Health care a hot issue for Presidential candidates

September 17, 2007

Pharmacists could turn out to be a key factor in the 2008 presidential election. With 10 Republicans and eight Democrats in the running at last count, health care is already emerging as a top issue.

"Health care is definitely one of the top issues in play," said Hrant Jamgochian, American Pharmacists Association director of state relations and political action. "In 2006, only the Iraq war appeared in more campaign ads than healthcare issues, and it will probably be in a similar position this time. The fact that candidates are offering healthcare proposals this early is a real positive."

With the November 2008 election still some 14 months away, almost every candidate is staking out some sort of position on health care.

On the Republican side, former Mayor Rudy Giuliani (N.Y.) and former governor Mitt Romney (Mass.) had the most detailed healthcare proposals at deadline. Most other Republican Presidential wannabes have either not announced a stance on healthcare issues or have limited themselves to single-issue themes such as abortion.

Here's a look at what leading candidates are saying about health care as the race moves into the fall:

Hillary Clinton has a seven-step plan to provide universal, affordable coverage. She calls for disease prevention programs, paperless health information technology, transformation of chronic disease care, ending discriminatory insurance coverage policies, an independent "best practices" institute, competitive purchasing for pharmaceuticals and provider services, and medical malpractice reforms.

Chris Dodd advocates universal coverage through a "healthcare general fund" (HCGF). Employers must either provide insurance coverage or contribute to the HCGF. Individuals not covered by their employers would be required to purchase HCGF coverage based on income in relation to federal poverty levels.

John Edwards calls for universal coverage. Employers must either provide coverage or help employees finance individual coverage. Regional healthcare markets would create more affordable plans by giving insurers more bargaining clout. He also wants to reduce the cost of U.S. health care by removing patents for breakthrough drugs and requiring health insurance companies to spend at least 85% of their premiums on patient care. He would require the pharmaceutical industry to quickly implement nonforgeable electronic "track-and-trace pedigrees" to ensure that drugs stay safe at every step in the supply chain. He has also offered a strategy for treating cancer patients that would boost research funding, create support networks, and encourage lifestyle changes.

Rudy Giuliani proposes moving away from employer-based coverage to individual coverage and free-market pricing. He proposes health insurance that is similar to auto or home owners' coverage, where policyholders pay for routine maintenance and repairs.

Mike Gravel advocates universal coverage through a voucher system paid for by the federal government. Individuals would be free to spend healthcare vouchers for the providers and services they prefer.

Dennis Kucinich calls for a universal, single-payer, not-for-profit plan to cover dental, mental health, vision, physical health, prescription drugs, and long-term care. The program has been introduced into Congress as H.R. 676.

John McCain (R., Ariz.) calls for bringing all stakeholders to the table to hammer out a principled solution that promotes high-quality health care at lower costs.