As part of our ongoing interview series with presidential candidates, Women’s Voices for Change spoke with former senator John Edwards about his health care plan, specifically how it will benefit women and older Americans. Our questions and his responses follow below. Please add your comments at the end.


Women’s Voices for Change
: How does your health care plan differ from those proposed by the other Democratic candidates, particularly Senator Clinton’s? Why do you think your plan is the best option at this time?

John Edwards: We desperately need truly universal health care in this country — we can no longer afford incremental steps. We have to stop making promises about "increasing access to health care" when we know with certainty those words mean something less than universal care. Who are you willing to leave behind without the care she or he needs? Which family? Which child? We need a truly universal solution, and we need it now.

I was proud to be the first major presidential candidate to offer a detailed plan to provide truly universal health care. And I’m proud to still be the only major candidate who not only has a plan that will provide coverage for every man, woman and child in America, but who has also given the American people information about how I will ensure that everyone will be covered.

Under my plan, businesses will either cover their employees or help pay their premiums. The government will make insurance affordable through new tax credits and by leading the way toward more cost-effective care. New "Health Care Markets" will give families and businesses purchasing power and a choice of quality plans, including one public plan. Finally, once these steps have been taken, all American residents will be required to take responsibility and get insurance.

The government and health care providers will require proof of insurance at key times: when health care is provided, when children are enrolled in school, and when income taxes are paid. Families found to be without insurance will be enrolled in a plan like Medicaid or SCHIP if they are eligible, or they will be assigned a plan within Health Care Markets. New subsidies will ensure the plans are affordable. For the few people who refuse to pay, the government will help collect premiums with the same tools it uses for student loans and taxes, such as collection agencies and wage garnishment.

My plan also calls for cutting Medicare payments to drug and insurance companies and using the savings to strengthen Medicare by addressing the Part D benefits "doughnut hole," provider shortfalls and extending the life of the program. Some of my opponents make the same cuts but use the savings to help pay for universal health care — removing the resources from Medicare.

I am able to put those savings toward Medicare because I’m willing to be more aggressive on taxes. For example, I have proposed strategies for increasing tax revenues by cracking down on offshore tax havens and by closing the loophole that allows wealthy hedge fund managers to avoid paying taxes.

WVFC: Does your plan recognize that the Baby Boomers are aging, and women, who live longer than men, will need more care for longer and a ramped-up focus on geriatric practices?

Edwards: Yes, my health care plan calls for strengthening geriatric primary care. Patients treated by doctors trained in geriatric care are a third less likely to become disabled, half as likely to develop depression and 40 percent less likely to require home health services, according to one study. But reimbursement rates for this care are so low that the division was shut down soon after the study was completed. The number of certified geriatricians fell by one-third between 1998 and 2004, and only 330 doctors nationally will complete geriatrics training this year.

As president, I will emphasize primary care in the Health Care Markets by writing reimbursement rules that encourage proven geriatric care. I will also call on experienced geriatric doctors to train the next generation of primary care doctors and nurses in geriatric care, including how to identify treatable conditions in older Americans — like depression, malnutrition, isolation and podiatric problems — that  if ignored often lead to a downward health spiral.

WVFC: What effect do you think your national health program will have on our nation’s economy?

Edwards: No single step is more important to ensure the security, shared prosperity and dignity of every American family than true universal health care. In a country as rich as America, no one should have to live a life that is shorter and less healthy because they cannot buy insurance. Health care reform will also bring down health costs, helping American businesses and workers compete.

Reducing costs is essential to achieving true universal health insurance and it is a critical goal of my health care plan. My plan will cut waste in the insurance and drug industries and invest in cost-saving steps like chronic and preventive care to eliminate at least $130 billion a year in wasteful health care spending and reduce the cost of a typical family policy by $2,000 to $2,500 a year.

Universal coverage will bring down premiums for employers that provide insurance today. The cost of caring for the uninsured adds $922 to an average family policy. Guaranteeing universal care will end irrational cost-shifting, the practice of providers charging more to those with insurance to cover uncompensated care.

Employers can choose to enroll their workers in Health Care Markets, which will bring down costs through negotiating power and administrative efficiencies. Giving individuals in Health Care Markets a choice of insurance plans, including a public plan, will force private insurers to operate in a more competitive market, holding down costs and improving care. If families find that the public plan offers the best care at the best price, the system could evolve toward a single payer approach.

Finally, I will take on the big insurance and drug companies whose excessive profits are making the system needlessly expensive. 

WVFC: What does your plan mean for women who sometimes find themselves needing specialists whose services are not covered within their current plans?

Edwards: Under my approach, health insurance plans offered through the Health Care Markets will include comprehensive benefits — including basic and primary care — hospital stays, prescription drugs and full mental health benefits. There will be a special emphasis on low-cost chronic and preventive care.

WVFC: Does your plan address issues of mental health services so vital in the transitions faced by older Americans?

Edwards: There is a mental health epidemic in this country, but stigma and cost keep us from fully addressing these issues. We need a health care system that offers comprehensive benefits to every man, woman and child in America. Under my universal health care plan, there will be full mental health parity. Health insurance should cover the care that people need to get and stay healthy, and that includes not just physical health care, but mental health, substance abuse and chronic care.

I co-sponsored the Wellstone Mental Health Equitable Treatment Act and I will continue to work to make insurance companies responsible for providing the same level of coverage for mental and physical illnesses.

WVFC: If elected, how would you ensure that the services provided under a national health care program don’t also end up reflecting "Two Americas"?

Edwards: My plan will make coverage affordable to every American by bringing down the costs of health care and offering tax credits and subsidies for those who need it. Premiums would be limited to a low percentage of family income. For example, a family of four earning $40,000 a year will be asked to pay about $175 a month for comprehensive family coverage.

By promoting competition between health insurance plans, my uniquely American solution will reward insurers that offer the best care at the best price. Medicare has shown that public plans have lower administrative costs than private plans — 4 percent of its budget compared to 12 percent for the average private insurer. Health Care Markets will create competition between private and public plans, which will create pressure on all insurers to keep costs down and deliver better coverage.

In addition, I will create a new tax credit to subsidize insurance purchased through Health Care Markets, making premiums affordable for all families. The tax credit will be available on a sliding scale to middle class families earning up to $80,000 a year and will be refundable to help families without income tax liability.

For families with greater needs, I will expand Medicaid and the State Children’s Health Insurance Program (SCHIP). I will strengthen the federal partnerships supporting these programs, committing the federal resources necessary to allow states to expand Medicaid and SCHIP to serve all adults under the poverty line and all children and parents under 250 percent of the poverty line — about $50,000 for a family of four.

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  • B J Johnson January 5, 2008 at 10:32 pm

    how do you feel about the nra? and what do you plan for the nra?

  • Punishing Non-Compliance? January 3, 2008 at 2:08 pm

    We need health care ASSURANCE, not insurance.
    Not until the Fed fines both States and Insurers will the insureds be guaranteed health care.
    So, if premiums are mandated, care must be mandated.
    I support Edwards; however, the harsh rhetoric of “personal responsiblity” does not help those with incomes so low they have no tax liability.
    I can’t afford the $7,800 annual premium I am required to pay to be insured. My home value, inflated by the booming housing market scam, makes me unqualified for Medicare/Medicaid.
    Lastly, at age 60, even if I did pay $7,800 a year, I have no faith the insurer would be honorable if I needed a heart or kidney transplant. My heart and kidneys both existed before becoming insured, right?
    Until the Insurers have to pay more for REFUSING health care than they pay for providing health care, nothing will change except people NOT going to the doctor because they can’t afford to be haunted by collections agencies.
    My income is enough to survive but too low to be taxed.
    How can I join your organization?