Corinne Ramey

Where Do the Candidates Stand on Health Care? John Edwards

You know that American health care is getting bad when a presidential candidate threatens to take away the health care plan of every single member of Congress. John Edwards did just that on Tuesday when he released a video ad with the following text:

“When I’m president I’m going to say to members of Congress and members of my administration, including my cabinet: I’m glad that you have health care coverage and your family has health care coverage. But if you don’t pass universal health care by July of 2009 – in six months – I’m going to use my power as president to take your health care away from you. [Applause] There’s no excuse for politicians in Washington having health care when you don’t have health care. I’m John Edwards and I approve this message.”

Sure, the ad -- which was released in Iowa -- has all the trappings of a political gimmick. But Edwards does have a point, and, as David Sirota points out, Edwards would actually have this power if elected President. If members of Congress have such an awesome health care plan, shouldn't the rest of the country have access to affordable and quality care, too? And if ending health care for all members of Congress, senior political appointees, and the President assures that universal care gets passed, then I'm all for it. Given the legislative pinball match that we saw with SCHIP -- the bill bounced back and forth between the House and Senate and Bush's veto pen -- threats at this point might be a good idea.

Edwards' health care proposal is the best of the candidates' plans that I've seen so far. It's universal, comprehensive, fairly detailed, and provides care for every American. Here are the details:

The plan calls for expanding both public and private insurance, and will require every American to have coverage. Universality would be "enforced" by checking insurance at schools, hospitals, clinics and other locations. Premiums could also be collected through the tax system, and people could be enrolled in a default plan if necessary.

Edwards plans to expand SCHIP and Medicaid to cover all adults under the poverty line and all families under 250% of the poverty line. Employers will be forced to either provide health care for their employees or pay into an insurance fund. Edwards will also regulate private insurers, forcing them to charge fair premiums regardless of preexisting condition like medical history, job type, or age. "No longer will insurance companies be able to game the system to cover only healthy people," his health care policy states.

One thing that differentiates Edwards from other candidates with universal plans -- especially Obama -- is his creation of regional Health Care Markets. Health Care Markets are, according to Edwards, "non-profit purchasing pools that offer a choice of competing insurance plans." These regional government agencies would collect premiums, enroll members, and negotiate with private insurers. The Markets would also allow people to keep their insurance when they change or lose jobs or are in between employers. According to Edwards, the Markets will also reduce administrative cost because of the reduced need for marketing and underwriting, which Edwards says makes up 2/3 of the overhead of private insurers. The Markets will also work with insurers to provide preventative care and increase care quality through a community rating system.

And now for the most interesting part of Edward's health care plan. Not only does Edwards' plan do a darn good job of providing affordable universal health care, but it sets up a bit of an experiment between private and public insurance systems. Edwards' plan reads:

"Health Care Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan."

The choice between public and private insurance, hypothetically, will increase competition and force private insurers to lower cost and increase efficiency or risk losing customers to the public plan. If private insurers can't survive, then we could end up with a single-payer system. As EJ Eskow says in the Huffington Post, "It's interesting to contemplate government takeover of the health economy happening in reverse - but with a twist. If the private sector can prove it really is more efficient - or can if it become more efficient - it stays in the game and might even gain ground." Edwards' doesn't just tell us that the government can do a better job of providing care than the private sector -- he makes the market figure that out for itself. And even if he's wrong, and the private sector wins, he still comes out on top for forcing insurance companies to increase efficiency and lower costs.

There are some ambiguities in this plan that I think should examined, such as what would happen if an employer actually chooses to provide insurance instead of relying on the Health Care Markets. Additionally, Edwards' plan isn't cheap -- he estimates that the plan will cost between $90-120 billion each year, and he'll pay for his plan by canceling Bush's tax cuts on Americans who make more than $200,000 each year. But, considering that the plan could end up saving $130 billion in health care spending each year and would provide affordable care for all, those billions of dollars are certainly worth it.

Stay tuned! The "What Do the Candidates Stand on Health Care?" series continues next week.

Corinne Ramey: Author Bio | Other Posts
Posted at 7:07 AM, Nov 18, 2007 in Health Care | The Candidates on Health Care
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