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Clinton vs. Obama on Health Care


Obama and Clinton have different solutions for health care.

Democratic Debate in Las Vegas, November 15, 2007

HILLARY CLINTON:

"His plan would leave 15 million Americans out...I have a universal health care plan that covers everyone."

BARACK OBAMA:

"The fact of the matter is that I do provide universal health care."

They can't both be right--or can they? The health care plans proposed by Senators Clinton and Obama are similar in many ways, but they differ in several important respects. The Clinton plan "mandates" health insurance for everyone. The Obama plan requires that all children have insurance, and subsidizes health care for other Americans who are presently uninsured. Clinton estimates that her plan will cost in the region of $110 billion a year; Obama has put a $50 to $65 billion price tag on his proposals.

The Facts

The truth is that neither the Obama plan, nor the Clinton plan, guarantees "universal coverage" for all Americans, although they both aspire to this goal. Let's look at the Clinton plan first.

MIT economics professor Jonathan Gruber, one of Clinton's health care advisers, describes her plan as a "universal coverage" plan, in contrast to the Obama plan, which he terms a "universal access" plan. But he also acknowledges that the Clinton plan will not include everybody. "Any system that does not have a single payer will not have 100 per cent coverage," he told me, when I reached him after the Las Vegas debate. "But you can come very close."

By "single payer," Gruber means a national health insurance system along the lines of Britain or Canada, which do provide universal coverage. The system proposed by Clinton is more analagous to the government-subsidized private insurance system in the Netherlands, where roughly one and a half per cent of the population is estimated to fall through the cracks.

The Clinton plan is also comparable to the health care plan introduced in Massachusetts by Governor Mitt Romney (who is opposed to extending the experiment to the rest of the United States.) It provides various incentives and penalties for uninsured residents of Massachusetts to subscribe to a health plan. Known as "The Connector," the Massachusetts plan has so so far enrolled 200,000 out of 400,000 uninsured residents. The big unknown is how many of the remainder will sign up once health insurance becomes "mandatory" at the end of this year. Some Massachussets residents have already been exempted from the "mandatory" health insurance requirement.

"The only place in the U.S. that has attempted a mandate is Massachusetts, and we do not know if it is going to work here," said David Blumenthal, a professor of health policy at Harvard university and an adviser to the Obama campaign. "A mandate is not a slam-dunk solution. The key question is whether there is the political will to enforce the mandate once it goes into effect."

Blumenthal concedes that the Obama plan will not cover all the uninsured, at least to begin with. But he claims that Obama will do a better job than Clinton in reducing the cost of health care premiums. He says that Obama might consider a mandate at a later stage, if his present plan does not achieve its goal of universal coverage.

So where did Clinton get her figure of 15 million uninsured under the Obama plan? Her website cites an article in the New Republic, hardly an authoritative source. On the other hand, it is more than just a wild guess. The Urban Institute, a Washington-based think tank, gamed out various different models for health care reform in Massachusetts several years ago. According to John Holohan, one of the authors of the study, "we estimated that we would probably get half the uninsured without a mandate." Extrapolated to the whole country, that would leave 22 million out of 45 million people still uninsured. Since the Obama plan provides for mandatory insurance for children, the total number of uninsured would probably come down to around 15 million.

Like the other experts, Holohan does not believe that either the Clinton or the Obama plan will eliminate the problem of the uninsured altogether. "We would all be very happy if we got down to one and a half per cent," he said.

The Pinocchio Test

Neither Clinton nor Obama are being fully candid about the gaps in their health care proposals. Neither plan truly provides for "universal" coverage, although Clinton's proposal probably comes somewhat closer to reaching this goal than Obama's. There are strengths, drawbacks, and loopholes to both plans. At this point, nobody knows how many uninsured they will include, but it will not 100 per cent. Much will depend on their ability to work with Congress once they are elected. If they were being honest with the voters, they would say that universal health care coverage is an aspiration, not a guarantee. Two Pinocchios apiece.

(About our rating scale.)

USEFUL LINK

The Henry J. Kaiser Family Foundation has assembled data on the health care plans of all the leading candidates, Democrats and Republicans. Here is their comparison of the Clinton and Obama plans.

Posted on November 19, 2007 at 6:00 AM ET  | Category: 2 Pinocchios, Barack Obama, Candidate Watch, Health, Hillary Rodham Clinton
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Previous: Four Pinocchios for Ron Paul | Next: Who is More 'Pro-Life': Fred or Mike?

Comments

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They scare me!
MS should be put in charge of healthcare!
http://fakesteveballmer.blogspot.com


Posted by: steve ballmer | November 19, 2007 08:24 AM

It would be nice if in the future presidential contenders are able to present their proposals such civilized way. However, I do not believe much to what Mrs. Clinton campaign is advertising. The main reason for that - her plan looks very costly, which the creators admitted, placing the price tag on it, and everybody knows, and Mrs. Clinton admits herself that there is no money or practically no federal money currently available. So, it would be another hoax promise of Mrs. Clinton (or Clintons). So, I would not trust her proposals, and would not pick her.

Posted by: apelbaum | November 19, 2007 08:30 AM

let's see, you all say obama is lying more, but it's equal noses.

wow... talk about biased!

Posted by: B.Williams | November 19, 2007 11:55 AM

One thing you did not cover is that Clinton is not saying how she will Mandate coverage. She is not willing to say what penalties she will put on people who don't buy coverage. What will she do to poor people who have to choose between insurance and paying the rent. What will be the consequences? How much subsidy will there be? And a tax credit sounds great, but what about people living pay check to pay check? How can they wait a year for the tax credit? I think mandates are very scary, and Obama is right to get the program started and then see if mandates are needed.

Posted by: A. Adams | November 19, 2007 12:26 PM

There is one critical difference between the Clinton and Obama plans -- the person proposing them. Clinton is driven to push her agenda through Congress. The only thing that has really changed since 1992 is who has her ear this time around. Her approach to politics generates resistance and anger among her opposition, limiting future progress.

Obama is far more open to listening to others so he arrives at the best solution to a problem or issue. His consensus building is far more likely to produce a positive outcome that others can accept and embrace.

Neither candidate provides a truly optimum health care plan. But, who would you rather have leading the drive for health care change? A consensus builder like Obama or a person who figures its "my way or the highway." That is the real choice we face.

Posted by: PJW | November 19, 2007 12:49 PM

My health insurance now costs me less than $70 a month, and I have great coverage and benefits. I won't be voting for anybody who would require me to pay more and get less. End of story.

Posted by: WashingtonDame | November 19, 2007 01:07 PM

At the end of the day, which candidate is more likely to succeed? It doesn't matter how many people are covered under what plan if that plan dies before enactment.

Clearly it doesn't take a genius to see that Obama has a MUCH better chance of getting any health care plan implemented. Fair or not, the truth is that Hilary Clinton and Health care have become synonymous with large government bondoogles. I particularily like the fact that Obama is willing to incorporate reasonable Republican ideas and put together something that could actually happen. This is one of the reasons I support Obama for president.

Posted by: reussere | November 19, 2007 01:26 PM

I'll take the Obama plan.

I'm curious as to how one "mandates" -- that is forces -- people who can't afford health insurance in the first place to get coverage. From whom? At what cost? At what penalty? Are you going to put them in the modern day equivalent of debtor's prison?

I'd rather have the concensus builder looking for way to bring about coverage than the former First Lady.

And Fact Checker, how do you come down on the side (once again) of the Clinton plan? When as I read your article, the Obama plan is acknowledge as the better of the two. And I might note, you did not report the number of uninsured the "Clinton mandate" (HA!) leaves out in the cold.

And finally as you report: "But he (David Blumenthal) claims that Obama will do a better job than Clinton in reducing the cost of health care premiums."

You might not be aware of this, Fact Checker, but it is the expensive premiums that keep most people from acquiring insurance coverage. Even the SCHIP bill, which Mr. Bush loves to veto, is designed for those working families who cannot purchase insurance because the cost of premiums is exorbitant.

Seems to me the correct allocation of Pinocchios is 2 or Clinton, 1 (maybe) for Obama, and 1 for Fact Checker, who tried too hard to make Clinton come out on top once again.

Posted by: Jade7243 | November 19, 2007 02:26 PM

Had to prove me right, eh Mr. Dobbs (for others, see my comment in the previous article 'Four Pinocchios for Ron Paul')? Had to give the two Pinocchios, just like I said you would for Obama and Hillary? WaPo...what are you paying Dobbs for? I'm doing his job better than him. This fact checking blog is joke. Dobbs reminds me of that other idiot blogger Penelop Trunk.

Posted by: Playa | November 19, 2007 02:27 PM

Quality Vs. Quantity

What health plan do you believe would maintain quality of health care?

http://www.youpolls.com/details.asp?pid=1029

.

Posted by: PollM | November 19, 2007 03:16 PM

"I won't be voting for anybody who would require me to pay more and get less."

That leaves all of the candidates as options. Guess you still have some whittling down to do.

Posted by: Judge C. Crater | November 19, 2007 05:54 PM

Hillary & Obama...Hillary & Obama. Why doesn't the mainstream media talk about the ONLY candidate that can actually WIN in 2008....John Edwards. John is a TRUE advocate for the poor and un-insured, an articulate orator, an intelligent and reflective thinker, and plain speaker who actually admits mistakes when made, and he's a SOUTHERNER. Ask yourself when was the last time a candidate from above the Mason-Dixon Line actually won the White Hous?. The answer...John F. Kennedy in 1960, almost fifty years ago. And he ran against another Northerner. We need a Southern Democrat who has already proven he can win in a RED state...North Carolina. We need John Edwards in order for the Dems to win back the White House.

Posted by: A.Lincoln | November 19, 2007 08:17 PM

Clinton proved that she is untrustworthy. The 1990's sham of an effort that resulted in her dropping the topic like a hot rock, after Bill was elected to his second term proves she is a con-artist.

Obama is unelectable.

The only hope for the Democrats is John Edwards.

Posted by: the Man In Black | November 19, 2007 11:31 PM

QUIBBLE: "Universal health coverage" can be taken two ways, abstract or concrete. The former is what Obama obviously meant, i.e. access. It's not honest to talk about the latter until it's true, i.e. everyone has been covered. By the same token, Hillary is wrong to say that Obama would leave out 15 million, because she can't know whether everyone would sign up. Likewise, she's wrong to say her coverage would cover all, because everyone might NOT sign up. If Obama simply asserted his plan is universal, he earns ZERO Pinochios. I'm a Hillary supporter, but fairplay requires me to request that Obama NOT be done in like Gore. Hillary's point of view shifts from "seller" to "buyer" applying the former to her plan, and the latter to Obama's plan. I'd give her 3 p's for being "shifty".

Posted by: jhbyer | November 20, 2007 12:15 AM

does rudy's health plan leave out anyone? How about Kuccinich?

Posted by: george | November 20, 2007 12:17 AM

Why is this column titled "The Fact Checker" when it is really just another opinion piece?

"MIT economics professor Jonathan Gruber" says one thing in support of the Clinton plan.


" ... said David Blumenthal, a professor of health policy at Harvard university " in a counterpoint opinion.

"The Urban Institute, a Washington-based think tank ..."


"According to John Holohan, one of the authors of the study ..."

Name-drop much?

Who is to say any one of these peoples' OPINIONS, or your own (fact-checker), are more valid than any other opinion, since you don't provide any evidence or facts, but instead just a bunch of heresay?

Posted by: Joseph | November 20, 2007 12:53 AM

Obama's not credible. Again. He's an empty suit with a nice smile and oratory skills. The opposite of Bush.

His high estimate is $65 billion to insure 45 million Americans, plus help those who do have coverage. I've heard him in speeches describing his plan: "...if you have insurance, the only difference is your premium will go down..." but leave that aside for now.

$65 billion divided into 45 million is a bit short of $1,500 per person per year. What kind of coverage would THAT buy?

The real costs are much higher, and Obama Bin Barack knows it.

Posted by: The Angry One | November 20, 2007 01:09 AM

A fact is something like: 2 + 2 = 4.

It would not be possible for someone to post a comment saying, "No, your're wrong, 2 + 2 is not equal to 4" without being, well, just wrong.


What is an opinion? Well, a good example of an opinion is the first sentence that the "fact-checker" wrote under the heading "The Facts":

"The truth is that neither the Obama plan, nor the Clinton plan, guarantees 'universal coverage' for all Americans, although they both aspire to this goal."

See, that is an opinion, not a fact.

Posted by: Joseph | November 20, 2007 01:24 AM

2008 Presidential Election Weekly Poll
http://www.votenic.com
The Only Poll That Matters.
Results Posted Every Tuesday Evening.

Posted by: votenic | November 20, 2007 11:21 AM

I just wanted to clarify what I told Michael Dobbs for this story. There is an enormous difference in the coverage effects of the Clinton and Obama plans. While it is technically true that the mandate won't bring us to 100% universal coverage, it will take us much farther than a plan without a mandate. The debate here comes down to universal access (obama) vs. universal coverage (Clinton), and should be cast in those terms.

Posted by: jonathan gruber | November 20, 2007 02:59 PM

Thanks, Mr. Gruber, for your clarifying comment.

Posted by: jhbyer | November 21, 2007 09:14 PM

Although the Clinton or Obama health plans would be big improvements over the current mess we have with our health system,the best solution would be a single payer plan like the one proposed by Dennis Kuchinik.What he advocates is Medicare for all.Iknow the right wingers will scream and holler that that's socialized medicine,but the fact is that the overwhelming majority of senior citizens would be up in arms if Medicare was taken away from them,even senior citizens who are Republicans would be outraged.Our current health care system is very expensive(about 14% of GDP);overhead for for insurance companies fees cost about 20% for every insured person compared to under 3% for Medicare;our health outcomes are rated 37th in the world;our businesses' ability to compete internationally are hampered by their health care costs;and when compared with other industrialized nations that have national health care,our wait time to see a doctor no better and in some cases longer.It's time for national health care for every American and if that's socialism,I'm all for it!

Posted by: John | November 26, 2007 05:51 PM

How is hilary going to reduce healthcare cost when she takes campaign money from big drug companies, it's been brought up that anti-biotics should be over-the-counter like every other countries out there. That along can save you a trip to Doc office everytime you get a bad cold. And she is not the one who can make this happen. Go Obama 08!

Posted by: soldier | November 29, 2007 02:15 PM

(Obama supporter)

Boos and hisses to both Clinton and Obama for using the term 'universal.' Neither plan is truly universal, though for different reasons. The media needs to get into the full substance of their proposals rather than continuing a false debate about universality.

Posted by: wesfromGA | December 6, 2007 02:41 PM

P.S. If I read Professor Gruber's clarifying comment above correctly, he says the Clinton plan does not actually provide universal coverage, but it should be described as a universal coverage plan anyway.
I hope the media does not follow that suggestion. Let's avoid use of the word universal.

Posted by: wesfromGA | December 6, 2007 02:51 PM

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