Thank you for joining us recently for our conference call with the Friends of the Galen Institute. We had a lively discussion about the presidential race and the health care plans of the leading candidates. We'd like to thank AEI's Tom Miller for his contribution to the call. A summary is below.
We look forward to talking with you again soon.
Grace-Marie  Health Plans of the
Presidential Candidates
Galen Institute Conference call held February 21, 2008
Grace-Marie welcomed everyone and gave an overview of the agenda for the call. She said she would offer an overview of the health policy proposals of the Democratic presidential candidates. Tom Miller of AEI would offer insights into the health reform plan for Senator John McCain, whom he advises, and then we would open the phones to questions from those on the call about these plans and an exchange of information about other health policy issues.
Grace-Marie: Now that it appears the Democratic presidential contest will keep going for some time, health care will continue to be a major topic of debate.
While most of the disagreement between Sens. Hillary Clinton and Barack Obama has focused on universal coverage -- and particularly an individual mandate -- that dispute is actually overshadowing how many similarities there are between their two health policy proposals.
The sooner that voters focus on the larger picture, the better informed their decisions can be.
There are a number of provisions in both the Clinton and Obama health plans which are not controversial, such as a greater emphasis on using health information technologies, offering a choice of health plans, better prevention and chronic care management, etc.
But here is a partial list of what Sen. Clinton and Sen. Obama are proposing that underscores their visions of a much larger role for government in our health sector. Both, for example, would create new health care purchasing arrangements that would heavily regulate the health insurance market. In addition, they both propose:
• Requiring insurers to charge basically the same premium to everyone regardless of age, gender, or occupation, called community rating
• Requiring insurers to offer coverage to anyone who applies through guaranteed issue and prohibiting denials for pre-existing conditions
• Requiring insurers to offer health insurance that is at least as generous as the comprehensive coverage available to members of Congress
• Requiring employers to contribute to the health coverage for their workers through a "pay or play" mandate, with small business getting added help to offset costs
• Creating new government payments to businesses to reimburse them for some of the catastrophic costs of employees with large medical expenses -- providing certain conditions are met. This was a proposal similar to one offered by Democratic presidential candidate John Kerry in 2004.
• Opening the Federal Employees Health Benefits Program to millions more workers and setting up other regulated health insurance purchasing exchanges
• Expanding Medicaid and the State Children's Health Insurance Program
• Allowing people to buy in to Medicare, thereby setting up competition between a taxpayer-subsidized program with federal pricing and policing authority and private health plans
• Curtailing private competition in Medicare by scaling back payments for Medicare Advantage and allowing the government, rather than private companies, to negotiate prescription drug prices for the Medicare drug benefit
• Allowing prescription drug importation from abroad, which means importing other countries' systems of price controls (as Sen. McCain also has proposed), and placing new controls on prescription drug prices
• Inserting greater government involvement in determining the comparative effectiveness of medical treatments and requiring doctors and hospitals to practice according to these evidence-based protocols.
Sen. Clinton has criticized Sen. Obama for proposing a plan that does not have universal coverage as its central goal, even though he would begin with a mandate that all children be covered.
This dispute is important, but it should not obscure the many, many other provisions in their plans over which there is little debate but which would inject a much larger role for the federal government in health care financing and delivery.
Tom Miller: Most of the Republican presidential candidates' plans have been organized around the ideas of creating greater fairness in the way the tax code treats health insurance and making health insurance more portable.
Sen. McCain would focus in particular on giving individuals and families greater control over their health care and health coverage decisions. Here are some highlights of his health policy proposal:
• A refundable tax credit of $2,500 for individuals and $5,000 for families toward the purchase of health insurance and health care services
• No mandates on either employers or individuals to purchase health insurance
• Focus on lowering costs first
• Better chronic care management
• Paying for value
• Personal health responsibility
• Deregulation of health insurance to produce more competition in the health sector
• Allowing people to purchase health insurance across state lines
• Deregulation of care delivery by encouraging retail health clinics, national licensing of providers, etc.
Questions and discussion from participants included conversations on how Sen. McCain's tax credit would work, other state-based initiatives to protect individual rights in health care, intellectual property rights including the Patent Protection Act making its way through Congress, and the impact of having government plans, like Medicare and the FEHBP, compete with private plans as new health coverage options.
Grace-Marie concluded that there will be much more time to analyze all of these provisions in the coming months, and we will continue to host these calls and discussions so we all can stay informed. | 
