The third session of the World Health Care Congress was begun by a talk from Rep Jim Cooper (D TN), one of Barack Obama’s health policy folks. Rep Cooper primarily condemned Sen McCain’s policy, while noting that both Democrats’ platforms were essentially identical – with one notable exception – Obama does not mandate coverage.
(A comparison of the Clinton and Obama plans is here)
According to Cooper, the upfront problem w universal coverage is that it will result in “zero Republican votes” – a completely wrong statement. For example, Ron Wyden’s (D OR) Healthy Americans Act has six (6) GOP cosponsors – and the HAA specifically calls for universal coverage.
McCain’s spokesman, Thomas Miller of the American Enterprise Institute, talked a good bit about the tax implications of McCain’s plan – a program that is remarkably similar to Pres. Bush’s plan (that got absolutely zero traction in Congress). Miller noted that McCain’s plan relies on the market and individual motivation to buy insurance, a motivation that will be enhanced by a tax credit for those how buy coverage (a tax credit that amounts to $2500 for an individual or $5000 for a family, about half of what coverage actually costs).
I’d note that Mr. Miller did not mention that Sen McCain’s plan will also be quite expensive. The cost of the Senator’s tax credits would be $206 billion in FY 2009 and $3.6 trillion over 10 years.
Chris Jennings spoke for Sen Clinton, and he started with the (I would argue sole) difference between the Clinton and Obama plans – she wants mandated universal coverage and he does not. Mr Jennings noted that half the cost comes from rolling back the Bush tax cuts and half from programmatic savings, but he did not add much in the way of new insights into how Sen Clinton’s plan will reduce costs.
There were two commentors – George Halvorson, CEO of Kaiser Permanente, and fomer Sec of State (and other departments) George Shultz. Halvorson began with the good news, that candidates are talking at a level of detail and comprehension re health care that is unprecedented. We’ve moved away from sound bites and deep into the details, a transformation that is quite encouraging to Mr. Halvorson.
George Shultz noted that if people work longer there will be more GDP, and this will help pay for more health care. He also opined that the reason people are living so much longer over the last 60-80 years is due to basic research and development of technology and pharmaceuticals. This, I would note, is in direct conflict with every other expert’s view on the subject – sanitation, nutrition, antibiotics and infectious disease control are overwhelmingly responsible for the improvement in lifespan, not MRI machines and new drugs (with the notable, but not overwhelmingly important, exception of antibiotics).
Finally, someone raised the question of comparative effectiveness evaluation – and all spokesmen agreed that we need to do a lot more of it. The elephant in the room is the AMA, and their likely-nuclear reaction to anything that smacks of ‘telling physicians how to practice medicine’.
But here’s my primary takeaway – everyone on the panel called for universal coverage even if McCain’s spokesman’s support was muted at best.
Apr
21
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