American Madness

Intelligent Criticism in the Service of a Better Nation

Health Questions for the Presidential Candidates

Posted by Josh Friedlander | 1 Comment

[ This opinion piece appeared in the Wall Street Journal on February 20. It is reprinted here with the permission of author Betsy McCaughey Ross, a former lieutenant governor of New York, currently serving as an adjunct senior fellow at the Hudson Institute (the original "think tank"). ]

health care and the 2008 presidential electionOn March 4, voters in the Texas Democratic primary will choose between Hillary Clinton and Barack Obama. The battle is shaping up to be a health-care Alamo. Twenty five percent of people living in the Lone Star state are uninsured, according to the U.S. Census. That’s the highest rate of any state.

Sen. Clinton has issued the challenge, telling Sen. Obama “I’ll see you in Texas.” She promises to provide health coverage for “every single one of the nation’s 47 million uninsured,” and she accuses Sen. Obama of offering a “band aid” solution that would leave about a third of those 47 million uncovered.

In preparation for the Texas showdown, Sen. Clinton and Sen. Obama will debate this Thursday night in Austin — and both candidates have called for less oratory and more specifics. With that in mind, here are some of the questions they should be asked:

- Sen. Clinton: When you pledge to cover every one of the 47 million uninsured, do you include recent and future newcomers to the United States, legal and illegal?

The recent rise in the uninsured is due primarily to new arrivals and their U.S.-born children, and it is happening mostly in the five border states, according to the Center for Immigration Studies and U.S. Census data. In Texas, the cost of caring for these newcomers and children has been paid by local and state taxes, with little help from the federal government. For example, 39% of babies born in Parkland Hospital in Dallas are children of illegal immigrants. County taxpayers foot the bill.

At the University of Texas Medical Branch at Galveston, doctors are thrust into an ethical crisis. The hospital provides charity care to all. Its budget is at breaking point, and the hospital has had to lay off workers. In December, the hospital proposed that doctors triage cancer patients based on immigration status rather than medical need. But Galveston doctors say they are bound by their oath to heal, and that border control is Washington, D.C.’s problem.

Texas, as a border state, has specific problems, but also some typical ones. Of the nine million children in the U.S. considered “uninsured,” six million are already eligible for government programs such as Medicaid or Schip, but their parents have not signed them up.
[Barack Obama]

- Sen. Obama: You have said that you will require all parents to have health insurance for their children. What will you do to enforce this law?

In Texas, 850,000 children are eligible but not enrolled. The available programs provide check-ups, prescription drugs, hospital care, and dental care. The state runs radio ads, hands out brochures in several languages, and partners with community organizations to inform parents about these programs, but parents still fail to act.

- Sen. Clinton: a question about young adults. They think of themselves as invincible and are not apt to buy insurance. Your “mandate” would force them to do so, and more than that, to pay the same premium as middle aged people whose health care needs generally are much greater. You defend the one-price rule as “shared responsibility,” but isn’t it an unjust, hidden tax on the younger generation?

Today in Austin, Texas a 25-year-old man can buy a $1,000 deductible policy for $70, according to A 55-year-old man pays $270 for the same policy. In nearly all states, young adults currently get price breaks, and for good reason. They need, on average, about $1,500 a year in health care. Your health plan bars insurers from giving these price breaks to the young.

- Sen. Obama: You have pledged to make health insurance “affordable.” Texas lawmakers have made insurance less affordable by requiring that every plan include in vitro fertilization, acupuncture, marriage counseling and some 50 other features. This is like passing a law saying that the only car you’re permitted to buy is a fully loaded luxury sedan.

Would you allow Texans (and all of us who live in states with similarly costly insurance requirements) to shop for cheaper insurance outside our own state?

- Sen. Clinton: You promise that “everyone who is already insured will be able to keep the coverage they have today.” Yet your proposal says all health plans must cover services “experts deem necessary.”

About 4.5 million people have high-deductible insurance, because it costs less and allows them to make their own decisions about where and when to get medical care. But when Massachusetts passed mandatory health insurance, people with high-deductible plans were forced to switch to more expensive medical policies to meet that state’s definition of insurance.

Will that also happen under your proposal?

- Sens. Obama and Clinton: Some doctors and hospitals are worried about your plans to make electronic record-keeping compulsory. What will be the penalty for a doctor who doesn’t get computerized?

In the California primary debate, Sen. Clinton claimed a Rand study shows that savings due to information technology could pay for half of her $110-billion-a-year universal health coverage plan. What the Rand study actually says is that information technology will produce savings, estimated at $77 billion a year, but not until year 15 — and not necessarily for the thousands of doctors and hospitals who are forced to spend $125 billion (Rand’s estimate) up front for the equipment.

- Sens. Obama and Clinton: Both your proposals call for limits on the profit margins of insurance companies. Attacking the most unpopular industry in America may sound politically attractive, but if profit margins are legally capped, investors will flee to other industries and private insurance could become a thing of the past. That would leave only a government-run health-care system.

Do you believe the nation should take that risk?


One Response to “Health Questions for the Presidential Candidates”

  1. Eric Hazard
    February 28th, 2008 @

    No, no I do not.

    There are three problems with health care in the United States not being addressed by Clinton or Obama: health care being tied to your employer, the amount spent on end-of-life care and the high cost of malpractice insurance. “Mandates,” “affordable care” and “universal coverge” are great populist themes, which may inspire people, but they do nothing to address the real challenges our health care system faces.

Leave a Reply

  • Trust us

    As with Anna Karina, we prefer to remember the U.S.A as she was in the 1960s.
  • Archives

  • RSS Matt Friedlander’s Tumblr Feed

  • RSS Josh Friedlander’s Twitter Feed