Without a doubt, the upcoming election will rank among the most historic our country has seen in decades. While the obvious issue – "It's the economy, stupid" - is directly in the spotlight, just off center stage sits a related issue that has millions of Americans - men and women, young and old, and Democrats and Republicans alike - crying out for equal attention.
That issue is health care, and it is the "sleeper" issue of the 2008 election that has millions of Americans losing sleep.
"Will my co-pays and premiums continue to rise?" "Will my employer still provide my coverage?" "What will happen if I lose my job?" These are the questions that are surging to the forefront of Americans' minds in today's uncertain economic environment.
In a nationwide survey of 1,500 likely voters we conducted earlier this month, we found the economy and the turmoil on Wall Street to be the top national issue on voters' minds as they head to the polls. However, when asked to think about the most important personal issue on their minds, health care was the single most serious personal concern - beating out the cost of gas, spiraling prices on consumer goods and even falling retirement savings.
That's because in households across America - from liberal stronghold Philadelphia to conservative powerhouse Provo, health care is a pocketbook issue, and its prominence rises in tandem as folks' sense of economic uncertainty rises.
Americans will be taking this concern to the polls. The same survey found that among women, who make the majority of health care decisions, over six in ten (62 percent) said health care is "the major issue" or "one of the major issues" influencing their voting decision this November.
A surprise finding was health care is also a top concern for men - a finding that suggests this issue has increased in importance for this voting demographic who traditionally placed a lower priority on health care reform. More than half of men (54 percent) in the recent survey reported it as the major or one of their major voting issues.
The presidential candidates would be wise to take note of this. Voters are hungry to hear what the candidates are proposing and, more importantly, want the next president to provide real leadership on this issue. They want to hear what the candidates will do to make health care more affordable and more accessible.
When given a list of proposals and asked if each would improve health care in this country "a lot," "somewhat," "a little" or "not much at all," the No. 1 response that voters believe would improve the system "a lot" is catching and treating chronic disease early (69 percent). Voters are familiar with chronic disease - with 73 percent either having a chronic disease or close to someone with a chronic disease - and recognize the impact on personal lives as well as the overall health care system.
Chronic diseases drive 75 percent of health care spending in the United States., and every year, they represent more than two "Wall Street bailouts," amounting to a whopping $1.5 trillion. If chronic diseases continue to affect more Americans at their current rate, the price tag could balloon to nearly $6 trillion by the middle of the century on the seven most common chronic illnesses alone. This is a fact that voters seem overwhelmingly familiar with.
However, Sen. Barack Obama and Sen. John McCain look to be missing a prime opportunity to reach out to voters on this critical issue. Despite being a top priority for voters in health care reform, six in ten (60 percent) say this is not an issue that has been addressed by the candidates. mericans' are eager to hear how the next president plans to address the prevention and management of chronic disease once he is in the White House, but have been met with silence to date.
The calendar is quickly approaching Nov. 4, but each candidate would be wise to utilize the time left to heed the concerns of Americans and address this looming concern at the forefront of voters' minds, causing many to lose sleep.
Arvid "Dick" Tilmar is a partner in Diversified Insurance Services Inc. in Waukesha and is involved with the Wellness Council of Wisconsin and the Well City Milwaukee project.
6 Comments
>>> "Americans are eager to hear how the next president plans to address the prevention and management of chronic disease once he is in the White House, but have been met with silence to date."
Well, Dick, we've heard the political answer. They both promise "affordable health care." That's the right thing to say, don'cha know. It's meaningless, but how can you go wrong with that?
Problem is, they are both jockeying around so the don't upset the insurance interests. The best way to fix the system is with a Medicare-for-all program that eliminates the wasteful insurance bureaucracy, and the industry doesn't like that a bit. I can understand that. But by being non-specific at the moment they are avoiding confrontation.
It will get changed after the election, but I am reminded of the quote by Winston Churchill: "America will always do the right thing, but only after everything else fails."
The insurance industry, of which the author is a part, is not looking at where the final domino is going to fall. Health care is going the way of Motorola or via coops, and the industry is going to be on the outside looking in. They would be far better off embracing a Medicare-for-all program and making their profits from the added Gap policies that will be needed. For more details on that see http://moneyedpoliticians.wordpress.com/medicare-for-all
Jack, you hit it right on the head. Unfortunately, there are way too many people employed in the medical insurance industry, which is part of the reason it costs so much. The Medicare-for-all idea would put many people out of work (life-long careers lost), entire large companies nearly put out of business, and more importantly (for politicians at least), it would reduce the amount of dollars they see from insurance companies, lobbyists, etc., most likely to ensure a system like that is NOT adopted.
Also, I believe too much would have to be invested in a Medicare-for-all system to ensure the quality of care is not compromised. We all know that the quantity of people covered, as well as the quantity of claims/person will rise dramatically. And, with our current economical dilemmas, massive employee layoffs in other industries, dwindling retirement funds, etc., another mass layoff from health insurance companies would be more detrimental to our society than helpful.
Perhaps making medical care more affordable to all, including those who aren't covered by insurance, would be a more viable option.
These are only my opinions though.
That's a reasonable first-argument, Shelly, but when you look at it carefully you will find that extending single-payer health care to 47 million currently uninsured people will put new requirements on the industry and require additional nurses, physicians, technicians and administrative staff. I doubt that finding new jobs for the displaced workers will be difficult. But additionally, a more efficient health care system will free up corporate revenues to hire additional people in the US rather than outsourcing.
As well, this business growth will also benefit the insurance industry.
But it never makes sense to sustain a needless process just to keep people in make-work jobs. The funding then must come from productive sources.
But on your other point, for the same 16.5% of GDP that we are spending to cover 85% of the public today, we could provide first-class care to 100% of our people. And *without* the wait times Canada sees with its spending of 10% of GDP.
You cannot really reduce the costs needed to provide services, but you can eliminate the unnecessary services to save money. That's where the savings can come from. Again I'd recommend reading the details at:
http://moneyedpoliticians.wordpress.com/medicare-for-all
It's hard to tell whether people are deliberately spreading misinformation about Sen. McCain's health care plan, or if they genuinely don't understand it. Or maybe they're misunderstanding it on purpose.
John McCain's health care plan supports job-related health insurance by replacing (replacing, not eliminating) the existing tax exemption on health coverage with a tax credit that benefits all Americans, whether they have job-related health insurance or not.
Sen. McCain's $5,000 tax credit ($2,500 for individuals) will replace the tax exemption for the 59% of Americans who have employer-provided health plans with a federal tax credit that will also go to the 41% of Americans who don't get health insurance at work, giving 100% of Americans the same tax benefit. Currently, that 41% get no tax benefit for health insurance. No wonder there are so many working uninsured.
Employers will continue to offer health insurance because their business deductions stay exactly the same under Sen. McCain's plan. People will not lose their job-related health insurance, nor will they have to pay for their health insurance out of the tax credit, as Sen. Obama's campaign has claimed.
Here's how it will work: a family making $80,000 year pays 25% in income taxes. If they get a $12,000 a year plan at work (that's a really GOOD plan, the same as members of Congress get), their $5,000 tax credit will replace the existing $3,000 tax deduction (the value of their $12,000 plan at their 25% tax rate), leaving a $2,000 surplus that will be deposited into a Health Savings Account for the family's use on medically-related expenses.
Families in lower income tax brackets will get a bigger surplus, and even those in the highest income tax bracket (35%) will still have money left over for their HSA. Families which currently pay no income tax can use their refundable tax credit to buy health insurance or have it deposited in a health savings account.
For the 41% of Americans who don't get health insurance at work, the $5,000 tax credit can be used to buy a plan on the open market. That's $5,000 (or $2,500 for individuals) more help from the federal government than they're getting now.
And since Sen. McCain wants to let people buy plans across state lines and take advantage of expanded, non-traditional group plans, increasing competition and taking advantage of different mandates and lower rates in other states, that $5,000 per family ($2,500 for individuals) will go pretty far toward reducing the number of working uninsured in America. One study says 24 million uninsured families will be able to afford to buy their own plans under this plan.
Sen. McCain's plan would finally give people who don't get health insurance at work the same tax benefit as those who do. Isn't that a whole lot more fair than only giving federal tax subsidies to people who already have the advantage of employer-provided health care?
Sen. McCain's plan won't "tax your healthcare for the first time." It will change an inherently unfair federal tax exemption that only 59% of Americans receive into a tax credit that benefits all Americans. Sen. McCain's plan will help millions of Americans who can't afford health insurance to get it without forcing them into a huge new government-run health plan.
It's hard to believe that smart guys like Senators Obama and Biden think that paying taxes on $12,000 actually COSTS $12,000 (unless they think that's how it should be….), or that $3,000 in additional tax liability (see the $80,000 income family example above) isn't less than the $5,000 tax credit that replaces it, or that there's not $2,000 left over when you subtract $3,000 from $5,000.
Hard-to-insure people with pre-existing conditions can rely on a Guaranteed Access Plan (GAP), and, no, despite the scare tactics of the other side, Sen. McCain isn't going to "cut" Medicare and Medicaid benefits to pay for it. He wants to streamline how providers are paid, expand the use of information technology, eliminate fraud and waste, get better drug prices through faster introduction of generics and safe re-importation, and reduce costs through preventive care and reducing defensive medicine - all of which will generate enough savings to cover providing a fair health care tax benefit to all Americans.
Seems to me that they're misunderstanding the plan on purpose, so they can tell lies about it in their commercials.
>>> "John McCain's health care plan supports job-related health insurance..."
And Donna, that's its problem. That "job related health insurance" is draining 31% of the dollars we are spending on health care.
It never ceases to amaze me, the amount of energy that can go into a project just to avoid doing the right thing. The best, simplest, least costly, most effective thing we could do is expand what has been working so well for years, Medicare. You get sick, you get care, and the caregiver gets paid. Nothing could be simpler. Nothing could be cheaper.
War Economy and Change to Distrust!
During the primary months, the Iraq War appeared to be potentially the top issue for the 2008 election. Since then, the 1992 campaign slogan: It's the Economy Stupid has gained ground. More narrowly we have the housing crisis, by Presidential decree the root cause of the financial crisis. The more likely the root causes of both of these crises are Greenspan's unsustainably low interest rates and the unbridled, unregulated competition by lenders and their financiers.
With regard to the "Terror War", it is actually two wars, but not Iraq and Afghanistan touted by the presidential campaign candidates. The first war, declared, was Al Qaeda's War on America; with it central goal to "bleed America to bankruptcy" and the second is America's "War on Terror", with Iraq proclaimed by Bush and Cheney to be its central front. Aside from aforementioned unbridled/unregulated competition, our most pressing economic woes are traceable not to the acts of 9/11 but to Cheney/Bush response to the acts of 9/11 and resulting unorthodox War Economy. The "War on Terror" and the Bush tax-cuts have been financed by foreign borrowings primarily by China and OPEC. This fiscal irresponsibility is the primary driver toward Al Qaeda's central goal and amounts to trading certain economic insecurity for questionable homeland security.
A no-new-tax style War Economy and an overly accommodating fiscal policy have resulted in huge budget and trade deficits. These deficits have accumulated into an unsustainable national debt and an unsustainable balance of payments deficit, which when combined with an overly accommodating monetary policy unleashes "Weapons of Economic Destruction". The high oil/gas prices, a high tolerance for China's protectionist currency manipulation and the housing/financial crises are early effects of the resulting destruction and any reversal requires changing the unorthodox War Economy.
The changes necessary to reverse the effects of the ill-conceived 2003-2008 War Economy are unlikely to come from the no-new-tax advocates, who provide President Bush's current 25% favorable rating. These approvers make-up more than half of Senator McCain's current support. Unless Senator McCain flip-flops and throws the Bush/Cheney base under the proverbial political bus, promise of change by Senator McCain to address the root causes of economic woes is: Change to Distrust.