Presidential Candidates’ Health Care Plans Lack Key Reform Elements, Aspen Institute Finds
An analysis by the Aspen Institute has found gaps in the health care reform plans of Senators Hillary Rodham Clinton, John McCain and Barrack Obama even as each of the three offers thoughtful proposals that hold the promise of improving health care in the United States.
The Institute’s analysis is based on a detailed questionnaire submitted to each campaign. The questionnaire and the principles that guided the analysis were developed by the bipartisan Aspen Health Stewardship Project. The Project’s work is guided by leaders from the public, private and nonprofit sectors dedicated to improving the health care system. The Project’s core principles, the questionnaire and the full response by each candidate can be found on the Project’s Web site, www.AspenHealthStewardship.org.
“While the candidates have clearly focused on the issue and have proposed different approaches, no one plan takes into account all of the core principles we think are needed to build a healthier nation,” said Christine Todd Whitman, former governor of New Jersey and one of the Project co-chairs. “We’re calling on the candidates to target not just the symptoms of our nation’s broken health care system but the root causes as well.”
Even as they affirmed the importance of the Project’s core principles, the candidates failed to fully grasp the fundamental changes required to transform the nation’s ailing health care system. This was apparent even in basic questions, such as:
Question: How will you define and measure the success of your health proposals and their impact on health outcomes?
- Clinton commented on the need to “shift our system from focusing on and providing sick care to focusing on and providing well care,” but stopped short of directly answering the question.
- McCain discussed the importance of “injecting competition into all aspects of health care,” controlling costs, managing chronic diseases and the need to “increase personal responsibility for our health,” but did not answer how he would define or measure success.
- Obama would “require hospitals, health care providers and insurers to report quality outcomes to the government and the public,” he responded. He proposed to establish and monitor a “report card” for the various parts of our health care system but gave no details on what it would look like or how it would function.
“If we’re going to create a just, effective and sustainable health care system, we need to begin by having a debate on terms that will get us there, and that means discussing more than access and cost,” said Project Co-Chair Mark Ganz, president and CEO of Regence BlueCross BlueShield. “This far into the campaign season, the candidates should be able to offer more detailed descriptions of their plans and how they will put them into action.”
The lack of clear solutions for meaningful reform was evident throughout the responses. For instance, the candidates did not fully consider the role of patients as drivers of their own health, did not offer facts to back up their assertions, and did not describe how they would improve key programs. Examples include:
Question: What will you do to ensure that health information is readily accessible, meaningful and accurate so that it helps people make decisions and take action?
- Clinton proposed to drive a “paperless revolution,” requiring providers who participate in federal programs to “adopt private, secure, and interoperable technology.” Such an approach may lead to cost savings and reduced medical errors, which would be a clear improvement. But her response did not take into consideration consumers or how they could be empowered by having the right information when needed.
Question: How would your health care system promote greater equity of health outcomes among men and women of different races, income levels and geographic locales?
- McCain said “access to insurance is the gateway to better health care. Providing a fair, equal credit to all is an important step.” He did not, however, offer facts to support his assertion that individuals with a tax credit would be best positioned to demand better outcomes and greater equity. Nor did he address the various factors that impact health disparities.
Question: What will you do to encourage innovation in biomedical research, the science of prevention and the delivery of care? How will you promote the use of these advanced technologies to improve health?
- Obama said he would “improve the efficiency of (biomedical research) by improving coordination both within government and across government/private/non-profit partnerships,” adding that an Obama administration would “ensure that we translate scientific progress into improved approaches to disease prevention, early detection and therapy.” Obama’s response concentrates on increased funding, and yet increased funding alone thus far has not brought more solutions. Additionally, he did not say how he would improve coordination.
“It is important for our next President to lead our nation to true health care reform, and this will be possible only when these complex issues are discussed fully with the public,” said Project Director Dr. Michelle McMurry. “While we give great credit to the candidates for affirming that change needs to be made, we hope that there will be more in-depth discussion so that when one of these candidates is sworn in, he or she can pass a reform proposal that addresses all of the problems in our health care system.”
Launched in October 2007, the Aspen Health Stewardship Project seeks to bring about a more multi-dimensional national conversation on what it will take to transform our health care system into a system that is affordable, sustainable and delivers quality health care to every American. The Project co-chairs are Christine Todd Whitman, former governor of New Jersey and founder of the Whitman Strategy Group; Mark Ganz, president and CEO of Regence BlueCross BlueShield; Elizabeth Teisberg, associate professor of the Darden Graduate School of Business and co-author of Redefining Health Care; and Joe Hogan, president and CEO of GE Healthcare. The Project also features an advisory board of top physicians, scholars, health policy experts and information technology leaders. For more information, visit www.AspenHealthStewardship.com.