Bold medicine needed

Families in Florida and across the country don't have to study opinion polls to know health care ranks among the top issues in the 2008 presidential election. Health care remains inaccessible for many and unaffordable for many more, including those fortunate enough to have health insurance. Any prescription for meaningful relief requires significant change to the current system, and Democratic candidates offer far bolder plans than Republicans who contend the cure somehow lies in tax policy.

The leading Democrats reasonably argue government has to play a larger role to ensure more Americans have health insurance. After all, the number of uninsured Americans has risen to more than 47-million, including more than 3.6-million in Florida. At the same time, health care spending rose nearly 7 percent in 2006 and now represents more than 16 percent of the national economy. Competition and the normal forces of supply and demand are not going to fix what ails the health care system.

Hillary Clinton, John Edwards and Barack Obama call for expansions of Medicaid and the successful State Children's Health Insurance Program, known as Florida Healthy Kids here. That is the same program President Bush has prevented from enrolling more uninsured kids by twice vetoing justified spending increases. As they move toward universal coverage, the Democrats would help pay for their plans by repealing Bush's tax cuts for those earning more than $250,000. They also would prohibit insurers from denying coverage to people with pre-existing health conditions. Large companies would have to insure their workers or contribute to the cost of covering them.

The Democrats have skirmished over some of the details and who would get to universal coverage the quickest. Clinton is the most ambitious would require every American to obtain coverage and provide financial help or health plans for those who could not afford coverage or find it in the private market. Edwards would move more gradually, and Obama initially would require all children to be covered. But all of the leading Democrats offer substantial overhauls that would improve the accessibility and affordability of health care for millions -- and be inaccurately blasted by Republicans as socialized medicine and worse.

The leading GOP candidates spend far less time talking about health care, and when they do they sound like a broken record. They repeat the same themes Republicans have relied upon for years from Congress to state legislatures: limit awards for noneconomic damages and pain and suffering in medical lawsuits. Offer tax cuts or tax credits to encourage consumers to buy health coverage on their own. Reduce regulation and increase competition. Allow states to experiment with Medicaid.

These market-driven approaches are not going to result in health care that is more available and affordable. They are blind to the practical and moral obligation of government to see that its citizens have access to medical care that gives them every opportunity to lead productive, healthy lives regardless of their economic or social status.

Mitt Romney saw the light as governor of Massachusetts. He helped push through a 2006 law aimed at creating universal coverage by requiring residents to obtain some form of coverage or face financial penalties. It isn't perfect and it hasn't reached its ultimate goal, but the number of insured residents has increased by 300,000. Yet Romney now criticizes a Clinton plan that embraces the same concepts even as he defends the Massachusetts experiment from attacks by fellow Republicans. And his proposal as a presidential candidate isn't nearly as bold, does not require individuals to obtain coverage and calls for the states to act. That's not change, and that's not leadership.

Many Americans benefit from marvelous health care providers and incredible technological advances every day -- and far too many don't have access to medical care and can't afford it if they find it. The goal should be universal coverage, and the next president should answer the growing cry for help.

[Last modified January 15, 2008, 01:34:18]