Controlling Costs and Providing Quality Care

Aug. 19, 2007 — -- How big an issue will health care be in the 2008 presidential election?

Some current polling indicates it is now the No. 1 domestic issue for voters.

Though that billing could change as the campaign season wears on, right now the health care debate is reminiscent of the early '90s, when it became a very prominent issue, culminating in the ill-fated Hillary Clinton proposal.

People are talking about it, even those with some kind of health insurance. So I expect it will heat up as we head into the next election.

While some politicians still like to use the cliché that we Americans have "the best health care system in the world," most politicians are smart enough to know that many Americans are struggling with their health care even if they have insurance.

In general, and with many other issues up for debate in the election, Republican and Democratic candidates take different approaches.

Most Republicans are trying to avoid detailed proposals, and when they do speak about health care, they warn against "government involvement," which would lead to "socialized medicine."

Instead, they champion "free market" and "consumer driven" health care. They talk about a change in tax policy that would give individuals a deduction for buying their own health insurance.

In short, they seem interested in driving Americans into the individual health insurance market with policies that may cost less initially but that come with very high deductibles that they hope might encourage people to spend their own money more carefully on health care.

However, critics point out that the average person has a very hard time making informed health care choices, and that high deductibles might encourage people to avoid needed basic and preventive care.

Democrats are generally much more inclined to speak about the need for the federal government to be involved in providing "universal coverage," meaning health insurance for all citizens.

They argue that the 45-47 million uninsured in our country are mostly working people who either work for employers who don't provide insurance or cannot afford the insurance offered.