Time for Universal Coverage?

Sen. Barack Obama became the latest presidential candidate to call for universal health coverage this past week.

It's been 13 years since First Lady Hillary Clinton's effort at creating universal health care helped cause Democrats to lose control of Congress. Nevertheless, Democratic presidential hopefuls are once again embracing the proposition, following the lead of some Republican governors.

Earlier this year, California Gov. Arnold Schwarzenegger unveiled a plan to cover all of the state's uninsured and Massachusetts next month implements the nation's first comprehensive coverage plan, requiring residents to buy health insurance or face tax penalties. That plan was signed into law by then-Gov. Mitt Romney, now a Republican candidate for president.

Here's a closer look at the issue:

Why the new focus on health care?

Rising public support for health-care reform reflects increasing costs for employees and employers. Health-care costs per capita will reach $7,500 this year, an $800 increase over the past two years and more than double the $3,470-per-person figure in 1993.

Meanwhile, the ranks of the uninsured have grown to 45 million from 37 million since 1993, and those costs are passed onto the government, taxpayers and insurance holders. In 2005, those with insurance paid a "hidden tax" of about $922 on their insurance premiums to cover unpaid health-care costs of the uninsured, according to a study by Families USA, a consumer advocacy group. The rising costs of the uninsured could raise premiums by an additional $1,500 by 2010.

While employers are leery of mandates that require them to insure employees or face fines, big businesses have increasingly called for government action because rising health costs put them at a competitive disadvantage with foreign companies.

How do the parties differ? Republicans support measures that minimize costs to the government and encourage greater consumer choice. Earlier this year, President Bush proposed taxing employer-provided health insurance, which is currently tax-exempt. He argues that the current system encourages workers to choose more expensive coverage in order to get a bigger tax break.

The plan, which wouldn't increase costs for the government, would give all individuals -- those who purchase their own coverage and those who have employer-sponsored coverage -- tax breaks of $15,000 for families and $7,500 for individuals. The proposal received a cool response on Capitol Hill.

Congressional Democrats tried to pass a bill earlier this year that would have allowed the government to negotiate directly with drug makers to lower drug prices for Medicare. But a Congressional Budget Office report said that allowing negotiations would have a "negligible effect" on federal spending, saving about $2 million in its first year, unless the government was willing to restrict formularies, or the lists of drugs available to beneficiaries.

Democrats also favor an expansion of the State Children's Health Insurance Program. But few advocate as ambitious an approach as the 1993 Clinton plan, which included an employer insurance mandate and would have created competitive but highly regulated HMOs.

How would candidates pay for their reforms? Both John Edwards and Mr. Obama would fund their plans by ending President Bush's tax cuts for the wealthy, effectively raising taxes on those who make more than $250,000. Mr. Obama would repeal the Bush tax cuts on capital gains and dividends and Mr. Edwards advocates increased efforts to collect capital gains taxes by requiring brokerage houses to report capital gains from stock sales.

Would Americans support higher taxes to pay for reforms? Polls show that they might. According to a March NBC News/Wall Street Journal poll, 52% of respondents would pay higher taxes in order to provide universal health insurance, compared with 41% that opposed.

Americans cited health care as the top domestic priority, and the second-most important priority overall after the Iraq war in an April poll, topping issues such as illegal immigration, energy and the economy.

Does either party have an edge among voters? A March survey by Harris Interactive and The Wall Street Journal Online showed that more Americans trust Democrats to improve health-care policies, at 50% and up from 45% last year, than Republicans, whose support fell to 28% from 31% last year.
Source :http://online.wsj.com