality of healthcare, with emphasis on "evidence based medicine", best practices, information technology, public-private research partnerships, and reducing medical errors.
Edwards also proposes to reward higher quality health care by paying higher rates to plans and providers that deliver the best health care, and to penalize plans that "fail to meet critical, easily quantifiable goals."
Edwards would create a "Consumer Reports" for health care to "help Americans evaluate hospitals' effectiveness in treating injuries and diseases." Edwards would also fund programs to eliminate health disparities among low-income and minority populations.
Barack Obama:
Obama's plan is similar to Clinton's and Edwards' except it would only be mandatory for children to enroll. It would establish a public program similar to the Federal Employee Health Benefit Program for those without access to insurance through their employer or a public assistance program such as Medicaid. There would be subsidies for low-income families and individuals who do not qualify for Medicaid or SCHIP. Medicaid and SCHIP eligibility would be expanded. There are also several proposals for overall improvement in public health.
A "National Health Insurance Exchange" would allow anyone to "enroll in the new public plan or purchase an approved private plan, and income-based sliding scale subsidies will be provided for people and families who need it."
Employers who do not provide health insurance would be required to contribute a percentage of payroll to help fund the national plan.
Obama would improve quality and lower costs by requiring data collection and reporting for providers who participate in the public plan, promoting patient safety, promoting best practices, providing incentives for higher quality health care, supporting disease management programs, coordinating and integrating care, promoting better use of information technology, and requiring full transparency regarding costs. Obama would also offset employer health care plans for costs related to catastrophic illness or injury as long as employers use the money to maintain lower premiums.
Obama would also increase competition through the National Health Insurance Exchange, and would "force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration" in markets that are not competitive. Obama would also allow drug reimportation, increase the use of generics, and allow Medicare to negotiate prescription drug prices.
Obama's plan also mentions "medical malpractice reform." He proposes to "strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance" and to "promote new models for addressing physician errors that improve patient safety, strengthen the doctor-patient relationship, and reduce the need for malpractice suits."
Conclusion
Clinton, Edwards, and Obama all propose essentially the same thing. They all focus on employer-provided insurance as the primary source of health care, they all expand or at least "fix" (in Clinton's case) Medicaid and SCHIP, they all propose a new national health care plan with access to portable, private plans for anyone, and they all propose a variety of measures to improve quality of health care and control costs.
The Dodd and Richardson proposals are similar. Richardson would also lower the eligibility age for Medicare to 55. Biden would also expand Medicare to cover those 55 and over, expand SCHIP, allow buy in to the Federal Employee Health Benefit Program, and also establish a "reinsurance" program to cover catastrophic costs if insurers agree to not exclude anyone from coverage.
You can review the other Democratic candidate's positions on health care here:
• Dennis Kucinich
• Chris Dodd
• Bill Richardson
• Joe Biden