A Healthy Debate

A Healthy Debate


Twelve years ago, Harris Wofford made healthcare an issue. Promising to fight for coverage for all, Wofford scored a surprise victory in a Pennsylvania Senate race–inspiring speculation that a President named Bush could be beaten in 1992. Wofford handed the issue to Bill Clinton, who won the election but lost the war by proposing a plan that offered more in the way of bureaucracy than a clean break with the existing for-profit system. Since the Clinton crackup, Democrats have struggled to reassert the healthcare issue. While the 2004 campaign has yet to experience a “Wofford moment,” Dr. Norman Daniels of the Harvard School of Public Health says rising numbers of uninsured and underinsured should move healthcare to the fore as an issue. “The question,” he says, “is whether the new crop of candidates will address it effectively.”

Enter Representative Jim McDermott, a physician and the new president of Americans for Democratic Action, who has taken it on himself to sort through candidate proposals (www.adaction.org). As McDermott sees it, the plans of Howard Dean, John Edwards, John Kerry and Dick Gephardt “are all quite similar–they each combine modest expansions of public sector programs such as Medicaid and [children’s health programs] with private sector initiatives to encourage employers to provide health insurance for their employees.” While under each of these plans the government becomes an even greater purchaser of healthcare, McDermott says that “because most of the new expenditures are through the fragmented private insurance market, the government will continue to waste its considerable market power.” He’s still reviewing Lieberman’s plan, which looks to resemble the others.

In contrast, McDermott notes, Representative Dennis Kucinich offers a single-payer national healthcare plan based on a bill by Representative John Conyers, of which McDermott is a co-sponsor. While he sees value in incremental reforms, McDermott says, “I continue to believe that a national health care plan, with a government-guaranteed revenue stream for providers, would be most effective in providing universal coverage and controlling costs while guaranteeing high quality care.” A separate study of the candidate proposals, done by The Commonwealth Fund (www.cmwf.org), says Kucinich’s plan would cover all Americans, while those of Lieberman, Dean, Gephardt, Kerry and Edwards would leave 9 million to 19 million uninsured. Single-payer backers Al Sharpton and Carol Moseley Braun have not offered details; Gen. Wesley Clark has yet to make his views clear.

While McDermott’s analysis will please Kucinich backers, his candidate choice won’t. The Congressman just endorsed Dean. Two reasons, he says. First, “as governor of Vermont, Dean implemented reforms. He got people covered. One of the problems the Clintons had is that they were starting without ever having done it. For them, it was theoretical. Experience helps you avoid big mistakes.” Second, “Electability. Dean isn’t my perfect candidate, but I think he can beat Bush. Beating Bush is the first step toward healthcare reform.”

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Katrina vanden Heuvel
Editorial Director and Publisher, The Nation

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