The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Candidates Need to Address the Real Health Care Reform Issue: Cost

Posted by Alan on February 13, 2008

Senators Hillary Clinton and Barack Obama have agreed to two debates before the critical Ohio and Texas presidential primaries. They’ll face off on February 21st in Austin, Texas and then meet again, just five days later on the 26th, in Cleveland. At both sessions Senator Clinton will go after her rival’s health care plan for failing to seek universal coverage. After all, she’ll remind viewers yet again, universal coverage is a moral obligation of society and a litmus test for real Democrats. Been there. Done that. Now it’s time for a new discussion on health care reform.

Health care reform is complicated, complex and challenging, but at its core it boils down to two issues: access and affordability. Access is actually the easier of the two for politicians to address. Just promise voteres they’ll be covered and, if at all possible, avoid talking about what that coverage will look like. If you must address the benefit package, say it will be similar to”fill in the blank” — Medicare, Medicaid, Congress’ health plan, Canada’s. Everyone will assume it covers what they want it to cover. (How many people know prescription coverage is not covered in most Canadian provinces?)

Controlling skyrocketing health care costs is a lot tougher. But as Congressional Budget Director Peter Orszag has made clear, it’s absolutely critical to the country’s financial wellbeing. Yet the topic makes politicians uncomfortable. They have to talk about voters getting the coverage they need, not everything they want. It means tough choices about what’s the responsibility of the coverage provider (whether it’s a private insurance company or a government agency) and what’s the responsibility of individual Americans. It requires explaining what is driving the costs — not only an aging population and new technologies, but consumer expectations, as well. There was a time when a drug addiction was dealt with by the criminal justice system; now it’s a medical issue. It means addressing America’s life style and pointing out that America’s obesity rate is 30 percent higher than Canada’s. That’s a harsh statement to make when you’re going after the couch potato vote. 

During previous debates, the candidates have gotten a free pass on addressing the issue. They’ve made vague references to how they’d reduce medical costs, but I don’t think there’s been a single follow-up question on the topic.

That should change — and it might. The Austin debate is hosted by CNN. On the channel’s Anderson Cooper 360 Degrees on Tuesday night, the pundits actually acknowledged the importance of addressing health care costs, lamenting the candidates’ failure to address the issue.

Was anyone at CNN watching CNN at the time? It’s a 24-hour news channel. CNN and its competitors have to put something between all those commercial breaks. If getting the candidates to talk about controlling medical costs, make them talk about it. Devote a 30 minute segment to the cost control provisions in the both the Democratic and Republican candidates’ health care reform packages. Ask them what ideas they are they pushing and which ones they won’t even consider. Ask them to discuss rationing. Make them describe the sacrifices they’d ask of Americans.

And those debates? CNN is hosting the one on February 21st. Maybe CNN could bring up this issue then?

There’s no need for CNN’s talking heads to lament the candidates’ failure to address an issue: they have the power to force them to discuss it. And they should.


3 Responses to “Candidates Need to Address the Real Health Care Reform Issue: Cost”

  1. conductor4 said

    I believe it is an industry wide issue. Look at what the insurance industry did to the people hit by katrina. They find ways not to have to cover the customer that paid faithfully for the coverage,then posted record profits for the year. INTEGRITY where is it in America ? Cut out profit and we might have a chance

  2. You are so right that neither of the candidates is addressing costs. They are both stuck in the current paradigm of health care delivery, that they have lost sight of other possible ways of examining health care, such as re-vamping the entire system.

    We recently completed two market research surveys in Iowa and Washington state and much more consensus exists on what the public does and does not want in health care. This was high level research, but it does show there is significant common ground on some core concepts. It also shows the critical role Independents play in reform. They tend to side with the Democrats on access and benefits and with the Republicans on personal responsibility and financing.

    Click to access CBN%20Pulse–IA%20and%20WA%20by%20Voting%20Record%20FINAL.pdf

    What is refreshing, however, is where there is little consensus, the public tends more to “don’t know” rather than “disagree.” This means it is safe to have a thoughtful conversation to explore the options open to us, rather than hiding under a log to avoid the anticipated fist fight.
    The American public can be thoughtful, practical people if they are invited to solve a problem rather than having solutions rammed down our throats.

    But whatever direction we take on cost control, we need to listen to all voices–Democrat, Republican and Independent, because it is the Independents who will sway the outcome.

    Kathleen O’Connor

  3. The high healthcare costs in the U.S. are the product of the current regulations. U.S. tax law, combined with the idea that employer-sponsored health-care is “a good thing”, have combined to create a situation where health-insurance is not insurance at all. Instead, it covers every little expenditure — like a managed account. From this root, springs the fact that a huge bureacracy is required to monitor these managed spending accounts.

    Here’s a good article on the history of health-care costs.

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