From Tribune
By Mike Dorning, Washington Bureau; Tribune senior correspondent William Neikirk contributed to this article
January 26, 2007
Candidates embrace universal insurance
WASHINGTON -- Leading Democratic presidential candidates are showing a passion for ambitious plans to provide health-care coverage to all Americans that the party has not shown since the Clinton administration's health plan turned into a political debacle in 1994.
The GOP takeover of Congress that year was credited in part to opposition to the Clinton plan. Since then, Democrats have concentrated on more modest, incremental efforts to expand health coverage, such as subsidized insurance for low-income children and prescription drug coverage for the elderly.
In 2003, President Bush secured passage of a Medicare drug benefit, though many Democrats thought it did not go far enough.
But this year, the three most prominent Democratic presidential candidates all have declared their intention to move the country toward universal health-care coverage
Sen. Barack Obama (D-Ill.) committed on Thursday to providing health-care coverage for every American within six years.
"I am absolutely determined that by the end of the first term of the next president, we should have universal healthcare in this country. There's no reason we shouldn't have that," Obama said in a speech to Families USA, a liberal health advocacy group.
Big issue in campaign
Former Sen. John Edwards of North Carolina declared in announcing his presidential campaign in December that he would back universal healthcare, even if it required expanding the federal budget deficit.
And Sen. Hillary Rodham Clinton (D-N.Y.), who as first lady spearheaded the Clinton administration's ill-fated plan, also has made health-care coverage for all a central theme--highlighting her commitment by appearing at a community health-care center last weekend, the day after announcing she was forming an exploratory committee.
"One of the goals that I will be presenting . . . is health insurance for every child and universal healthcare for every American," Clinton said on Sunday. "That's a very major part of my campaign."
An adviser to one of the Democratic candidates said that healthcare is among the top concerns of the public, particularly likely Democratic primary voters, and that campaign strategists expect health coverage will be a paramount issue in the struggle for the nomination.
"We expect that it's going to play a bigger role than it ever did," said the Democratic adviser, who declined to be otherwise identified.
Governors offer plans
Several Republican governors also have recently embraced the goal of health-care coverage for all.
Former Massachusetts Gov. Mitt Romney, who is expected to be a GOP presidential candidate, signed legislation requiring all state residents to get health insurance by July 1 or face a tax penalty, with the state subsidizing insurance for lower-income residents. California Republican Gov. Arnold Schwarzenegger kicked off his second term this month with a call to assure healthcare for all state residents.
The president, meanwhile, this week offered a health-care plan of his own, aimed at helping more Americans obtain health insurance. Bush spoke Thursday about his proposal at a conference outside Kansas City, Mo.
In Illinois, Democratic Gov. Rod Blagojevich's All Kids program was the first in the nation to offer state-subsidized health insurance to all children. During his re-election campaign last year and since, Blagojevich has spoken of his interest in moving the state toward a broad universal health-care program.
In his speech Thursday, Obama argued that the political climate has shifted since 1994, opening an opportunity for universal healthcare.
He noted that more employers have dropped private health-care coverage since then. Employees with coverage are paying higher premiums and co-payments. And, he said, American companies face greater competitive pressure from foreign businesses that are not burdened with health-care costs because their governments provide coverage.
"We are not in 1992. We are not in 1993. We are not in 1994. We don't have to be intimidated," the senator said.
Obama: 'A top priority'
Obama said he would offer a plan for universal health coverage within "several months" and said the goal would be "a top priority" for him.
He otherwise provided few details, though he called for a greater focus on preventive healthcare to reduce doctors' visits and argued that the country could save on administrative costs by requiring greater use of electronic insurance claims. He said the country should examine "how much of our spending is going toward the record-breaking profits earned by the drug and health-care industry."
Obama hinted that he might re-examine the building block of the current health insurance system, in which most workers received group health insurance through their employers.
"At a time when businesses are facing increased competition and workers rarely stay with one company throughout their lives, we also have to ask if the employer-based system of healthcare itself is still the best for providing insurance for all Americans," Obama said.
Asked to clarify the comment afterward by reporters, he said, "I don't think we immediately replace the employer-based system."
He added that he would be looking at such options as broadening employer-based group plans into larger insurance pools and improving the portability of health-insurance coverage as employees move in and out of jobs.
Edwards and Clinton also have yet to offer detailed plans on health coverage, but spokesmen for both said they would release proposals in the coming months.
47 million uninsured
Economist Henry Aaron of the Brookings Institution, a think tank with a liberal leaning, and health-care expert Stuart Butler of the Heritage Foundation, a conservative think tank, both said establishing universal health-care coverage would be enormously difficult.
Butler, who has studied America's health-care system for 30 years, said he supports universal coverage, but that the current system would require a drastic overhaul and that the "costs would be staggering." An estimated 47 million Americans have no health insurance.
Aaron, who has been working on reform of America's health-care system for more than 25 years, said the climate for universal coverage has improved, but probably not enough to get very complex legislation passed in the next several years.
To adopt a universal plan is "technically enormously difficult," Aaron said, and would have to take into account that the U.S. has a highly diverse population and a highly diverse health-care system. It would require passage of several pieces of legislation that could take years to get through Congress, he said.
"I am not sure that even a new president and a new Congress can work through those devilish details" in the next presidential term and pass a universal plan, he said. Still, he said, if the supporters of a national plan avoid the mistakes of the Clinton administration, "they've got a shot."
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mdorning@tribune.com
Copyright © 2007, Chicago Tribune
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