We Brake for Details: WomenMatter Gives You Specifics of Candidates’ Health Care Plans

How do we compare proposals for the next four years against action taken in the last four? Voters have to measure Democrats’ plans for the future against Republicans’ accomplishments of the last four years in which they had control of Congress and the White House. As the Kerry explains his proposals, the Bush campaign works to meet them with something that sounds similar, but matches their own basic philosophy.

WomenMatter reminds us that the philosophies of the two major parties do not match. So it is important to know the details and decide where you stand.

What’s a girl have to do to get some details? It’s hard to get specifics from the media, and the candidates don’t tend to explain comprehensive proposals in their speeches.

For example, we know that both George W. Bush and John Kerry promise to improve our healthcare system, but how? What exactly are their plans? And how do they compare?

Well, weary web wanderers, look no further. WomenMatter examines Bush’s and Kerry’s healthcare plans and lines them up side by side.

Does size matter?

Kerry’s healthcare proposal is certainly much longer than Bush’s. In Our Plan for America: Stronger at Home, Respected in the World, Kerry and running mate John Edwards offer 20 pages of healthcare proposal. This lengthy discussion dwarfs Bush’s 3.5 pages on healthcare in A Plan for a Safer World and More Hopeful America. But, who’s to say that bigger is better?

Children first

Problem: More than 8 million uninsured kids. Children without health coverage are less likely to get treatment when they need it and are more likely to miss days of school.

Kerry’s plan: For the federal government to pay all of the costs of the 20 million kids on Medicaid so that state governments (which currently pay half of the costs) can use their resources to expand coverage to more children and low-income adults.

Kerry wants hospitals, health centers, and schools to automatically sign-up children who are eligible for federal and state insurance programs. Currently, lots of kids could be covered by state or federal programs, but their parents are not aware of these programs or have difficulty signing up.

Kerry plans to offer states $5 billion in enrollment bonuses, an incentive to find uninsured kids and keep them enrolled.

Bush’s plan: Bush also wants more kids to sign-up for state-sponsored health insurance. He plans to launch Cover the Kids, a campaign to help more eligible children join State Children’s Health Insurance Program, or SCHIP.

Bush also wants to build more community health centers in rural and urban neighborhoods with limited access to basic health care services. These centers would serve the poorest Americans, including the homeless, migrant workers, and their children.

The upshot: Both candidates plan to get more kids enrolled in federal and state- sponsored health programs. Kerry has plans to expand the eligibility of these programs to include more kids and some adults; Bush wants to increase the number of community health care centers.

Helping individuals buy health insurance

Problem: Many working people do not get health coverage through their employers and cannot afford to pay for private health insurance.

Kerry’s plan: Kerry wants every American to have access to the health plan that is offered to members of Congress; he describes the Congressional Health Plan as high-quality and affordable. He would also offer low and moderate-income Americans a tax credit to help them afford the plan.

In addition, Americans between 55-64 years old with low or moderate incomes would get a 25 percent tax credit to help them pay the cost of their premiums. Low and moderate-income Americans who are between jobs would receive a 75 percent tax credit.

Bush’s plan: Bush also proposes a tax-credit to help low-income Americans buy health insurance or low-premium, high-deductible health plans and Health Savings Accounts (HSAs). Low-income families would get a maximum of $2,000 for their premiums and $1,000 to deposit into their HSAs to help pay for future deductibles. Individuals would get as much as $700 for their premiums and $300 for their HSAs.

The upshot: Kerry would make a federal health insurance program available to everybody. Both candidates offer tax credits to help low-income families afford health insurance. Bush also provides incentives for people to purchase HSAs. For more on HSAs, click here.

Making healthcare more affordable

Problem: Total health care costs increased four times faster than wages in 2003, making it more and more difficult for families and small businesses to afford health care. Businesses are slowing their hiring or hiring more part-time and temporary workers so that they don’t have to buy more employee heath insurance.

Kerry’s plan: To keep down the cost of catastrophic health care costs. Insurance claims over $50,000 are a major cause of rising insurance premiums - even though such catastrophic claims are rare (less than one half of one percent of all claims). Kerry wants the federal government to pay for 75 percent of catastrophic health claims if (and only if) employers agree to:

• Provide quality health coverage to employees.
• Lower employees’ premiums as their own premiums fall.
• Implement programs that encourage healthy habits.

Kerry says that this effort would expand employer-based coverage and could reduce a family’s health care premiums by as much as $1,000 each year.

Kerry plans to modernize the healthcare system. Currently, many doctors and hospitals use outmoded systems to process paperwork at a huge cost. To encourage the medical system to get updated, Kerry will

• Require private insurers that do business with the federal government (through programs like Medicare and the Veterans administration) to renovate their record keeping and book keeping.
• Give bonuses to health care providers that use modern information systems.
• Make electronic health care records available to all Americans by 2008.

To combat the rising cost of malpractice insurance, Kerry wants to:

• Make it more difficult for plaintiffs to be awarded huge sums, except in cases of intentional misconduct, gross negligence, or reckless indifference.
• Require that patients making medical malpractice claims first see a qualified medical specialist who can confirm the grievance.
• Require states to make certain that malpractice claims have the option to settle out of court.
• Punish plaintiffs and lawyers who bring frivolous claims, including a "three strikes and you’re out" policy preventing lawyers who file three frivolous cases from bringing another malpractice suit for 10 years.
• Prevent insurance companies from working together to raise malpractice premiums.

Kerry believes that these remedies will lower malpractice insurance, which will lower overall health costs.

Bush, however, does not feel that these resolutions are enough to drastically reduce malpractice insurance premiums.

Bush’s plan: Bush wants to impose caps on malpractice damages. Republicans feel that injured patients can be fairly compensated within reasonable limits. They say that million-dollar awards cause more expensive malpractice premiums for all doctors, which then results in higher health care costs.

Like Kerry, Bush is in favor of promoting information technology in the health care field. He also wants to make electronic health records available in the next decade.

The upshot: Both candidates want to reduce the cost of health care by introducing the medical community to the same information technology that helps other industries to thrive. Both want to reduce doctors’ medical malpractice premiums, though Kerry will work to avoid frivolous lawsuits and reform insurance company practices while Bush wants to limit the dollar amount that plaintiffs can be awarded. Kerry plans to lessen the cost of catastrophic health care costs through federal spending, while Bush is opposed to increasing federal spending on health care.

Helping small businesses afford health care

Problem: Small businesses have trouble affording health care for their workers. They often pay higher premiums than large corporations for the same coverage.

Kerry’s plan: Kerry will offer small businesses a tax credit that covers up to 50 percent of their premiums for low to moderate-income employees.

Bush’s plan: Bush will give tax rebates to small businesses and small business employees who set up Health Savings Accounts (HSAs). The rebate limits are $500 for families and $200 for individuals.

Bush will also allow small businesses to set up association health plans, which means that small businesses can band together and negotiate with insurance companies for lower premiums and better coverage.

The upshot: Under Kerry’s plan, small businesses would get a tax break for providing insurance to low and middle-income employees. Bush’s plan provides a tax rebate for small businesses and employees who establish HSAs. Bush also wants to help small businesses increase their bargaining power through association health plans.

Healthcare - the philosophies

Kerry’s philosophy is that all Americans are entitled to health care. He believes that the federal government should provide health coverage to the less fortunate and that federal spending and tax cuts can help make health care more affordable for the middle class.

Bush’s philosophy is that health care should be largely separate from the federal government. Bush favors a free-market approach to health care in which private competition, not public funds, works to increase quality and lower costs.

Which philosophy most closely matches your own? Now that you’ve had a chance to really look at the candidate’s health care proposals, which do you favor?

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Posted on: 9/15/2004