Clinton, Romney Unveil Contrasting Health Care Visions

by Seth Michaels, Aug 24, 2007

Sen. Hillary Clinton (D-N.Y.) and former Gov. Mitt Romney (R-Mass.) both have been involved in health care—but with vastly different goals. Clinton spearheaded the effort for comprehensive reform during President Bill Clinton’s administration, while Romney signed problematic legislation in 2006 that required Massachusetts residents to buy their own health insurance. Now, each has made a major address this week on health care—offering starkly different visions for the future of our nation’s system.

Clinton, like other Democratic candidates, is looking for ways to broaden coverage, share responsibility and fix the market failures that have crippled the health care system. Romney, meanwhile, wants to leave more families in the hands of private insurers whose bottom lines don’t often match with quality, affordable care.

Clinton’s address was the second in what she says will be a three-step process of unveiling her plan. In her first speech, in May, she talked about controlling costs, expanding prevention programs and making coverage more affordable. Yesterday, she discussed ways to improve health care quality in a speech that took place at a familiar location: New Hampshire’s Dartmouth-Hitchcock Medical Center, where in 1993 she announced her first attempt at a universal health care program.

According to the Nashua Telegraph, Clinton offered a wide variety of specific programs to improve health care quality. In particular, Clinton would provide billions in emergency funding to train and retain nursing staff. Her proposals also include increased Medicare reimbursements for doctors who obtain special training and certification, improved electronic record keeping and a “Best Practices” program for the latest medical research.

While she hasn’t fully unveiled the portions of her plan that would provide universal access, she suggested some of the mechanisms by which she planned to do so. According to The Washington Post:

Clinton said her universal health care plan would not involve a single-payer government system. Instead, she said, she would consider expanding Medicare and allow people to join the federal employees insurance program.

“I think you don’t want to take choices away from Americans. We’re big on choice here. But you’ve got to have some framework so the choices work better,” she said.

Meanwhile, Romney’s plan was announced in a speech before the Florida Medical Association today. According to The New York Times, there are no guarantees of universal coverage in Romney’s plan. Instead, he hopes to use a combination of tax deductions and changes in financing to encourage individuals to purchase their own health insurance in the private market. Romney’s new plan further exacerbates the worst aspects of the flawed Massachusetts legislation by leaving consumers on their own to deal with insurance companies.

Romney’s plan depends on, as the Wall Street Journal notes:

providing incentives for individuals to buy their own plans.

The St. Paul Pioneer Press further details the mechanisms of Romney’s plan. The relationships between the federal government and the states, and between the states and low-income families, would both change. Rather than having open-ended federal Medicaid funding, Romney’s proposal would provide fixed block grants to states. Rather than current state and federal funding for care for the uninsured, he would use those funds to help individuals purchase private insurance.

Romney’s plan is similar to the one recently proposed by former New York Mayor Rudy Giuliani (R). Both depend heavily on the private insurance market. Giuliani’s plan, according to The New York Times, is based on the assumption that leaving individuals to their own devices in the market will reduce costs by creating “incentives to wellness.”

The Wall Street Journal notes:

The fact that expanding coverage is even an issue in a Republican presidential primary is testimony to how much political momentum has developed behind the cause, amid widespread voter concerns about economic insecurity.

It’s true that both Republicans and Democrats are taking notice of health care, but as we’ve noted before, the two parties are having completely different conversations.

Sen. Chris Dodd (D-Conn.), Sen. Barack Obama (D-Ill.), Gov. Bill Richardson (D-N.M.) and former Sen. John Edwards (D-N.C.) already have proposed plans, and Rep. Dennis Kucinich (D-Ohio) is a co-sponsor of H.R. 676, which would create a single-payer universal health care program.

You can find out more about the candidates’ positions on heath care at Working Families Vote 2008.

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