August 14th 2008
No rest for reform chatter
It was a relatively quiet week on the US campaign trail, with Democratic candidate Barack Obama vacationing in his former home state of Hawaii and John McCain noticeably scaling back appearances at press conferences. With the campaigns on autopilot, the debate over the best roadmap for health-care reform continued with campaign advisors, pundits, columnists, and reporters all weighing in on the issue.
In Pittsburgh, Democrats over the weekend refined their party’s platform by calling for guaranteed access to affordable, comprehensive health care for “every American man, woman and child”. This move draws the health care component of the Democrat’s platform—expected to be adopted at the Democratic National Convention, which begins Aug 5 in Denver—closer to that of Obama’s former rival in the Democratic presidential race, Senator Hillary Clinton.
The move, writes The Nation’s John Nichols, appeases the party’s more progressive members and is a step beyond Obama’s proposal, which stopped short of committing to guarantees.
As both parties’ nominating conventions draw near—the Republicans will hold theirs Sept 1-4 in Minneapolis—the health-care debate broadened this week as speculation grew over who Obama and McCain would select as their vice-presidential running mates. Typically, one would not expect vice-presidential candidates to play a major role in promoting health-care policy. But, reports ZDNet’s Dana Blankenhorn, health-care reform in the USA is already taking shape through efforts by state and local governments, and three of McCain’s potential running mates have already gained insightful experience.
One of McCain’s possible picks is Minnesota Governor Tim Pawlenty. Last month, after vetoing a health care reform bill promoted by state Democratic legislators, Pawlenty unveiled his own state plan for health care reform, which promised to “put consumers in charge” by giving them access to on-line medical profiles and treatment options, as well as debit card spending accounts. The plan will be offered to some 50 000 state employees and could eventually be extended to all Minnesotans.
Pawlenty has so far refused to increase taxes to pay for health-care reform, a stance that could mesh well with McCain’s plan. His push for better utilisation of technology to make delivery of health-care services more efficient is also in step with McCain’s market-driven reform package.
There are risks to letting the market shape reform, argues Chicago-based physician Cory Franklin. One potential concern is the merger of medical and credit histories by private companies. One company has already begun compiling consumers’ medical payment histories, and other companies are likely to follow, Franklin stated in a recent Chicago Tribune column.
“The next logical step would be to market that information to health-care providers”, allowing health-care providers to identify patients that are “unlikely to pay their bill”, Franklin wrote. Unpaid bills total an estimated US$40 billion annually in the USA.
“Both major-party candidates for president should state their position on what, if anything, they are prepared to do to protect patients in the face of this threat from cooperation between the credit and health-care industries”, Franklin stated.
Campaign pledges aside, neither candidates’ reform plans nor the experience level of possible vice-presidential picks will come into play without the support of lawmakers in the 111th Congress, who will have to put aside party differences to accomplish meaningful change, writes Steve Davis, of AISHealth.com.
“I don’t think either candidate will be able to move the needle on their own. Congress holds all the keys right now”, said analyst Carlton Doty of Forrester Research, Inc.
David Boddiger
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