Democrats lead way on health insurance

By A TIMES EDITORIAL
Published September 19, 2007

This should be the presidential election that pushes health care to the top of the national agenda. The number of uninsured Americans has risen to more than 47-million, including more than 3.6-million Floridians. Those who do have coverage often struggle to pay for it, as health care costs continue to rise faster than inflation and income. The question should not be whether there should be universal coverage but how to get there.

So far, the Democratic candidates are offering the most ambitious and thoughtful approaches. Hillary Clinton unveiled a plan for universal coverage Monday that would work within the current system and is a far cry from her proposal for an entirely new government-run system that failed spectacularly in the early '90s. This time, she is very careful to talk about consumer choice and reassure patients who have coverage now that they could keep it and not change doctors. That should go a long way toward developing a consensus.

In fact, Clinton's plan is strikingly similar to those already proposed by John Edwards and Barack Obama. All three would help pay for increased coverage by repealing President Bush's tax cuts for those earning more than $250,000. They also would prohibit insurance companies from denying coverage to people with pre-existing health conditions, and require large employers to insure their workers or contribute to the cost of covering them. These are sound building blocks for a more accessible health care system.

The Democrats differ a bit on the details. Clinton and Edwards are the most ambitious and would require every American to have coverage. Clinton would allow people without coverage to enroll in plans similar to those for federal employees or to Medicare. Edwards would create new regional health care markets that would offer insurance plans, a concept somewhat similar to what Gov. Lawton Chiles tried in Florida in the 1990s. Obama is a bit vaguer and stops short of requiring all Americans to have coverage. But all three are headed in the right direction, and the details can be debated on the campaign trail.

The same cannot be said of the Republican candidates for president, who are clinging to a market-driven approach that has failed to expand access or control costs and to tax credits that will not translate into more accessible health care. Former Massachusetts Gov. Mitt Romney is particularly disappointing. His most significant accomplishment as governor was pushing through a 2006 state law aimed at universal coverage. But as a presidential candidate he calls for offering states incentives to create their own systems and for deregulating insurance markets. He left his boldness in Boston - and now hypocritically criticizes a Clinton plan featuring some of the same concepts as Massachusetts' law as socialized medicine.

Romney, Rudy Giuliani and other Republicans will try to turn back the clock and scare voters into believing the former first lady is resurrecting a government-run plan that will fail again. But Clinton is wiser and more cautious now, and the landscape has changed over the last 14 years. The need for affordable, accessible health care for every American is even greater - and voters are less likely to fall for campaign scare tactics than when the insurance industry's Harry and Louise filled the airwaves.

[Last modified September 18, 2007, 21:40:41]