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Presidential Candidates Discuss Health Care During New Hampshire Debates

Six Republican presidential candidates on Saturday at St. Anselm College in Manchester, N.H., participated in a debate hosted by ABC News and Facebook during which they addressed health care and other issues, the Los Angeles Times reports.

During the debate, Sen. John McCain (Ariz.) criticized the pharmaceutical industry. He said, "Why shouldn't we be able to reimport drugs from Canada? It's because of the power of the pharmaceutical companies." McCain added, "We should have pharmaceutical companies competing to take care of our Medicare and Medicaid patients." In response, former Massachusetts Gov. Mitt Romney said, "Don't turn the pharmaceuticals into the big, bad guys." McCain said, "Well, they are."

"No," Romney said, adding, "Actually they're trying to create products to make us well and make us better, and they're doing the work of the free market. And are there excesses? I'm sure there are, and we should go after excesses. But they're an important industry to this country" (Decker/Finnegan, Los Angeles Times, 1/6).

Former Sen. Fred Thompson (Tenn.) criticized Romney for his enactment of a Massachusetts health insurance law that requires all state residents to obtain coverage. Romney said that he supports certain mandates, to which Thompson responded, "The ones you come up with." Former New York City Mayor Rudy Giuliani and Rep. Ron Paul (Texas) also participated in the debate (AP/St. Petersburg Times). Democratic Debate
After the Republican debate, four Democratic candidates participated in a debate on the same stage during which they addressed health care and other issues, the St. Louis Post-Dispatch reports (Herman/Shepard, St. Louis Post-Dispatch, 1/6).

In a discussion of their records on health care, former Sen. John Edwards (N.C.) discussed his efforts to pass a patients' rights bill, and Sen. Barack Obama (Ill.) cited his efforts to reduce the influence of lobbyists on legislation related to health care and other issues. In response, Sen. Hillary Rodham Clinton (N.Y.) said that the patients' rights bill never became law and that Jim Demers, the co-chair of the Obama campaign in New Hampshire, works as a lobbyist for pharmaceutical companies (Kornblut/Balz, Washington Post, 1/6). Obama communications director Robert Gibbs said Demers is a state lobbyist with no involvement in federal legislation. He said that in the campaigns ban on taking money from lobbyists, it distinguishes between state lobbyists and those who lobby on the federal level (Kuhnhenn, AP/Google.com, 1/7).

Clinton also criticized Obama because his health care proposal would not require all U.S. residents to obtain health insurance. She said, "You stop short of going the distance to making sure that we have a system that can deliver health care for everyone" (Sherman, Pittsburgh Post-Gazette, 1/6). Obama "could have a pretty good debate with himself because, four years ago, he was for single-payer health care," Clinton said, adding, "Then he moved toward a rejection of that, a more incremental approach. Then he was for universal health care. Then he proposed a health care plan that doesn't cover everybody" (Liebowitz, Concord Monitor, 1/6).

Obama said, "I have been entirely consistent in my position on health care" (Pittsburgh Post-Gazette, 1/6). Obama said that such a mandate is not necessary because most residents who do not purchase health insurance make the decision based on cost, not a lack of desire to obtain coverage (Washington Post, 1/6). He added, "What I said ... is if I were designing a system from scratch, I would set up a single-payer system." But given the existing health care system in which so many people already receive coverage through employers, such a change would be impractical, he said (Liebowitz, Concord Monitor, 1/6).

New Mexico Gov. Bill Richardson also participated in the debate (Washington Post, 1/6). Broadcast Coverage
ABC News video of comments from Republican candidates on health care during the debate is available online (ABC, 1/5). A transcript of the complete Republican debate also is available online (ABC.com, 1/5).

CNN video of comments from Democratic candidates on health care during the debate is available online (CNN.com, 1/6). A transcript of the complete Democratic debate also is available online (ABC.com, 1/5).

CNN's "Late Edition with Wolf Blitzer" on Sunday included discussions with Edwards and Thompson about health care and other issues (Blitzer, "Late Edition with Wolf Blitzer," CNN, 1/6). A transcript of the complete program is available online. Other Appearances
Earlier on Saturday, Clinton appeared at a high school in Penacook, N.H., to discuss her health care proposal. She said, "People should stand for universal health care ... more independents and even Republicans are now understanding that it is morally and economically imperative" that the U.S. provide health insurance for all residents. In addition, Clinton said, "Who is ready to be president on Day One?" adding, "We've got 47 million uninsured Americans. We have an economy that is faltering" (Pittsburgh Post-Gazette, 1/6).

Obama on Saturday appeared at a Nashua, N.H., high school. He said, in reference to his victory in the Iowa Democratic caucus, "What we saw during this past week was the American people rising up and saying to each other that we are on the cusp of creating a new majority ... that will actually deliver on the promises of health care" (Nagourney, New York Times, 1/6). Additional Coverage
Edwards: Edwards recently "has been bashing big health insurers" with the story of Nataline Sarkisyan -- a 17-year-old girl who died after Cigna refused to cover a life-saving liver transplant that she required -- as part of his call for health care reform, the Wall Street Journal reports. Cigna initially rejected coverage for the liver transplant but later reversed the decision. However, Sarkisyan died before she could receive the transplant. Edwards said that Sarkisyan "lost her life ... because her insurance company would not pay for a liver-transplant operation." He added, "We need a president who will take" on health insurers (Fuhrman/Meckler, Wall Street Journal, 1/7).

Election issue: The U.S. health care system is "sick, and the presidential hopefuls are ready to play doctor," the St. Louis Post-Dispatch reports. According the Post-Dispatch, the "ailments are clear: The cost of health care and insurance premiums have skyrocketed, and the ranks of the uninsured have swelled" -- both of which have "badly frayed the current health care system, in which employers are the leading source for health insurance and the government provides a safety net for the poor and elderly." Employers have begun "balking at insurance costs and shifting more of [them] to workers," and lawmakers face "new demands for health care programs at a time of growing budget deficits," the Post-Dispatch reports. "Health care has been catapulted to the top of the priority list in terms of domestic issues voters want to hear about," Ron Pollack, executive director of Families USA, said, adding, "In the past, health care has often been viewed as an issue of altruism for somebody else. ... This issue has now been transformed into an issue of self-interest." A "spat" among Democratic candidates over whether to require people to obtain health coverage "will pale in comparison to the confrontation expected once each party determines its nominee," the Post-Dispatch reports. "The Democrats are aiming for universal coverage and the Republicans are not," said Larry Levitt, vice president of the Kaiser Family Foundation. "Once we come to the general election, there will be a very clear divide between the major party candidates," and health care is likely to become a significant battleground by this summer (Shesgreen, St. Louis Post-Dispatch, 1/6).

General election issue: "Spiraling medical costs, tighter government budgets and a presidential election are three big reasons why health care will be front and center as an economic issue" in the 2008 general election, the Orlando Sentinel reports. Des Cummings, executive vice president for corporate development for Florida Hospital, said, "If the war in Iraq is not the next centerpiece (in 2008), health care will be." As a result of the "front-loaded primary system that could determine the parties' winners by February," the debate over health proposals from the Democratic and Republican presidential nominees "could dominate the entire year," according to the Sentinel (Wessel, Orlando Sentinel, 1/7). Editorial, Opinion Pieces
Wall Street Journal: The health care proposals from Clinton and Obama both would "create a public insurance option managed by the government," implement "more stringent regulations on insurance companies" and "institute new taxes on business," but the "main substantive difference" is that Clinton would "dictate that everyone have health insurance," rather than only children as Obama proposes, according to a Journal editorial. Both proposals "speak to aspirations" to "use incremental steps to gradually achieve a government-run health care system -- and Mr. Obama's steps aren't grand enough" for liberals, according to the editorial. "However, it turns out, this less than Grand Guignol ought to provide a warning to Republicans," the editorial states, adding, "Whatever the minor policy differences among Democrats, their major domestic ambition is ... the government takeover of the health care market," and the Republican nominee "will need a free-market alternative and a way of explaining it that is more concise and compelling than we've heard so far" (Wall Street Journal, 1/7).

Tarren Bragdon, Wall Street Journal: "Clinton is running for president, in part, on a platform that calls for more government health care. So let's ask a question that may hit a little too close to home: Why does New York spend more on Medicaid -- a health care program for the poor -- than every other state but still have a larger portion of its population walking around without health insurance than states that spend far less?" Bragdon, a health policy analyst with the Empire Center for New York State Policy at the Manhattan Institute writes in a Journal opinion piece. He continues, "One reason is that New York has made private health insurance too expensive for many people by imposing a long list of mandates" on health plans. According to Bragdon, a "better path would be to reinvigorate the private, direct-pay health insurance market" through the establishment of a new "risk pool" for high-cost patients, possibly "subsidized by a tiny surcharge on other policies." He adds that the pool would allow health insurers to "charge rates that more closely track the actual cost of providing health care to individuals." In addition, Bragdon writes, "The evidence suggests ... that almost everybody could buy private insurance if carriers were allowed to tailor plans to meet consumers' needs" (Bragdon, Wall Street Journal, 1/5).

Matthew Collier/Lisa Walsh, Wall Street Journal: "Given the trajectory of health care costs and the growing number of uninsured people, it's no surprise that health care reform is a top agenda item in the 2008 elections," but the "real surprise is that some of the nation's largest insurers are starting to recognize that selling insurance in a subsidized market might be a good business to be in," Collier and Walsh, senior members of global health care practice at Bain, write in a Journal opinion piece. Health insurers have begun to understand that the "nation's 47 million uninsured are not as bad a risk as is commonly assumed" and that they "no longer can afford to ignore the uninsured market" because their "core business -- selling group plans to large employers -- is stagnant," the authors write. They add that "this means that their greatest source of future growth is selling policies to individuals -- not corporations." The authors conclude, "For the insurance industry, the bottom line is simple. No matter what happens with insurance reform, a new market is emerging. The winners will be those who prepare now for a world where individuals matter" (Collier/Walsh, Wall Street Journal, 1/7). Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.





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