MELISSA BLOCK, host:
Health care was a big part of last night's Democratic presidential debate. Most of the back and forth between Hillary Clinton and Barack Obama wasn't new, but it does represent one of the few issues on which the candidates have a serious policy disagreement.
We've asked NPR's Julie Rovner to help us truth squad some of the charges and countercharges from last night's exchange.
And Julie, let's start with what the candidates' health plans would do because they're actually quite similar, right?
JULIE ROVNER: Yes, indeed, they are. And that's not really a coincidence. They were built off the same foundation, if you will; a plan that was shopped around to all the Democratic candidates by a Yale University political science professor named Jacob Hacker.
Actually, Senator Obama put it very well in the debate last night. Let's let him describe the similarities.
Senator BARACK OBAMA (Democrat, Illinois; Presidential Candidate): We both - 95 percent of our plans are similar. We both want to set up a system in which any person is going to be able to get coverage that as good as we have as members of Congress. And we're going to subsidize those who can't afford it. We're going to make sure that we reduce cost by emphasizing prevention, and I want to make sure that we're applying technology to improve quality, cut bureaucracy.
BLOCK: So he's saying the plans are 95 percent similar, but in that remaining 5 percent is one key difference and that's whether or not the candidates would require, would mandate, everyone to have health insurance.
ROVNER: That's right. It's the one key difference. It's called an individual mandate. She has one. He doesn't. And that leaves her free to make charges like this one.
Senator HILLARY CLINTON (Democrat, New York; Presidential Candidate): When I proposed the universal health care plans, as did Senator Edwards, we took a big risk because we know it's politically controversial to say we're going to cover everyone. And you chose not to do that. You chose to put forth a health care plan that will leave out at least 15 million people. That's a big difference.
BLOCK: A plan that will leave out at least 15 million people, Julie. Is that number correct?
ROVNER: Well, Senator Obama and his experts certainly don't think so. They think that they can cover almost all of the uninsured simply with a voluntary system. But most of the economists say that you can't do that. That you need some sort of a mandate. And in fact, the urban institute came out with a study just a couple of weeks ago that said having a voluntary system like the one that Senator Obama has proposed would in fact leave uncovered about fifteen and a half million people. So that number is pretty close to what Senator Clinton has been saying.
BLOCK: So, then, Senator Obama raises the question that if you have a plan to mandate insurance for everyone, how do you go about enforcing that?
ROVNER: That's right, and that's been his main argument against Senator Clinton's plan, what it would mean to actually have to enforce that mandate. And here's how he put it last night.
Sen. OBAMA: In order for you to force people to get health insurance, you've got to have a very harsh stiff penalty. And Senator Clinton said that we will go after their wages. Now, this is a substantive difference, but understand that both of us seek to get universal health care. I have a substantive difference with Senator Clinton on how to get there.
BLOCK: Julie, has Hillary Clinton said that under her plan, they would go after people's wages, if they don't buy health insurance?
ROVNER: Well, it's not part of her plan, but she has been ousted by some reporters and she said that that was a possibility. But what Senator Obama is not saying is that he might have to do that too since he has a mandate in his plan for children, so he might have to go after parents' wages if they don't pay the health insurance premiums for their children.
Now, Senator Clinton makes the point that health insurance shouldn't be any different than any other type of social insurance.
Sen. CLINTON: It would be as though Social Security were voluntary. Medicare, one of the great accomplishments of President Johnson, was voluntary. I do not believe that is going to work.
BLOCK: Drawing a tie between what she is proposing for health insurance and programs that have long been accepted as part of our economic and social system.
ROVNER: Yes. And I think this is, you know, the remaining - one of the few differences, I think, between these two candidates is they go down the line toward these two very big primaries.
BLOCK: Okay. NPR health policy correspondent Julie Rovner, thanks so much.
ROVNER: You're welcome.
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