To save myself from writing many posts (and you from reading them) I have lumped the republican presidential candidates’ health care plans into one post. I know it looks partisan – a slight to the Republicans – but if we get serious, the Republicans have slighted health care reform. There is just not that much to discuss.
For example, take a look at
Huckabee’s health care plan. He states that our system is broken, that we do not need universal health care mandates, that he will allow for the public sector to innovate, and the States should act as laboratories. It’s a great opening. Now where is the plan?
McCain’s health care plan is stronger (maybe the strongest of the Republicans). The details are not there, but it seems that McCain wants to de-link health insurance from employment. I say this because he talks of portability of plans, purchasing plans nationwide, allowing families to buy insurance from any group (churches, professional associations, etc.), and he wants to change the tax code so that it does not favor employee sponsored insurance. He favors tax credits to purchase insurance instead. He also talks about risk adjustment within Medicaid. I like that he mentions risk adjustment, but it certainly is not a well developed idea. Lastly, McCain states that costs must be reigned in before any real reform can take place. I agree with him there. How exactly? McCain has ideas – some of them good – but I wouldn’t call it an integrated plan.
I searched Giuliani’s website and could not find a health care plan (it was at least not under the category “Issues”). I’m basing this critique off the Kaiser Family Foundation’s website. Giuliani wants to cover the uninsured by making it easier for them to purchase insurance. One, there will be a tax deduction for the those who buy insurance in the individual market and a tax credit for the poor. He seems to favor free market incentives. What those are seem unclear. He also seems to understand that selection issues might pose a problem, so he leaves that up to the States to figure out (he’ll provide block grants to the States so they can create innovative procedures to address adverse selection). Again, it can’t be called a plan. Giuliani has cobbled together some ideas – that’s about it.
Lastly, Romney. After he played a crucial role in creating and implementing the Massachusetts’ universal health care plan I was expecting so much, but sigh. He has nothing. Absolutely nothing. Deregulate, States take the lead, tax deductions for those without employer insurance, and medical liablity reform. Okay, something, but that is literally it. I’m disappointed.
The Republican health care plans are light except for a few good ideas from McCain. They generally believe in deregulation, a federalist approach, medical liability reform, improved medical information technology, decreased fraud, market reforms and no government mandates. Most of them don’t mention (or briefly mention) the selection issues, provider payment schemes, cost containment, or what they would do with the current public systems. Besides McCain, they give few hints that they have a grasp on health care policy. Romney’s history speaks to his understanding of health care policy, but he won’t show it for political reasons. If voting only on health care I would have to choose a Democrat.