Presidential Candidates Discuss Health Care Plans

Presidential candidates share their health care plans during a forum that focuses on a single but complex issue. The candidates, who participate in the forum at different times, are able to go beyond the usual sound-bite and give their rationale for supporting their positions.

RENEE MONTAGNE, host:

We turn now to presidential politics in the U.S. And one of the domestic issues voters say is most important to them is health care. In an effort to get beyond the usual soundbites in the debates or on the stump, two health groups - one led by a Democrat, the other by a Republican - decided to try something different.

This fall, the groups Families U.S.A. and the Federation of American Hospitals have organized hour-long forums where individual presidential candidates are questioned about their health care plans by four independent health policy journalists.

NPR's own Julie Rovner has been one of those questioners at the six forums held so far. And she joined us to give us an update about what she's learned.

Hi, Julie.

JULIE ROVNER: Good morning.

MONTAGNE: Let's start with the list of candidates who have attended these forums. It's supposed to be bipartisan. Has it been?

ROVNER: Well, that is bipartisan as we'd originally hoped, though mostly for scheduling reasons. In order, we've had Democrats John Edwards and Hillary Clinton and Dennis Kucinich and Joe Biden; then Republican John McCain and Democrat Bill Richardson. We've got at least three more Republicans who are committed to participating and one more Democrat.

So by the time we're done, I think we'll have a bit better balance between the parties. I think still more Democrats. But that may be more a reflection of the fact that health care is still more an important voting issue for Democratic voters than for Republican voters.

MONTAGNE: Well, okay. Then let's start with Democrats. What's the headline here?

ROVNER: Well, I think Senators Clinton and Edwards and Governor Richardson have pretty similar plans. Interestingly enough, they're actually based in large part on the plan that's now being tried in the state of Massachusetts.

Here is how Senator Edwards explained it.

Mr. JOHN EDWARDS (Democratic Presidential Candidate): If we want to solve the big problems facing this country, it's going to require all parts of America to take some element of responsibility. All of us are going to have to have a shared responsibility to get away from a dysfunctional health care system and go to a system that covers everybody and is more efficient and dramatically reduce cost.

MONTAGNE: And Julie, what's interesting here is that shared responsibility that Senator Edwards is talking about is a concept that was developed in Massachusetts, pioneered by then-governor, now a Republican candidate, Mitt Romney. But he's not running on that plan, is he?

ROVNER: No, I think it's one of the big ironies of this campaign season that arguably the biggest breakthrough in health coverage of this decade is being shunned by the one politician who could be taking credit for it. I can't wait to ask him about it, and Romney is one of the Republicans who has agreed to participate in these forums. We're just trying to find a date.

But while Republicans may have invented the idea of this individual mandate, which is requiring individuals to purchase health insurance the way people are required to have auto insurance, rather than requiring employers to provide insurance, that doesn't sit very well with the more libertarian wing of the Republican Party. And that was something that John McCain made clear when he came to the forum.

Senator JOHN McCAIN: I don't think that there should be a mandate for every American to have health insurance. I think that one of our goals should be available and affordable college education, but I'm not going to mandate that every American go to college.

MONTAGNE: But it's not just Republicans like John McCain who are shying away from these mandates.

ROVNER: No, actually Democratic Senator Joe Biden, whose plan would concentrate on having the government pick up the cost for people with catastrophic health expenses, is trying to differentiate himself from most of the other Democrats, specifically by not having a mandate.

Senator JOE BIDEN (Democrat, Delaware): And one word Americans don't like - mandate. I don't want to make this hard. I want to make this simple and not susceptible to what some of the insurance companies and the right wing will argue this is, a mandated socialistic system. I don't want Harry and Louise eating me alive. Remember Harry and Louise?

MONTAGNE: Harry and Louise, of course, for those who don't remember, being the characters in the insurance industry ads that helped sink President Clinton's health reform efforts in the early 1990s. You know, and speaking of that effort, what does Senator Hillary Clinton say she's learned from those mistakes?

ROVNER: Well, she says she's learned quite a lot, and she's actually trying to turn that debacle into a positive, says she's learned how not to do health reform and she wouldn't make the same mistakes twice. Here's one of several things she has cited as a problem with that 1990s effort that she was part of.

Senator HILLARY CLINTON (Democrat, New York): Certainly the fact that the White House took on the responsibility of writing the legislation turned out to be a mistake. At the time it seemed like something worth doing, but I don't think that it was a smart way of investing the Congress in this rather daunting task we were taking on together. So that's why I believe presidential leadership on this issue should set a goal and set a framework, but not get into the details.

MONTAGNE: Well, finally, Julie, while most of the Democrats are running away from the label socialized medicine, there is one candidate who embraces it.

ROVNER: Right. That would be Congressman Dennis Kucinich. He's been pushing for a single-payer national health insurance program that would eliminate not only private health insurance, but all profit-making entities from the health care system entirely.

Representative DENNIS KUCINICH (Democrat, Ohio): Government works. The question is, who is it working for? And in health care, it's working for the insurance companies right now. It's working for the pharmaceutical companies. You look at their profits. You look at their Wall Street ratings. And I'll tell you something: when I'm president of the United States, it will work for the people.

MONTAGNE: That, of course, Democrat Dennis Kucinich. And Julie, this is a fair approximation of what these candidates have said.

ROVNER: Yes, it is, and there are several more to come.

MONTAGNE: That's NPR's Julie Rovner.

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