Opinion Pieces
Summaries of an editorial and an opinion piece on health care in the presidential election appear below.

• Baton Rouge Advocate: "As the candidates talk about health care in this election year," much of the discussion "will be on the uninsured," but U.S. residents with health insurance also are "seeing an erosion of coverage that is causing pain in many households," an Advocate editorial states. "Hospitals and doctors are turning to credit card companies or other means of providing credit" to patients without health insurance, as well as those enrolled in high-deductible health plans, the editorial states, adding, "Upfront costs are one thing, but fear of medical debt" can prompt those with health insurance to "delay or forgo health care they might otherwise get." The editorial states, "At its core ... health insurance is intended to shield -- by spreading around risk and premiums -- families from financial devastation caused by health problems." The editorial concludes, "When candidates talk about health care this year, we hope that they look at all sides of this issue" (Baton Rouge Advocate, 5/13).
  
  
• Grace-Marie Turner, Seattle Post-Intelligencer: Obama and McCain have begun "gearing up for a general election battle" in which they will "offer very different visions for health care reform," Turner, president of the Galen Institute, writes in a Post-Intelligencer opinion piece. According to Turner, Obama, who "sees a much larger role for government" in the health care system, would require health insurance for children, require employers to "pay for insurance for their workers," expand public health insurance programs and "impose significant new federal regulation over health insurance." McCain, who has a "very different vision," would "focus on new financing tools to help people buy health insurance that would be portable from job to job, new mechanisms for those with pre-existing conditions to get coverage" and "prevention and better care coordination," Turner writes. However, she writes, Obama and McCain "agree the key to health reform is getting costs under control." Congress will "wrestle with the intricacies of reform, but in this election year, the vision is the key, and the contrast between the visions that Obama and McCain offer is stark," Turner writes, adding, "The bottom line question will be whether individuals or government will be in control of health care in the future" (Turner, Seattle Post-Intelligencer, 5/12).

Comments
Cathy Schoen, lead author of the article and senior vice president of the Commonwealth Fund, said, "This approach will eliminate wasteful administrative costs, enable people to keep their coverage if jobs or circumstances change, and provide affordable health insurance with good access to health care and financial protection for all." She estimated that the plan could save $1.6 trillion over 10 years if implemented in combination with new health information technology and negotiated prescription drug prices. The proposal would require about $15 billion in new spending, with the rest offset by reduced administrative costs (CQ HealthBeat, 5/13).

Commonwealth Fund President Karen Davis said, "Each of these features certainly has elements that will give pause to some groups," but "I think the basic bottom line is that if everyone will give a little, it means you can get universal coverage." According to Davis, those who would experience increased costs as a result of the plan include employers not currently offering coverage, health care providers not treating beneficiaries of current public health programs and companies selling individual health plans (Reuters, 5/13).

Dallas Salisbury, president of the Employee Benefit Research Institute, said businesses likely would support some of the article's proposals, including maintaining current tax exemptions for employer-sponsored coverage. "There's a consensus that an employer-based system should continue to be part of [the] overall approach," he said, adding that employers "want to continue to be part of the system" (CQ HealthBeat, 5/13).

The May/June issue of Health Affairs includes a number of articles that focus on prospects for health care reform in the current election cycle. The issue contains articles and perspectives by political pollsters, scholars and lawmakers, who examine the political climate surrounding health insurance, proposals for overhauling the health care system and past attempts at instituting a national health insurance program. The journal also includes articles that discuss important elements to be considered when evaluating health care proposals (Health Affairs release, 5/13).