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Clinton, Obama Clashing On Healthcare – Part 2Democrats Debate Requiring People To Buy Coverage

Posted Oct 02 2008 3:15pm


Stanley Feld M.D.,FACP,MACE

None of the candidates are discussing the origins of our dysfunctional healthcare system. If they understood the origin of the dysfunction I believe the cure would be obvious. The problems started with Medicare and mandated price controls.

Instead they fight over relatively insignificant issues.

“ Clinton is not alone among Democrats in calling for all adults to buy insurance. Former Sen. John Edwards of North Carolina, New Mexico Gov. Bill Richardson and Sen. Christopher J. Dodd of Connecticut have included the requirement in their health plans, making Obama the most notable outlier in the party's presidential field.”

An important question is; what is the definition of the middle class? The Drum Major Institute, a progressive think tank, has a website called www.themiddleclass.org that places the range for middle class at individuals making between $25,000 and $100,000 a year. The middle class comprise 60% of our population. These are the people the presidential candidates are begging to vote for them. However, the candidates from neither party are presenting viable solutions to the voters’ problems.

A middle class male with a family of four earning $40,000 per year will not be able to spend $10,000 a year with after tax dollars for healthcare insurance. He needs to feed and clothe his family. His home could cost $12,000 a year. Fuel, electricity and gasoline could cost at least $8,000, all with after tax dollars. Income tax bill could be at least $6,000 or more. All this without mentioning food and clothing and other essential expenditures to keep a roof over his family’s head.

A male independent contractor with a family of four who has hypertension and high cholesterol earns $50,000 a year. He does not have access to group healthcare insurance. He would not be eligible to purchase healthcare insurance from any healthcare insurance company. He is a poor insurance risk. Even if he was eligible, this middle class family could not afford the present healthcare insurance premiums.

The idea of making health insurance a requirement has grown in appeal as politicians and health advocates look for ways to cover the estimated 47 million Americans who do not have it.”

On the other hand, insurance executives are earning millions of dollars a year; hospital administrators feel they deserve one million dollar plus salaries. We all recognize the inefficiencies and waste in the system. The presidential candidates are not talking about how to solve these problems.

Pharmaceutical companies sell their drugs directly to the public through advertising. The FDA has recently taken many drugs of the market. How can the public develop trust in medications? Not a single candidate is discussing the patient safety issues of prescription medication.

Neither are any of the candidates discussing ideas to solve our national obesity epidemic. Obesity is the cause of many chronic diseases. Here is an idea for a candidate. Why don’t you make the War on Obesity a national issue. Two issues can be highlighted. First is the excessive calories in fast food and second the perverse incentives in the farm bill. The farm bill incentives can redirect corn and soybean from foodstuffs to fuel. The result would be decreasing our dependence on foreign oil and promoting a cleaner greener environment. Both initiatives would have a significant impact on our health.
Ninety percent of our healthcare dollar is spent on treating the complications of chronic disease. No candidate is advocating funding for teaching patients to prevent these complications.

Compliance/adherence rate for medication prescribed is about 50% for most chronic diseases. No candidate has mentioned developing public service educational programs to emphasize this problem.
These are a few of the problems that should be addressed.

Yet Clinton is attaching Obama with meaningless sound bites. "He's called his plan 'universal.' Then he called it 'virtually universal.' But it is not either," she asserted in a recent Iowa speech. "And when it comes to truth in labeling, it simply flunks the test."

The debate about healthcare is entertaining but shallow and negative.

" Clinton mailed a letter to Iowa voters, over the signature of former Gov. Tom Vilsack, which says "Mr. Obama threw back talking points worthy of Rudy Giuliani or Mitt Romney" when questioned about "flaws" in his plan.

In response, Obama distributed a piece in New Hampshire that defended his health proposals and urged voters to "remind Hillary Clinton" that the Jan. 8 primary "won't be won by launching misleading, negative attacks."

However Americans are tired of political rhetoric. Someone has to tell the candidates that we are smarter than they think.

“But as the concept of a health insurance mandate gains currency within top ranks of the Democratic Party, the feasibility of the idea remains uncertain and its effects are unproven. As the Obama campaign points out, similar requirements in other areas, such as mandatory automobile insurance and motorcycle helmet use, never result in universal compliance.”

I do not believe Hillary Clinton is interested in the feasibility of her ideas. She is more interested in spinning her sound bites so she can become president.

Obama might be the only one that has respect for our intelligence. I hope America’s intelligence shows up in the polls.

The opinions expressed in the blog “Repairing The Healthcare System” are mine and mine alone.

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