Those who are banking on the outcome of the 2008 presidential election to achieve universal health coverage may have been given pause in recent days by the quality of the debate thus far. It seems that the fallout from HillaryCare continues, as candidates fear that detailed plans would only make them targets.
Among Democrats, only former Sen. John Edwardsnever before much of a health policy guruhas gone beyond platitudes, giving him the chance to steal the thunder from his two main rivals on an issue clearly worrying most voters.
Most Republicans appear to have simply photocopied the Bush administrations talking points on market driven healthcare, but one, Mitt Romney, is running on a record of actually doing something about coverage while governor of Massachusetts.
For most of the candidates, if the devil is in the details, they are standing somewhat closer to heaven. At a health policy forum in Las Vegas late last month that drew all the Democratic candidates, Edwards stood out for his detailed plan to expand federal health insurance, family tax credits, and coverage requirements on employers, insurance companies and individuals. The $120 billion tab would require new taxes, usually political hemlock but maybe not at a time when polls show growing support for sweeping healthcare reform. Edwards also pointed to the real-world experiences of his wife, Elizabeth, whose cancer recurrence adds poignancy to the debate and sparks interest in his candidacy.
Hillary Rodham Clinton, who got nuked in 1993 over a health plan that had more than a thousand pages of specifics, says she is relying on voters to fill in the blanks in her plan this time. We are bigger and more diverse, and people like their choice, she says.
She also isnt sure that taxes have to be raised to pay for her plan, whatever it is. Weve got to get the costs under control. ... Why would we put more money into a dysfunctional system? she says. I agree on this point, but pose the next question: Why not provide the details on how to rein in those costs? Its not like she lacks expertise on the topic. So far all we really know is that she likes electronic health records.
As for Sen. Barack Obama of Illinois, who has called for universal coverage by the end of his first term in 2012, details will have to await further exploration. Looking a little bit like a deer in the headlights, Obama complained that he has only been in the race for eight weeks and needs time to get specific. He does say that he wants to foster federal and state health coverage pools. Employers would still have the option of providing coverage, he said, but after 10 or 20 years, many people may find that they get better coverage, or better value, outside their employers.
Romney wasnt at the forum, but he can point to the Massachusetts plan, now being implemented by the terribly named Commonwealth Health Insurance Connector Authority, which sounds like a commuter rail system. Unfortunately for Romney, it is way too early to point to the program as a role model for a national plan for covering the uninsured, as it still is being rolled out. However, he can say that as a Republican chief executive, he worked in a truly bipartisan manner with a Democratic-controlled Legislature to get something passed on health coverage. Now that could be a role model for Washington.
Romney and Edwards share the distinction of running third in the polls in their partys nomination race, each being eclipsed by what everyone is tirelessly calling the rock stars of their parties. Heres a suggestion for them: Hold a two-man debate on their respective plans, not only to bring more attention to each candidacy (imagine a general election-style debate amid the primary campaigns) but also to showcase the issue each hopes will give him a leg up in a race he is now trailing.