Politics as usual?

Just today I came upon this quote I found interesting (I'll get to the reason below):

"The American health care system is approaching a breaking point. Rapidly rising medical costs are increasing the numbers of people without health coverage and straining the system's capacity to provide care for those who cannot pay. The gap is widening between the majority of Americans, who can take advantage of the best medical services in the world, and the rest, who find it hard to get even basic needed care. As the gap increases, the weight of financing care for those without adequate coverage is undermining the stability of our health institutions. Even for the majority, the explosive growth in health care costs is steadily eroding the private insurance system -- the bulwark they count on as their defense against financial risk in case of illness."

Why do I find this quote interesting? It's not because it sounds reasonable, or timely. Many of the issues mentioned in the quote are covered in the health platforms of some of today's presidential candidates, as detailed in our Health Matters in the 2008 Election special.

What I find most interesting here is that the quote is included in the executive summary of The Pepper Commission, a bipartisan commission on comprehensive health care, chaired by the late Democratic congressman from Florida, Claude Pepper, in September 1990. I'll do the math: That was 17 years ago.

And we're still talking about the same problems. Well, sometimes at least. In last night's Democratic debate, there were a lot of attempts to knock Sen. Clinton off her front-runner pedestal, but little talk about health care.

Ohio Rep. Dennis Kucinich did bring up his plan for a single-payer (government-funded) health care system, but then he also admitted to seeing a UFO, which I think it's safe to say distracted from the debate a bit.

Meanwhile, the voters say health care is still very much on their minds, and it is becoming a fully bipartisan, not just a supposedly Democratic, issue. A recent poll from the Kaiser Family Foundation showed health care to be the second issue, behind Iraq, that both Democratic and Republican voters want the candidates to talk about.

For the time being, at least, we'll have to wait and see if they listen (and hope it doesn't take 17 more years to get something substantive done).

Sean Swint
Executive Editor, WebMD

Sen. Joe Biden announces health care plan

Democratic Sen. Joe Biden has officially announced his new health care plan in a speech in Des Moines, Iowa, dubbing it "CARE."

The acronym covers what the presidential candidate sees as the four most important steps necessary to improve health care and ultimately achieve universal coverage: Cover all children, better access for adults, reinsurance for catastrophic illness, and encourage prevention and modernization.

What Biden's plan doesn't do is mandate coverage for all Americans, but he's more in line with Sen. Obama's plan, which emphasizes coverage for all children. Biden would primarily expand the State Children's Health Insurance Plan (SCHIP), an ongoing area of debate in Congress at the moment, especially since the first go-round was vetoed by President Bush.

Biden would also stress access to insurance for all adults, in a major part by allowing Americans to buy into an insurance program similar to the federal program, called the Federal Employee Health Health Benefit Plan (FEHBP).

He also is the only other candidate, along with former Gov. Bill Richardson, to allow people as young as 55 to buy into the Medicare program.

Although there is a provision to provide a subsidy for low-income individuals, Biden says the benefit from preventing chronic illnesses could help cover the expense.

The third step in Biden's program would be reinsurance for catastrophic cases. He cites statistics saying that the top 1% of spenders on health, with expenses above $50,000, account for about 22% of health care spending.

So, Biden would create a federal reinsurance pool to reimburse employers, insurers, or associations for 75% of health costs above this $50,000 limit.

Biden's final step centers on prevention, which echoes his reasoning for bringing people into Medicare sooner. There could be major cost-savings, Biden says (and he's not alone in this, among both Democrats and Republicans), if we could get chronic problems like diabetes, heart disease and obesity under control.

Along with personal prevention, Biden proposes a panel to improve effectiveness of medical treatments and technologies. He would also invest in information technology to improve care and communication, while reducing duplication of services and treatments.

Biden would also allow the federal government to negotiate lower drug prices for the Medicare Part D prescription drug plan. This is prohibited under current law.

Much of this information is included in Biden's current profile in our election special, Health Matters in the 2008 Election, but we're in the process of fine-tuning and adding all of Biden's proposals as I write.

According to a report from the Associated Press, Biden's plan would cost between $80 billion and $100 billion each year, but would be paid for by rolling back tax cuts for the top 1% of Americans, eliminating tax breaks on capital gains and dividends, and plugging tax loopholes for hedge fund managers and private equity partners.

We'll keep you posted.

Sean Swint
Executive Editor, WebMD

(Jarret Cassaniti contributed to this post)

Brownback bows out, and an election with a bow on it

It's official. Republican Sen. Sam Brownback, saying "his yellow brick road came just short of the White House," has bowed out of the presidential race. We're updating our election special, Health Matters in the 2008 Election, as I write.

The other candidates are still running hard though, and word came today that there's a chance that the New Hampshire primary could even be held in December. The state's secretary of state, Bill Gardner, has until Nov. 2 to make his decision.

So even though it may seem early to some to be thinking about the election, you can consider our candidate comparison chart an early holiday gift.

We'll keep you posted.

Sean Swint
Executive Editor, WebMD

One candidate folds, and the Joker's wild idea

The number of presidential candidates may soon be down one, sort of (I'll explain in the next paragraph). Republican Sen. Sam Brownback is expected to withdraw from the presidential race tomorrow, according to wire reports. He reportedly cites lack of money, not lack of desire. As soon as it becomes official, we will of course update our election special, Health Matters in the 2008 Election.

Meanwhile, you may have heard Comedy Central's Stephen Colbert is considering bringing some "truthiness" to the campaign by throwing his hat into the presidential ring -- in South Carolina at least. He's serious enough about it (to take liberty with the word) that his staff actually reached out to the state's political committees to find out about getting on the ballot before making his "announcement."

Please excuse us if we're not in any rush to add his health platform to our list of candidates (he is just entering in one state, after all) -- but we may reach out to him and see how he answers our candid candidate questions. I'll let you know if he's game.

On to more serious news: The House failed to override President Bush's veto of an expansion to the State Children's Health Insurance Program (SCHIP), setting up a standoff between Democratic leaders (and many Republicans) in Congress with the White House. There's certainly been plenty of drama over what is usually a dry topic, and don't count on the political theater to go away any time soon.

We'll keep you posted.

Sean Swint
Executive Editor, WebMD

New views, new controversy

We have two new interviews published today that are worth a read. One is from Billy Tauzin, the head of PhRMA, the pharmaceutical industry trade group, and the other is from Bill Novelli, who is the CEO of AARP. They both have specific views, of course, that address each group's demographic needs, but you'll find, as with all the other interviews in the 1 on 1 interview section in our election special, that there are many areas of agreement.

Among them, that health care is important in this election and we need to find a way to help people that are uninsured.

There's also another issue still brewing on Capitol Hill that could be a key topic in the upcoming election: the Medicare prescription drug plan. The Democrats have released a new report showing that Part D, the Medicare prescription drug plan, may be limiting Medicare recipients' cost savings, which is a different story than what we've been hearing lately.

Why the new info? Since the Democrats took over the House, U.S. Rep. Henry Waxman became chairman of the House Oversight and Government Reform committee, and he says he now has access to documents that he didn't have before. The Republicans, and some others, dispute this new report.

I doubt this is the last we'll hear about this issue.

If you want to weigh in on your experience with Part D, and this new report, you can do so here.

Another issue we've discussed in this blog, the State Children's Health Insurance Program (SCHIP), the expansion of which was vetoed by President Bush, is expected to come up for an override vote this Thursday. It is not expected to get enough votes to snuff out the veto.

In a new USA Today/Gallup poll, it seems the American public is on the fence about the topic. Just over half have confidence in the Democrats to handle the issue while about the same amount, in a nod to Bush, think that the program must focus on families earning about $41,000 for a family of four.

We'll keep you posted.

Sean Swint
Executive Editor, WebMD

(Jarret Cassaniti contributed to the research and writing of this post)

John McCain announces his health care plan

Call it McCainCare ... Sen. John McCain has unveiled his healthcare plan, and we're in the process right now of updating our special, Health Matters in the 2008 Election, to reflect his new plan.

Meanwhile, here are a few highlights.

In a speech given in Des Moines, Iowa today, McCain said the cost of health care disturbs "the sleep of more Americans than any single domestic issue" and we are approaching a "perfect storm" of problems with our health care system.

Instead of focusing on any kind of mandate to cover the uninsured, as some Democrats stress, McCain cites spiraling costs as his chief concern -- and the true source of our healthcare ills.

He says the foundation of his health care plan will rest on three goals:

1) Paying only for quality care.

2) Offering diverse insurance choices responsive to individual needs.

3) Restoring a sense of personal responsibility.

Indeed, McCain puts a strong emphasis on accountability, both among the private sector, and among patients. His plan would espouse setting national standards for measuring treatments and outcomes. Doctors' performances would be rated, and errors deemed "preventable" and hospitalizations "unnecessary" would not be covered by Medicare. And that, McCain acknowledges, will present some friction.

While McCain stresses that Americans take responsibility for preventing "expensive, chronic disease," he also wants to provide tax credits of $2,500 to individuals and $5,000 to families, whether or not they already have insurance. He proposes allowing people to buy insurance nationwide (currently prohibited by state-to-state regulations). McCain also supports the use of walk-in clinics like those popping up in retail outlets across the country.

Similar to other Republicans' plans, this one does stress market-based solutions. More competition among insurers would means lower costs for consumers -- and McCain stridently says he's against a "one-size-fits-all-big government takeover of health care."

According to the Associated Press, McCain's campaign provided no estimated cost for any of his plans.

We'll keep you updated.

Sean Swint
Executive Editor, WebMD

(Patrick Adams contributed to this report).

A new candidate, and state of SCHIP debate

At this point in the election, I figured if anything we'd be dropping candidates from our Health Matters in the 2008 Election page, but actually, we're adding one: Alan Keyes. You may remember him from the last election, and he's back for more. He'll be on our page soon. Keyes announced his intention to run for president on Sept. 14 on his website, to little media fanfare.

Now, on to other matters ...

A new telephone survey held in Iowa among Democratic AARP members shows that 99% view health care as very or somewhat important to their vote. At the same time, almost 30% said they knew little about the different candidates' health platforms. If they check out WebMD, they'll get their answers.

The debate over President Bush's veto of SCHIP last week continues, and now there's a group spending nearly $1 million dollars on ads to make sure voters don't forget. The overt reason is to sway House Republicans to change their minds so Bush's veto can be overridden, but it's a political poke in the eye, too.

President Bush isn't laying low on the topic, though. He used his radio address on Saturday to acknowledge the "important debate" over SCHIP, defending his veto by saying six states allowed more adults to benefit from SCHIP than children. Bush also laid out the possibility of compromise with leaders in Congress (which until recently Democratic leaders have said is not an option).

The point of all this? As I said in an earlier blog, health (insurance) matters in the 2008 election.

Thanks for reading.

Sean Swint
Executive Editor, WebMD

Something new....

We added a new 1 on 1 interview to our election page today with Edward Langston, MD, the chairman of the American Medical Association. It's definitely worth a read ... as are all the expert interviews we have posted.

These are the people that decision makers in government go to for counsel, and they're sharing their insights with us. It's great stuff.

We have more great interviews coming up, including the head of AARP and the head of the pharmaceutical trade association. Both should offer fascinating points of view. We offer them up not to necessarily agree with, or to dispute, but to help make an informed decision when you go to the voting booth.

Thanks for reading.

Sean Swint
Executive Editor, WebMD

How Insurance Can Affect Election '08

There's a political serve and volley going on in Washington right now that should make for some interesting viewing well into the election, and even affect the election, and it has to do with insurance. Yes, insurance.

Mention the topic of insurance, and other than personal concerns over whether you have it or not, most eyes glaze over.

But the president vetoed a bill yesterday that would have expanded a government-funded health insurance program for children that goes under the acronym SCHIP (state children's health insurance program).

President Bush says it would "federalize health care," and would bring too many middle class kids into the program, who can afford insurance on their own. Congress (with some bi-partisan support) says we need to increase the funding because too many kids are falling through the cracks.

I found it interesting that a recent Associated Press article said the president cast a "quiet veto," but it seems to me to be anything but quiet at this point. Whatever side of the aisle you fall on, these types of issues will continue to get more attention as the election cycle heats up.

As you can see from our candidate profiles in Health Matters in the 2008 Election, insurance is front-and center in many of the candidates health plans, and some even mention SCHIP, especially the candidates that had to vote on it.

The bottom line is that for many of us, we don't want to think about these issues, and we're not interested until the hands are in our pockets. But one thing that kept hitting me in the face as I worked with the editorial team creating this election special: We need to deal with these kinds of problems now. Whether you prefer a solution promoted by a Republican or a Democrat, a solution is needed.

Why? Every time someone goes to the emergency room without insurance, be it a kid or an adult, it costs money. And someone pays. If you think a while about who ultimately gets the bill, you might start to see that hand getting closer to your pocket.

Meanwhile, as I said, this debate is anything but quiet.

The Wall Street Journal is calling the battle over the reauthorization and expansion of SCHIP " a dress rehearsal for the health care fight in 2008" -- a clash over the larger issue of who should make decisions for doctors and customers: government or private insurers.

Following President Bush's veto of the SCHIP bill, which some have called "a gift from the political gods," Democrats have embarked on a grassroots campaign and a barrage of TV and radio ads to win over the 15 Republicans needed to overturn it.

Failure to do so, says the New York Times, could turn that gift into a gaffe, adding to voters' frustration with Democrats and haunting the party's presidential candidates throughout the election.

We'll keep watching.

Sean Swint
Executive Editor, WebMD