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Over the next several days we will be presenting the various health care positions of the Presidential candidates. When the Democratic and Republican candidate is selected we will have an indept look at their specific health plan for America. First at bat is Senator Edwards. Recently Kevin Sack of the New York Times conducted an interview with Senator Edwards and we thought it best that you read the Senators words. It is a long blog post but our health care crisis deserves your attention.
Q. The plan you’re proposing is far more expensive than the one you proposed four years ago.
Senator Edwards (SE). Well, I concluded that something bolder was needed, that the health care system had become increasingly dysfunctional, and my contact with a lot of uninsured Americans, who were not children, made it clear to me that the plan had to be universal, that it had to cover everybody. So I think it’s a combination of what I saw as an increasing dysfunction, an increasing number of uninsured, health insurance premiums continuing to skyrocket, plus my personal contact with so many people telling me their stories.
Q. In shaping your plan why did you decide against single-payer that would guarantee universal coverage?
SE. I looked hard at single-payer. Proponents of single-payer have some very strong arguments, particularly the elimination of profit motive in a health care system. Medicare, for example, runs at 3 to 4 percent overhead compared to some insurance companies charging 30 to 40 percent profit and overhead, so I thought that there was a legitimate and strong argument for it. But I also believed that there are an awful lot of Americans who like the health care they have and are nervous about entirely government-controlled health care.
Q. …. in some way what the Republicans contend, which is that the Democratic plans are sort of a back door to single-payer. Do you think that’s right?
SE. There is nothing backdoor about it. It’s right through the front door. American health consumers will decide which works best. ….I think there are roughly $120-125 billion of savings each year in this proposal that I have made. …if we’re doing what we need to do to create efficiencies, drive down costs, get everybody covered and leaving open to America what system makes the most sense to them, to me that’s a sensible approach to this issue. First let’s distinguish between what I’m proposing and what Senator Obama is proposing. His plan has no mandate. I have seen some calculations that indicate there could be as many as 12-15 million people could be left uncovered. What you’re asking about now are people that may fall in the cracks. ….. What our mandate would do is anytime people come into contact with the system, whether it’s in the hospital or paying their taxes etc., and they’re not enrolled in something — Medicaid, S-CHIP, private insurance, Medicare plus — then they will be enrolled. If they then refuse to pay their premiums, it will be our responsibility as a nation to go collect the premiums.
Q. Well, how are you going to define affordable?
SE. Sure. If you are living at or near the poverty line, you’re going to be essentially 100 percent subsidized. If you are up to about 250% of poverty, which is probably around $50,000 income for a family of four, you will have very low premiums, very low co-pays. And then, above that level, you’ll continue to be subsidized up to about $100,000 of income.
Q. Are there any substantive differences between your plan and Clinton’s plan?
SE. Both of us have similar proposals for savings in Medicare. But because she funds her plan by rolling back Bush’s tax cuts for those who earn $250,000 and above, and I fund mine by rolling back Bush’s tax cuts for people who make $200,000 and above, that gap has to be made up somewhere. And so what she does is she takes the, and I’ll be glad to go through them, but our proposals are very similar for savings in Medicare, she takes that savings out of Medicare and uses it help fund her universal plan. I keep the savings in Medicare, and the reason I’m, and everyone knows how intensely sick Medicare is financially, and the reason I’m able to do that is because I went lower on the tax cuts that would be rolled back.
Q. Talk a little bit about your malpractice proposal….
SE. I am not in favor of taking away the rights of patients who have been badly hurt to have their day in court and to have the jury decide their case. I believe in the jury system. What I am in favor of is keeping cases out of the system that don’t belong there.
Q. Cost containment. Walk me through the keys to bringing down cost. SE. …..So, the big mechanisms for cost containment are, for the private insurers, they have to put 85 cents of every health care dollar into health care, which effectively caps profit and overhead at 15%. For the drug companies. We’re going …get the drug on the market more quickly, more available, cheaper. …. required use of technology, and electronic record keeping. And then in a bigger-picture way, the whole concept of the system is cradle-to-grave coverage, but not just for when you get really sick. ….. that from the time children are very young, they’re taught nutrition, health, well-being, exercise. So I think the whole concept of preventive care is also an important cost-saving mechanism.I think the public will, bringing America to the cause, and being able to work not just with Democrats but with Republicans, who are hearing the same thing from their constituents that I hear all over this country, I think there’s an enormous opportunity. And I think what will ultimately control is first the power of a good idea, second, the political will in America to actually create reform, and third, I think the political leadership of Democratic and Republican, recognize that this is something that’s time has come.
To read the entire interview click on the following link: http://www.nytimes.com/2008/01/25/us/politics/25edwards-text.html?_r=1&oref=slogin
Yours in Good Health
Photo by Chris Keane/Reuters
