Topic Brief: United States Healthcare

By Logan Scisco

One domestic issue that extempers will always encounter during the dreaded “social issues” rounds is the state of health care in the United States.  Navigating through the maze of health insurance coverage, why health care costs are high, and how the shortage of health care in the country can be solved can become a nightmare for even the most well read and skilled extemper.

Health care is a pressing social issue that is currently facing the United States.  According to the Census Bureau in 2006, 47 million Americans lack health insurance.  These 47 million Americans represent 15.8 percent of the population and the lack of health care coverage is linked to rising health care costs that are burdening the American economy and the American consumers who are fortunate enough to enjoy private or public health care coverage.

With a presidential election due in November 2008, health care has become the top domestic issue of the campaign.  Senator Hillary Clinton, Senator Barack Obama, and John Edwards, the three leading Democratic contenders for president, have released their plans to expand health care coverage in the United States and create a universal health care system.  The Republican Party has been mute on the issue of universal health care coverage but its leading candidates such as former Massachusetts governor Mitt Romney have acknowledged that change needs to be introduced into the American health care apparatus.

A full extemp topic brief on health care in the United States could span thirty to forty pages.  In order to make this topic brief manageable for extempers and for this brief book I have zeroed the focus on United States health care to a few critical issues:  how healthcare is provided for in the United States, the problems of health care in the United States, the pluses and minuses of universal health care coverage, and the different health care plans that have been proposed thus far by leading presidential contenders.

Note:  For a good explanation of the various issues facing the American health care system look at Yoni Schneller’s chapter on health care in VictoryBriefs Extemp Topic Brief books.  His write up can be found in volume one of those briefs (originally published in 2000) if they are still available for sale.

United States Health Care Provision

In contrast with European countries and most notably Canada, the United States does not have a public health care system that provides health care coverage for all of its citizens.  Instead, the United States provides health care to those citizens deemed most in need of it:  the elderly and the poor.  A government safety net for health care was noticeably absent until President Lyndon B. Johnson’s “Great Society” program which brought two critical programs to the forefront of American policy making:  Medicare and Medicaid.
Medicare was created in 1965 and it provides health care for those Americans who are over 65.  The federal government uses this program to cover the visits of the elderly to doctors and hospitals and assists in the payment of surgeries.  However, the federal government does not foot the entire bill for these procedures.  Instead, senior citizens are expected to make a small portion of the costs associated with their treatment, called a co-payment.  This co-payment represents ten to twenty percent of the costs associated with their treatment.  Extempers might also know that President Bush’s prescription drug benefit package subsidized senior citizens purchases of their prescription drugs through Medicare.  This has been a major issue of contention because Medicare is over ten percent of the federal government’s budget and its costs will continue to rise in the future as large amounts of America’s baby boom generation retire.

Medicaid was also created in 1965 under the Johnson administration and it covers some of the health care costs for poorer Americans.  Medicaid is administered by state governments and these states determine the eligibility of their citizens for Medicaid which usually involves those Americans that are on public assistance.  Medicaid has also been faced with funding disputes between who should foot more of the bill:  the federal government or the fifty state governments.

A big health care program that is currently being debated before Congress is the State Child’s Health Insurance Plan (SCHIP).  SCHIP is a federally funded program that provides health insurance coverage to children who are from families that are well below the poverty line.  This program has been a source of contention between states and the federal government because states are enrolling more children under SCHIP.  They are doing this by expanding their definition of what level below the poverty line constitutes eligibility for the program.  The federal government has faced this same problem from the states with Medicaid by states choosing to expand the eligibility of Medicaid and burdening the finances of the country.  President Bush has chosen to restrict the eligibility of SCHIP in order to stop its expansion and has created new rules according to The Economist on August 30th whereby states would have to demonstrate that they have 95 percent of children enrolled in the program from families that are 200 percent below the poverty line before they try to expand the program to those who are 250 percent below the poverty line.  Critics have argued that these new rules will leave poor children without health care coverage and that the 95 percent target is unattainable because families do not like filling out the paperwork for the program and some who receive public assistance are illegal immigrants who do not want to reveal themselves to authorities.  However, conservatives have applauded the Bush initiative in limiting the rules for SCHIP because they allege that the expansion of the program is a back door way of establishing a universal children’s health insurance system in the United States.  After all, if the program keeps expanding what incentive is there for families to purchase private coverage?  This is a major issue for extempers to face because President Bush has threatened a veto of Congressional legislation to renew SCHIP if these new rules are not implemented.  This could become a political nightmare for Republicans in 2008 because they could be painted by Democrats are being uncaring about America’s children and meeting their health care needs.

Aside from government run programs, there is still a large segment of the U.S. population that relies on their employer to provide them with health insurance.  There are also some Americans that pay for their own health insurance out of pocket.  Having health insurance is important because it covers part of the costs of visiting doctors, hospitals, and having treatments subsidized.  Therefore, health insurance allows health care costs to be shared between the insurance company and the consumer.  To afford insurance, individuals pay monthly premiums in order to maintain coverage.  It is important to note that the insurance industry relies on a principle of uncertainty.  In order to avoid economic hardship if a medical emergency arises, individuals and families have an incentive to obtain health insurance.  This principle of uncertainty often gets cited by critics of government plans that mandate insurance companies provide health insurance to all who apply for it.  After all, if an insurance company is forced to give insurance to someone with a severe medical condition then it is not insurance anymore.  Instead, it functions as a provider of monetary handouts to cover an individual’s medical condition.  In other words, the mystery and doubt of whether the person receiving insurance coverage will get sick is eliminated because there is a one hundred percent chance that the person will require expensive forms of treatment.

The reason that concerns are rising about providing health insurance to a large portion of the American population is that rising health care costs are causing a decline of employer provided health insurance packages.  No longer willing to pay to cover their employees under a health care plan, businesses are choosing not to provide insurance and employees have to seek out insurance on their own.  Many times employees choose not to do so and these people are faced with mounting medical bills if they get sick and if they cannot pay then medical costs go up for the rest of the country in terms of the burden of state and federal governments and higher medical insurance premiums.  This business dilemma heavily impacts smaller firms that have a very small workforce.  The profit margins of these firms are not often big enough to pay for growing medical costs and as a result their employees do not enjoy medical coverage at their workplace.  Bigger firms have also been impacted by rising medical costs, though.  Extempers only need to glance at what is occurring in the management of pension systems at General Motors and Ford, two automotive giants who are facing financial hardship because of obligations to pay for older workers medical expenses, to see this in the news.

Finally, it is worth mentioning that there is a segment of the American population, particularly younger workers who choose to be uninsured.  This segment of the population believes that they are too healthy to become ill and choose not to buy health insurance to cover future medical costs.  This hurts the health care system in two ways.  First, it does not broaden the risk pool in health insurance where premiums can come into the system from health individuals and lower the costs of having health insurance across the board because health insurance companies do not have risk pools of sick individuals that they have to pay to cover.  And second, if a person in this segment of the population gets very sick the cost of treating them is passed on to the taxpayer or those who have health insurance already leading to an increase in medical costs.

United States Health Care Problems

Nearly all of the problems associated with American health care are tied in with how much the system costs consumers and the federal government.  Presently, health care costs the United States sixteen percent of its gross domestic product (GDP).  These costs are expected to rise as the population grows older.  In fact, by 2020 health care expenditure is predicted to represent twenty percent of the output of America’s GDP.  To simplify what this means for beginning extempers reading this brief, by 2020 for every one dollar the American economy generates twenty cents will be going to health care.

One of the arguments against the current system of American health care is that it is too bureaucratic.  Senator Hillary Clinton, in arguing for universal health care coverage, states that twenty-five percent of the money the United States spends on health care goes into administration expenses.  She goes on to note that the United States spends six times what other developed countries do on health care administration.  The costs of this bureaucracy are predicted to be close to $100 billion a year.  What this means for American health care is that if a substantial amount of the money marked for health care is being spent on bureaucratic management then it is not being used for better ends such as funding preventative health care, educating Americans about health, or being used to expand health insurance coverage.

A big argument against the health care system is that the idea of having health insurance causes people to pursue costly treatments.  Economist and New York Times columnist Paul Krugman called this “pushing to the flat of the curve” meaning that an individual would pursue every medical option until they simply ran out of them.  After all, if insurance is footing most of the bill someone is more likely to keep pursing an expensive series of treatments versus someone who does not have health insurance coverage that might forgo those treatments because they are too expensive.

Another argument against the current system of health care in the United States is that it ignores preventative medicine.  Preventative medicine sees patients come in for regular checkups from their doctors and leads to early detention of medical conditions before they become serious.  For example, seeing a doctor on a yearly basis could lead to a faster detection of heart disease or seeing a doctor when you get a cold can lead to treatment that prevents it from turning into pneumonia.  The problem with the United States health care system is that it waits until conditions get serious to intervene.  Insurance companies do not give lower premiums to individuals who seek preventative treatment and some insurance carriers do not cover yearly physicals.  Also, those who do not seek health insurance often let a cold or bad cough go until it becomes so serious they have to go to the emergency room which increases the cost of treating them instead of if they had come in with their cold or cough earlier.  Also, some argue that the government needs to sponsor initiatives that will educate the American public about the dangers of obesity.  Frankly put, as Americans get fatter their risk of heart disease and diabetes rise and the costs of these preventable conditions represent two-thirds of America’s health care expenditure.  As Republican presidential candidate and former Arkansas governor Mike Huckabee put it on his campaign website “We don’t have a health care crisis, we have a health crisis.”

There is also the disputed argument that medical malpractice lawsuits have driven up the costs of American health care.  This has been a contentious issue between Republicans, who have sought to limit the awards in medical malpractice cases, and Democrats, who often receive campaign donations from trial lawyer associations and argue that such limits hurt individuals who have been seriously wronged by the medical community.  The costs of such malpractice lawsuits has been disputed and Peter Orszag, the director of the Congressional Budget Office, has stated that he believes the idea that malpractice lawsuits have led to rising health care costs is greatly exaggerated.  Those that argue medical malpractice lawsuits subscribe to the theory that due to the high awards generated in lawsuits the liability insurance premiums doctors and medical professionals have to pay increase and those increased costs are passed onto the consumer in terms of bigger medical bills.  While this issue is contentious, this argument is worth researching for extempers because a question centered on malpractice awards can often be thrown into a health or social issues round.

A final argument in terms of rising medical costs is linked to the prescription drug industry.  Drugs that want to come onto the American market have to be channeled through the Food and Drug Administration (FDA) and this process takes several years to complete.  During this process drugs are screened for defects and side effects and navigating the red tape can prove to be expensive.  This, coupled with the patents drug companies receive for their products, often see drugs priced outside of the reach of some Americans.  High drug prices are what lead us to the arguments around election time that some senior citizens have to choose on a weekly basis whether they will buy food or buy their prescription drugs.

Universal Health Care

The idea of universal health care has been a contentious issue in American politics for the last fifteen years.  When President Bill Clinton was elected to his first term in office in 1992 he promised to look into the idea of providing universal health insurance coverage to all Americans.  President Clinton put his wife in charge of a health care task force that spent a year designing a health care plan that was blasted by both sides of the political spectrum.  Republicans hated it because it mandated that employers provide health insurance to their workers and represented a large government program.  Republicans were also angry that none of their Congressional members were consulted on the plan.  Democrats also did not like the plan because they were shut out of negotiations on it as well.  The insurance industry responded with the so-called “Dick and Jane advertisements” that warned Americans that if they supported Clinton’s health care plan that the quality of health care in the United States would be greatly diminished.  As a result of opposition by both parties and fierce opposition from the insurance industry and small business associations, Clinton’s universal health care plan died in committee and never made it to the floor of Congress for a vote.  In fact, the failure and mismanagement of a universal health care system is credited with costing the Democrats control of Congress in 1994 which put President Clinton on the defensive for the next six years of his White House tenure.  The history of Hillary’s involvement in this health care reform plan is important for extempers because it puts a chink in her armor when she says that she has always defeated Republicans.  She definitely did not defeat them on this issue and in fact cost her husband a large deal of political capital.  Hillary’s involvement in this health care debacle also points to some defects in her management style.

When looking at how a universal health care system could be established in the United States, whereby all citizens would enjoy health insurance coverage, there are two separate paths to look at:  a single-payer system and an employer-provided insurance system.  In a single-payer system the government would manage the entire health care apparatus because they would the central figure paying for it (hence the concept of the “single-payer system”).  An example of a single-payer system can be found in Great Britain with its National Health Service.  An employer-provided insurance system is the opposite of a single-payer system in that employers are legally obligated to provide health insurance to their workers.  As noted above, this was the focal point of Hillary Clinton’s first attempt at health care reform and it repelled the small business community from her plan.  Knowing the difference between these two different types of models is important to know because you can impress your judge.  Also, if the time comes when Congress is debating a universal health care policy you can know what models to compare the policy to.  After all, if Congress is debating an employer-provided insurance system it would make little sense if you compared it to France (because France is a single-payer system).

The proponents of universal health care argue that it would lead to a reduction in medical costs.  First, they argue that without an uninsured population no one would have to pick up the costs of these people when they require treatment.  Furthermore, a universal health care system would allow the government to ration the use of expensive technologies to certain cases when it was definitely needed.  This would reduce medical costs because these technologies would be used less often and by fewer people.  In addition, with everyone having insurance the risk pool would be increased.  Massachusetts universal health care policy enacted under then Governor Mitt Romney mandates that everyone in the state carry health insurance.  This is meant to bring young, healthy workers into the system that usually do not carry insurance.  As a result, these healthy people can share costs with sicker individuals and lower the cost of premiums across the board.  To look for an editorial arguing for universal health coverage in America look at the New York Times article listed in the cards section.

Opponents of universal health care point to numerous defects in any universal health care system and argue that establishing one would erode individual liberty.  First, paying for a universal health care system would be great.  Democratic presidential contenders argue that they can pay for it through more efficient management of the medical system and rolling back President Bush’s tax cuts.  However, establishing such a system would most likely cost over $100 billion and some of that would most likely have to be established by higher taxes of some sort.  Critics point out that taxes in Canada are twenty-eight percent higher than in the United States due in part to their expansive health care apparatus.  Second, patients would be limited to what medical options they could pursue.  For example, in Canada’s health care system you have to be cleared to undergo a certain medical treatment and for someone who has cancer that medical treatment process could take weeks or months that they simply do not have to successfully beat back the disease.  Furthermore, some universal systems do not allow individuals to purchase medical options outside of their health care system.  This provides one of the great ironies of health care in North America:  senior citizens in the United States go to Canada to get cheaper medicine and senior citizens in Canada go to the United States for surgeries.  A final criticism of a universal health care system is that if the United States government provided all health care coverage it could install price caps on medical services which could severely limit innovation in the health care system, lead to caps on doctors salaries discouraging people from entering the medical profession, and the quality of health care would go down as drug companies would find more profitable places to do business.  In summary, opponents of universal health care rely on an economic maxim:  that the more quantity of health care that is available will lead to a lower quality of health care that is available.  To look at this side of the universal health care debate look at the article listed below from The American Chronicle.

Presidential Health Care Plans

As the Iowa caucuses and the New Hampshire primary approach, presidential candidates on both sides of the aisle are engineering plans for how they would deal with the health care problem in the United States.  Democrats, as can be expected, are open to the idea of government intervention into the health care system than are Republicans.  The three leading Democratic contenders (Clinton, Obama, and Edwards) have similar plans that rely on getting savings in the medical system from using more technology to store medical records, achieving a renewed focus in the medical system towards preventive medicine, giving the government greater leeway in regulating the health insurance industry, and make big businesses provide health insurance or make up the medical costs for their employees if those employees purchase other health insurance plans.  Republicans argue that there needs to be more liberalization in the health insurance market to encourage competition and that the savings generated from that will produce a more manageable path to health care recovery.

Extempers might ask why all of the action on the national level as opposed to the state level.  After all, Massachusetts has passed a universal health care initiative and California has been following in its footsteps.  Interestingly enough, there is a federal law called the Employee Retirement Income Security Act (ERISA) that shields businesses from laws on the state or local level that interfere with the benefits they give to their workers.  Health insurance is considered a benefit so businesses can use this law in court to attempt to overturn state or local regulation against their practices.  Extempers may recall the attempt by the state of Maryland to force Wal-mart to pay for their employee’s health insurance or they would be fined for each worker they hired.  Wal-Mart was able to use ERISA to get a judge to strike down that law.  As a result, advocates of government sponsored health care reform look to national legislation on health care, which is exempt from ERISA regulations, to force businesses to step in line.  For more information about ERISA (which I would heavily recommend) look to the Christian Science Monitor article entitled “State and city healthcare reforms collide with a U.S. law” which is listed in the cards section below.

For this section of the brief I have created sub-headings for each presidential contender with a major health care plan and provided details about their plan.  I thought this would be a more orderly way to read the brief and help extempers who wanted to refer to it more than once for information.  Also, I tried to provide a link to where you can obtain information about a candidate’s health care plan in the cards section.

NOTE:  None of the Democratic candidates plans call for a “single payer system.”

Senator Hillary Clinton (D-NY)

Hillary Clinton’s health care plan represents a more pragmatic and conciliatory approach to the issue than during her husband’s presidency in 1993-1994.  Hillary’s plan calls for a seven step approach to make health care more affordable.

First, Clinton argues for a renewed focus on preventative medicine so that serious medical conditions can be treated early and at a lower cost to insurance companies and the federal government.  Clinton calls for providing incentives to insurance companies so that they encourage those they insure to pursue preventative care.

Second, Clinton wants more computer technology to be used in the medical field, especially to maintain medical records.  She predicts that this will generate billions of dollars worth of savings in administrative costs and by prescribing the right drugs to individuals that will help to fund her plan.

Third, chronically ill patients should have their care co-coordinated across the medical profession.  This means if someone is being treated by different doctors for a variety of conditions those doctors and medical specialists work together to ensure that everyone is on the same page.  This would decrease the payment that had to be used for overlapping treatments.

Fourth, individuals and small businesses should be able to have access to large insurance pools that could have lower premium costs.  This is part of Clinton’s plan to make insurers provide care for those people who have existing medical conditions, a contentious issue that was covered in the opening part of this brief.

Fifth, Clinton envisions a public-private partnership where studies would be done into what technologies and drugs work best and incorporating those into the health care system.  This would drive down costs and increase efficiency in the health care apparatus.  This step has been called for by the Congressional Budget Office which argues that not enough research has been done into what treatments and technologies work best.

Sixth, to lower the price of prescription drugs Clinton would allow Medicare to negotiate prices with prescription drug companies, have more generic drugs be introduced into the American market, and if necessary, import drugs from Canada.

Finally, Clinton says she would reform medical malpractice law to benefit patients and doctors but is somewhat vague on the details of this last point.

In all, Clinton believes these seven steps will produce enough savings (along with a rollback of the Bush tax cuts) for the federal government to insure the 47 million Americans who lack health insurance through a system of tax credits and subsidies.  The Clinton insurance plan would mandate that everyone possess health insurance like the Massachusetts plan.  Small businesses would be encouraged to provide health insurance to their employees through a system of tax credits that critics say constitutes “a bribe.”  The estimated cost of Clinton’s plan is more than her Democratic opponents and rings in at $110 billion.

Senator Barack Obama (D-IL)

Obama’s plan also calls for the savings that Senator Clinton’s plan does.  For example, he supports the electronic conversion of medical records so that they can easily be transferred, calls for more competition in the insurance industry that would lower costs, allow the importation of medicines from other countries, and improve access to preventative medicine by mandating that insurers cover it.  Obama also calls for hospitals to report medical data about the costs in their hospital and the quality of care they are giving patients.

Obama, like Clinton, believes these savings (plus a rollback of the Bush tax cuts) will enable the federal government to fix the health care system.  Obama would expand SCHIP and Medicaid to serve as a safety net for the poor and mandate that parents buy health insurance for their children.  This is different than Senator Clinton and Senator Edwards plans because they require everyone to possess health insurance.  Obama’s plan does not believe in this mandate for adults to get health insurance and they are exempted from his plan.  Obama’s plan also differs from Clinton and Edwards in that he exempts small businesses from having to provide health insurance coverage to their employees.

Obama’s plan is the “cheapest” of the three top Democratic candidates for president clocking in at an estimated $50 to $65 billion.

Senator John Edwards (D-NC)

John Edwards and his wife Elizabeth have accused Hillary Clinton of “stealing” his health care plan.  In fact, Edwards and Clinton’s plans are virtually identical in terms of the ways they would go about cutting costs.

The vision of Edward’s plan is that the federal government would require all businesses to provide health insurance to their employees.  This is the firmest mark against business of any of the three leading Democratic candidates because Obama makes small businesses exempt and Clinton offers tax credits while Edwards offers nothing.  Edwards would then go about reforming insurance laws and making health insurance more affordable for people by giving them tax credits (and most likely subsidies for poorer Americans).  Edwards would achieve government savings to finance these credits and subsidies through the cutting of costs which mirrors Clinton’s plan.

After these credits and subsidies were allocated Edwards would create so-called regional “health care markets” allowing Americans to bargain for high quality health insurance plans and insurance plans would compete against each other thereby decreasing premium costs in the insurance market.  There is mention that costs would somehow be cut for businesses that provided health insurance to their employees, although this is confusing since Edward’s envisions that they will be required to provide coverage.

Once the steps above have been completed, Edwards would, like Clinton, mandate that all Americans have health insurance.  The cost of this plan ranks second behind Clinton’s at $90 billion but some project that it could cost more than Clinton’s plan at $120 billion.

Governor Mitt Romney (R-MA)

Although Romney presided over the establishment of a universal health care system in Massachusetts that mandated everyone acquire health insurance he has began to distance himself from that project to win the trust of the conservative base.  For example, Romney says he would oppose requiring anyone to get health insurance.

Romney’s plan would allow each state to come up with its own health care model as he believes the states should function as units of policy innovation.  However, states would develop their own health care models without financial assistance from the federal government because the federal government would be paying states to deregulate their insurance markets.  Romney’s team believes that if the insurance market is deregulated that it will provide consumers with a wider array of options.  It is hoped this competition between insurance companies would lead to lower insurance premiums and that would be an incentive for more people to obtain health care coverage.

To help Americans afford coverage, Romney, like a good Republican candidate, offers tax deductions for those that purchase it and he would work with states to take money directed to charity care to assist low-income people in getting health insurance.  Romney’s political team argues that the costs of this plan would be $10 billion a year, five times less than Barack Obama’s plan.

Governor Mike Huckabee (R-AR)

As governor of Arkansas, Mike Huckabee championed the fight against obesity.  In order to encourage his fellow citizens to join his efforts he lost over a hundred pounds.  He also led reforms about the nutritional foods offered in Arkansas schools.

Huckabee’s plan emphasizes preventative medicine by getting insurance companies to give lower premiums to those who live healthy lifestyles (no smoking, drinking, and exercising regularly).  Huckabee also emphasizes preventative care by calling for the eliminating of co-pays and deductibles for health screening such as mammograms.  Huckabee, like Hillary Clinton, argues for better management for patients suffering chronic diseases to eliminate overlap in the system.

The biggest part of Huckabee’s plan is the establishment of a more consumer based model where the cost of care is shared between employer and employee so that people understand the cost they put on the health care system.  He hopes that this will reduce costs as people will consume less if they have to pay a larger share of their care.

“A Bit Richer but a Bit Sicker.”  The Economist.  30 August 2007.

http://www.economist.com/world/na/PrinterFriendly.cfm?story_id=9725549.

WITH an election looming, even the driest documents can spark fury. Hillary Clinton expressed “outrage” at the news contained in the Census Bureau’s latest report on income, poverty and health insurance in the United States, which was released on August 28th. Barack Obama said it represented “a betrayal of the ideals we hold as Americans”. John Edwards, reviving a well-worn theme, said it confirmed that there are “two Americas”. To anyone not running for president, however, the report contained both good news and bad.

“Hillary’s Last Health Plan Still Looms Large.”  Chicago Sun-Times.  25 September 2007.

http://www.suntimes.com/news/hunter/572693,CST-NWS-hunter25.article#.

It has clearly ticked off the other Democratic candidates that Hillary Clinton has been receiving so much positive press for her newly unveiled health care plan. There has been a sympathetic column from David Brooks of the New York Times, an appearance with Wolf Blitzer on CNN’s “Situation Room,” a polite interview with Melissa Block on NPR’s “All Things Considered” and many other interviews.

“Pay a Premium.”  Houston Chronicle.  25 September 2007.

http://www.chron.com/disp/story.mpl/editorial/5164660.html.

Responding to Americans’ desire for health care reform, a near-desperate desire in some quarters, almost all of the presidential candidates have put forth a plan to increase access to medical insurance. The resulting options range from market-based solutions to national health insurance. The most intriguing proposals, and possibly the most pragmatic, would build on the successes of the private health insurance market and mend the cracks of its failures.

Cook, David.  “Peter Orszag: Rising healthcare costs pose fundamental risk to U.S.”  The

Christian Science Monitor.  20 September 2007.  http://www.csmonitor.com/2007/0918/p25s01-usmb.htm.

Rising healthcare costs are the most pressing budget issue facing the United States, and much more objective data on the effectiveness of medical treatment is needed to help contain those costs.

That is the view of Peter Orszag, the director of the Congressional Budget Office. He was the guest at Monday’s Monitor breakfast. The CBO provides objective and nonpartisan economic analysis to Congress.

John Edwards Health Care Plan.  http://johnedwards.com/issues/health-care/.

This is a link to John Edwards health care plan.

Barack Obama Health Care Plan.  http://www.barackobama.com/pdf/HealthPlanOverview.pdf.

This is a link to a summary of Barack Obama’s health care plan.

Hillary Clinton Health Care Plan Summary.  “Hillary Clinton Unveils Plan For Reducing Health Care Costs.” Medical News Today.  25 May 2007.

http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=72229.

This is a link to a report that gives the specific details of Hillary Clinton’s health care plan.

“Seeking a Second Chance.”  The Economist.  18 September 2007.

http://www.economist.com/world/na/PrinterFriendly.cfm?story_id=9825823.

ON MONDAY September 17th Hillary Clinton became the third of the three Democratic presidential frontrunners to offer voters a comprehensive health-care plan. It is a sign of how far America’s health-care debate has shifted that the first opponent to fire a broadside at it was Mitt Romney, a Republican who also hopes to be president. Predictably, Mr Romney criticised her proposal as a heavy-handed plan that would generate a lot of bureaucracy. But as governor of Massachusetts Mr Romney brought a similar, and widely-praised, scheme to his home state. Such has been the shift in attitudes towards covering America’s 47m uninsured.

Hseih, Paul.  “‘Single-Payer’ Health Care Anything but Free.”  The American Chronicle.  25

September 2007.

Michael Moore’s latest movie “SiCKO” sings the praises of the Canadian “single-payer” socialized medical system. Some Americans want a similar system implemented in the United States. Defenders of the Canadian system frequently claim that patients don’t have to worry about money when they’re sick–the health care is free. But is this really true?

No.

Arnoldy, Ben.  “State and city healthcare reforms collide with a U.S. law.”  The Christian Science

Monitor.  27 September 2007.  http://www.csmonitor.com/2007/0927/p03s01-ussc.htm.

The biggest name in healthcare reform isn’t Hillary, or Mitt, or Arnold – it’s ERISA. That’s the name of a federal law that could invalidate many of the budding efforts by states and cities to expand access to healthcare.

ERISA, which stands for the Employee Retirement Income Security Act, shields businesses from state and local regulation of the benefits they offer workers, including health insurance. Without the law, national companies in particular could achieve little uniformity in their benefit plans.

“The Battle Over Health Care.”  The New York Times.  22 September 2007.

One of the enduring frustrations of presidential elections is that candidates and their parties sound like Tweedledum and Tweedledee on many issues. In 2008, when it comes to health care, which is emerging as a defining domestic issue, voters will find stark differences in philosophy and commitment between Democrats and Republicans.

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