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How The Debate Over Health Care Is Changing — Just In Time For The 2016 Election

Politics Top News Tribune News Service

How The Debate Over Health Care Is Changing — Just In Time For The 2016 Election

Obamacare Protest

By Noam N. Levey, Tribune Washington Bureau

WASHINGTON — With the first contests of the 2016 presidential campaign just months away, the national health care debate is poised to enter a new phase, more focused on consumers’ pocketbooks than on relitigating the 5-year-old Affordable Care Act.

Hillary Rodham Clinton, who is campaigning on a detailed program to crack down on rising drug prices and runaway medical bills, is making a play for the hearts of voters increasingly irritated about what they have to pay for health care.

In the process, Clinton, the front-runner for the Democratic presidential nomination, has issued an implicit challenge to her Republican rivals, who continue to campaign with broadsides against Obamacare but few details about how they would address consumers’ basic health care worries.

“She is talking to people’s wallets … at a time when health care prices are a huge concern,” said Frank Luntz, an influential Republican strategist who helped develop the GOP’s highly successful campaign to tarnish Obamacare even before the law was enacted. “It’s smart.”

Clinton highlighted her health care plans on a two-day swing through Iowa last week. “We have to be really focused on how we fix what we have so it works better for everyone,” she told a crowd in Davenport on Tuesday.

Clinton’s proposals may not resonate with the many Americans leery of more promises from the federal government, especially after President Barack Obama pledged similar relief when he signed the current law in 2010. But the former secretary of State has focused attention on an agenda that, polls suggest, Americans want their elected leaders to take on.

Making high-cost drugs affordable should be the top health care priority for the next president and Congress, said three-quarters of Americans surveyed nationwide this year.

Most Americans polled also wanted their elected leaders to protect them from surprise out-of-network medical charges. They wanted the government to ensure health plans have sufficient networks. And they wanted more information about the prices of doctors’ visits, tests and procedures, according to the poll, done by the nonprofit Kaiser Family Foundation.

By contrast, fewer than half of respondents wanted their elected officials to deal with concerns about the Affordable Care Act. Just a third wanted it fully repealed.

“Health is really a pocketbook issue more than a political issue now,” foundation President Drew Altman said.

The evolution may reflect in part Republicans’ waning repeal campaign.

More than five years after its enactment, the law has survived two major legal challenges and three national elections. And, contrary to opponents’ warnings, it has extended coverage to millions of Americans without destroying the existing employer-based system that most in the U.S. rely on for health insurance.

But another factor is probably driving Americans’ concerns about drug prices and medical costs.

Over the last decade, the average deductible that workers must pay for medical care before their insurance kicks in has more than tripled — from $303 in 2006 to $1,077 today, according to a recent report on employer-provided coverage from the Kaiser Family Foundation and the nonprofit Health Research & Educational Trust.

That is seven times faster than wages have risen in the same period.

At the same time, nearly a third of Americans with private health insurance have received bills in which they were charged more than they had expected, a recent nationwide Consumer Reports survey showed.

In response, Clinton is proposing a series of new restrictions on insurers and drugmakers.

Among other things, she would put a $250 monthly cap on how much consumers could be required to pay out of pocket for medications. She would allow consumers to buy pharmaceuticals abroad, where they are often substantially cheaper.

Clinton also would create a new tax credit that Americans could use to help defray their out-of-pocket medical expenses.

Insurers would be required to cover at least three doctor visits annually that aren’t subject to a deductible.

And doctors who are providing care at a hospital that is in a patient’s network would be prohibited from charging the patient out-of-network prices.

Clinton is also pushing broader policies to clamp down on the pharmaceutical and insurance industries, including restrictions on drug advertising and new federal oversight of insurance rate hikes. She would also allow the federal government to negotiate lower drug prices for Medicare beneficiaries, something that could save billions of dollars but is currently prohibited.
Vermont Sen. Bernie Sanders, an independent challenging Clinton for the Democratic nomination, is proposing his own six-point plan for reducing drug prices, including allowing the federal government to negotiate Medicare drug discounts.

Some experts have dismissed parts of Clinton’s agenda as unrealistic, especially her proposal to require drugmakers to spend more on research.

But this kind of consumer-focused agenda holds great promise for Democrats who’ve been paralyzed by Republicans’ long campaign against the Affordable Care Act, said Celinda Lake, a veteran Democratic strategist. “This is a post-Obamacare message … that has something for the insured, as well as the uninsured,” she said.

In contrast, none of the leading Republican presidential candidates has a health care plan, though Florida Sen. Marco Rubio published a Fox News op-ed in March calling for broad changes to the health care system, including deregulation of insurance markets to lower costs.

The most detailed health care plan in the Republican field was put forward by former Wisconsin Gov. Scott Walker; he dropped out of the race two weeks ago.

Despite the lack of specifics, the GOP’s simple anti-government, anti-Obamacare message still resonates with large swaths of the electorate.

Although huge majorities of Americans complain about drug prices, for example, substantially fewer support government intervention.

In one recent national survey from market research firm YouGov, 86 percent of respondents said drug prices were either “far too high” or “a little too high,” yet only 50 percent said they would support “the federal government controlling the price of prescription drugs.”

(c)2015 Tribune Co. Distributed by Tribune Content Agency, LLC.

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  1. Dominick Vila October 11, 2015

    The fact that half of those polled believe the cost of RX is too high, but oppose Federal government intervention to reduce and regulate RX prices says it all. How exactly do they think RX prices are going to stop going up, stabilize, or Heavens forbid, go down?

    1. @HawaiianTater October 12, 2015

      Well, the solution is a single payer universal healthcare plan with heavy regulations on Big Pharma. I’m not anti-capitalist by any means but there are certain things that should just not be for profit. Life and death is not one of those things we should be allowing big corporations to profit off of.

      As for your opening question… I can answer that very simply. Republican voters like Democratic ideas but hate the Democrats themselves. If you put an R next to those ideas, they would jump at them in a heart beat. There’s been studies done on this. When you present these people with policies, their favorability ratings are directly tied to whether or not you tell them which party they come from. That’s why so many working class Republicans consistently vote against their own self interests. They buy into the fear propaganda of the Fox News and Breitbarts of the world so much that they would vote to let their own houses burn down if Democrats came out in favor of fire departments.

      1. John Murchison October 12, 2015

        It’s the Blatant obstinance of children.

      2. RED October 12, 2015

        So absolutely true!! This election is plainly showing who the Cons are. Trumps leads, followed by Carson. This shows us the character of the Con voter. I guarantee that if the grand wizard of the klan was in the Con primary he would be in the top three while the Republican primary voters expressed how much they liked that the grand wizard was not being politically correct. Because what they truly mean when they say that is they like someone willing to come right out and express the hateful ignorance & bigotry that is the glue that binds the Con party together.

        1. Dominick Vila October 12, 2015

          According to Donald, the reason people like him is because he is handsome!

          1. RED October 12, 2015

            You forgot “really rich.” And he did it all on his own, with nothing but a 200 million inheritance and a complete lack of morality or a soul.

        2. @HawaiianTater October 12, 2015

          Wait, the grand wizard is NOT in the Republican primary? Then who is that guy leading all their polls?

          1. RED October 12, 2015

            Great point, HT. I was certainly being presumptuous. After all these Con candidates may simply have their white robes out for cleaning or maybe waiting for a pointy hat upgrade. Or maybe just saving their grand wizard revelations for Super Tuesday? Who knows? But I do know, for certain, that the more racist, ignorant, crazy, & just plain stupid a candidate is, the higher they go in the Con polls. Really makes me question what kind of system we have created here in the US that turns out so many complete morons?

      3. Dominick Vila October 12, 2015

        We have to go no further than the Affordable Care Act, a concept advanced by The Heritage Foundation, one of the most conservative think tanks in the nation, and Beta tested by Mitt Romney. It became poison when President Obama embraced it and signed it.

        1. @HawaiianTater October 12, 2015

          I know where it came from and I know why it became poison but I do not understand your position on why we should go no further. I’ve always viewed the ACA as a stepping stone to get us where we need to go. It’s an extremely flawed system that’s still a helluva lot better than what we had but still nowhere near what we need. What is has done is shown the public that yes, you too can have healthcare. The next logical step is getting rid of private insurance companies that screw people over on premiums and move to a single payer system. The fact that so many other countries have healthcare for all at much lower prices than what we pay here is a strong motivating factor to get this done.

          1. Dominick Vila October 12, 2015

            Actually, I believe the opposite should be done. Like you, I believe the ACA is a first step towards universal healthcare, preferably without the involvement of for profit insurance companies. As a minimum, we should improve the ACA by finding ways to lower insurance premiums. To accomplish that, we must rein in and reduce the exorbitant prices that the pharmaceutical are charging for RX, the high prices that medical equipment manufacturers are charging for their products, and we must eliminate duplication by sharing medical test results.

          2. @HawaiianTater October 12, 2015

            I don’t disagree with any of that. You know how Americans are. Baby steps.

  2. Daniel Jones October 11, 2015

    Deregulation does NOT and never has lowered prices for any product.

    1. johninPCFL October 12, 2015

      The hard fact is that unregulated market prices are often lower than regulated prices (think: Rockefeller oil before the breakup), but once the costs of hiring those who specialize in making sure the regs are met has been borne, those costs then just become part of the “cost of doing business”.

      What you said is true, but only because those regulatory costs are folded into the business overhead and not specifically considered any further. If the regulations disappear those costs are still factored in, even though they no longer exist. Even if the regulatory overseers are fired, those costs are still in the pricing formulas.

    2. Otto Greif October 12, 2015

      The sky is green.


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