Fact Check: Democrats and Insurance
By BETH FOUHY
Associated Press
November 29, 2007
NEW YORK (AP) — Hillary Rodham Clinton and Barack Obama are in a tussle over whether the government should require everyone to carry health insurance.
Arcane as it may sound, the debate has become a proxy battle over questions of leadership, judgment and who is more committed to bringing health care to all Americans.
AT ISSUE:
All the leading Democratic presidential contenders have laid out comprehensive plans that they say will reduce the cost of health care and provide coverage to the 47 million uninsured. But they part ways over the issue of an “individual mandate,” which would require everyone to have insurance just as most states require drivers to purchase auto insurance.
Clinton has made such a mandate the centerpiece of her plan, insisting that it is the only way to bring coverage to all. The New York senator would offer federal tax subsidies to help consumers pay for insurance, with the expectation that costs would come down over time as insurers begin to compete for a larger pool of consumers.
She has not yet said how she would enforce such a mandate, saying those details would be worked out in consultation with Congress.
John Edwards has also proposed an individual mandate and this week laid out the steps he would take to enforce it. Under his plan, those who refuse to participate could see their wages garnished or face penalty payments.
Obama’s plan does not include an individual mandate. The Illinois senator has argued that people cannot be compelled to buy insurance until the cost of coverage is substantially reduced. He would require all children to be covered and would offer subsidies to the working poor. Over time, he says, the cost savings realized through his plan would enable everyone to afford to purchase insurance.
THE SPIN:
Clinton has sought to portray Obama as unwilling to fight for universal coverage, settling instead for a plan that could leave as many as 15 million people uninsured. Obama, in turn, has tried to depict Clinton as unrealistic and evasive on the issue.
“He has called his plan universal, then he has called it ‘virtually universal,’ but it simply does not deserve that label,” Clinton told an audience in Iowa on Wednesday. “When it comes to truth in labeling, his plan simply flunks the test.”
Obama responded to Clinton’s criticisms Wednesday, reiterating his view that people cannot be forced to buy coverage until it is made more affordable. And, he said, she has never explained how she would enforce her requirement that everyone must obtain coverage.
So until she clarifies what exactly she intends to do to enforce this mandate — is she going to fine people, is she going to take other steps to enforce it — this is more of a political point that she’s trying to make than a real point,” Obama said.
FACT CHECK:
Health policy experts generally agree that the only way to achieve truly universal coverage is to enact a “single payer” health care system that is run by the government.
While the health systems in most other wealthy industrialized nations are largely government-run, the single-payer model has been rejected as “socialized medicine” in the U.S.
Absent a single-payer system, many experts believe the individual mandate would help move the country toward universal health care but would not automatically result in everyone being covered. And Massachusetts, which last year became the first state to require its residents to carry health insurance, has vividly demonstrated its limitations.
Officials there have granted waivers to 20 percent of state residents who cannot afford coverage, even the new, lower-priced plans subsidized by the government. Hundreds of thousands more have refused to purchase coverage despite the mandate, risking a tax penalty that could be as high as $1,000 next year.
When she unveiled her health care plan in September, Clinton told The Associated Press that she was aware of the problems in the Massachusetts system but felt confident the federal government had “tools” at its disposal to address problems a state government might not.