Universal Healthcare Solutions Fall Short

(See below for related link:
"60 Minutes": U.S. Health Care Gets Boost From Charity
Remote Area Medical Finds It's Needed In America To Plug Health Insurance Gap)

In 1993, President Bill Clinton, with then first lady Hillary Clinton coordinating the effort, attempted to cobble together a universal health coverage plan that retained a central role for the private insurance industry. In response, the well-funded insurance lobby ran a multi-million dollar campaign, including the infamous Harry and Louise TV ad, that successfully killed the initiative before it ever got off the ground.

Now 15 years later, opinion polls tell us that the public overwhelmingly supports fundamental changes in our healthcare system. Sixty-four percent of those surveyed in a February 2007 CBS News-New York Times poll said they favored a government role to guarantee health insurance for every American. With 47 million Americans without health insurance, the U.S. remains the only industrialized nation in the world that doesn't provide its citizens universal healthcare coverage.

While the Republican presidential frontrunner candidate John McCain is opposed to a government-run universal healthcare system, both remaining Democratic candidates Hillary Clinton and Barrack Obama have proposed reforms that keep private insurance companies in place as the primary provider. Between The Lines' Scott Harris spoke with Dr. Don McCanne, senior health policy fellow with Physicians for a National Health Program, a group that advocates a single-payer universal system. Dr. McCanne discusses the presidential candidates' positions on reforming the failing U.S. health care system and why a single-payer system is not being considered by the candidates or the press. He begins with a summary of Sen. John McCain's health care platform.

DR. DON MCCANNE: He supports tax credits to help people purchase insurance, but the modeling that's been done of this type of proposal shows that if anything, will probably continue to have an increase in the number of people without insurance. Also, he would want the market to control health insurance products and what that means basically is trying to make them affordable, lower premiums by shredding the benefit of the health plans. So even though the private plans can compete in the marketplace for selling their insurance products, their products won't protect people from financial hardship should they develop a significant medical problem. So his (McCain's) proposal is really pretty much a step backwards exactly in the wrong direction.

BETWEEN THE LINES: So I think that's pretty clear. If you're for health care reform – major health care reform, univeral health care – you probably wouldn't be looking to John McCain. What about Democrats Hillary Clinton and Barack Obama? They both talk about universal health care; however, their plans are different in some important respects. But they are similar in that they do not call for a single-payer healthcare system as your group does.

DR. DON MCCANNE: That's right. They would continue to use the private insurance market to be the primary source of expansion in health care coverage. They would also offer a public option, a Medicare-like program that people could elect to purchase instead of private health plans. But if people like the plans they're in, they're allowed to keep them under their proposal. Now that's a political decision rather than a sound health policy decision. There are people who are happy with their plans, but more and more are not. The private insurance industry, in order to make their plans affordable are stripping out benefits which makes the insurance not work as well. It's really no longer affordable and that's the main reason their plan won't work is that they're building it on a structure of these private health plans which no longer provide the kind of financial protection we need.

BETWEEN THE LINES: Dr. McCanne, Hillary Clinton talks about mandating that citizens purchase their own health insurance, whereas Barack Obama does not mandate the purchase of insurance. He's been criticized for maybe leaving 15 million people out of any kind of goal of reaching universal health care.

DR. DON MCCANNE: That's right. That is the primary difference between their two plans –- Is that Obama would mandate purchase of insurance only for children, whereas Hillary Clinton would mandate it for everyone. But, neither of those work. Barack Obama's proposal doesn't work, because without a mandate, there are far too many people that are not going to purchase insurance because it's so expensive.

On the other hand, Hillary Clinton's proposal mandating that you purchase a policy that you can't afford is going to leave people uninsured too, because even though there are financial penalties for not purchasing it, if you don't have the money to buy the insurance, it's just not going to work. They know the modeling has shown that quite a few people would be left without coverage under her plan. To make her plan work, you would have to subsidize almost the entire premium for middle-income individuals and that's not her proposal at all.

BETWEEN THE LINES: Why is it that single-payer –- the kind of healthcare reform that your group advocates –- why is that off the table? It seems that none of the major candidates is really for transforming the U.S. healthcare system, which has failed so badly and turned to models which have worked in other countries such as many countries in Europe and Canada as well?

DR. DON MCCANNE: Well, it's perceived to be not politically feasible. Even though most polls show there is considerable support for national health insurance, there's a fear that if a politician comes out in strong support of it, that they'll be accused of supporting socialized medicine, which single-payer is not socialized medicine, it's just a public insurance, like Medicare. But, I think we're going to have a political climate in which the politicians are going to be very serious about crafting reform. It may not look exactly like what they're talking about now, but we're going to take a serious crack at it. So I think everyone will end up with health insurance.

Contact Physicians for a National Health Program by calling (312) 782-6006, or visit their website at http://PNHP.org

Related links:
- Universal Healthcare Solutions Offered by Candidates Fall Short
http://www.btlonline.org/2008/btl02208.html#1hed

- U.S. Health Care Gets Boost From Charity
"60 Minutes": Remote Area Medical Finds It's Needed In America To Plug Health Insurance Gap
- Video: http://www.cbsnews.com/stories/2008/02/28/60minutes/main3889496.shtml
-Text:
http://www.cbsnews.com/stories/2008/02/28/60minutes/printable3889496.shtml

Scott Harris is executive producer of Between The Lines, which can be heard on more than 45 radio stations and in RealAudio and MP3 on our website at http://www.btlonline.org. This interview excerpt was featured on the award-winning, syndicated weekly radio newsmagazine, Between The Lines for the week ending Feb. 22, 2008. This Between The Lines Q&A was compiled by Anna Manzo and Scott Harris.

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