Election 2004: Democratic Candidates Have Big Plans for Health Care

Last November, at a debate for Democratic presidential candidates, former Vermont Governor Howard Dean waved a stethoscope in the air and declared, "I'm the only one up here who's ever taken care of a patient."

In so doing, Dean, a physician, dramatized just how important the health care issue has become in the 2004 campaign. Nearly all the Democratic hopefuls, in fact, have offered ambitious proposals to overhaul the nation's health care system.

"It's remarkable that they all feel compelled to put out detailed plans," says Drew Altman, president of the Henry J. Kaiser Family Foundation. "Democrats are going to try to win back the health care issue."

As part of the AARP Bulletin's continuing coverage of the 2004 campaign, here's a rundown of the health care proposals put forward by Democratic presidential candidates:*

Wesley K. Clark
Retired Army General

• Overview: Clark's three-part plan is built around better preventive care, tax credits to make health insurance more affordable and universal coverage for everyone 22 and younger.
• Details: Clark calls for a comprehensive cost-containment system that would, among other things, set up a federal agency to determine the most effective health care services. And he would "get rid of public advertising for pharmaceuticals."
• Of 50+ interest: Clark would direct Medicare to set payment rates for drugs in line with wholesale costs.
• Price tag: $772 billion over 10 years.
• In his own words: "My plan focuses on getting more bang for the health care buck."
• Learn more about Clark's health care plan.

Howard Dean, M.D.
Former Vermont Governor

• Overview: Dean vows to bring health insurance to all Americans by creating a straightforward plan that Congress will pass.
• Details: Dean would use the Internal Revenue Service to automatically enroll uninsured taxpayers in some kind of health insurance plan. Dean would give tax breaks to small businesses that provide health insurance and penalize larger businesses "that could afford to but don't" by limiting their tax deductions and government contracts.
• Of 50+ interest: Dean would allow people ages 55 to 64 to join Medicare. He vows to put someone who has worked with patients in charge of Medicare.
• Price tag: $932 billion over 10 years.
• In his own words: "This is built on our experience in Vermont, where we have near-universal health insurance for everybody under 18, and universal health insurance for those under 150 percent of poverty."
• Learn more about Dean's health care plan.

John R. Edwards
U.S. Senator, North Carolina

• Overview: Arguing that "America's health care system is broken," Edwards proposes to begin overhauling the system by ensuring that every child has insurance.
• Details: Edwards would also offer "targeted help"—chiefly through refundable tax credits—to two-thirds of the nation's uninsured adults as well as to small businesses and the unemployed. He'd allow adults with incomes up to 250 percent of the federal poverty level to buy into Medicaid or children's insurance programs at subsidized rates.
• Of 50+ interest: Edwards would allow those ages 55 to 64, and the younger spouses of Medicare beneficiaries, to buy into Medicare. He'd also bind insurance companies that participate in Medicare+Choice to five-year contracts.
• Price tag: $590 billion over 10 years.
• In his own words: "Our health care system costs too much, expects too little and fails too often."
• Learn more about Edwards' health care plan.

John F. Kerry
U.S. Senator, Massachusetts

• Overview: Kerry's plan would provide coverage for every child and allow all uninsured Americans to buy into the same health plan that the president and members of Congress give themselves.
• Details: Kerry says that his plan will "stop spiraling health care premiums" by having the federal government absorb the lion's share of catastrophic costs for companies that provide affordable coverage for all their employees and promise to pass the savings on to their policyholders.
• Of 50+ interest: Kerry would allow those ages 55 to 64 to join the new federal program at subsidized rates. He'd change Medicare to cover home health care as an alternative to nursing home care.
• Price tag: $895 billion over 10 years.
• In his own words: "We cannot make health care affordable by tiptoeing around the edges—hoping to make progress without raising the wrath of the guardians of the status quo."
• Learn more about Kerry's health care plan.

Dennis J. Kucinich
U.S. Representative, Ohio

• Overview: Kucinich, who calls his plan "Medicare for All," proposes a universal, single-payer system of national health insurance, phased in over 10 years. Over time, everyone would be put into one risk pool and private insurers would be removed from the system.
• In his own words: "We're already paying for national health care; we're just not getting it."
• Learn more about Kucinich's health care plan.

The Rev. Al Sharpton
Director, National Action Network

• Overview: Sharpton favors an amendment to the U.S. Constitution "based on the right of every American to have health care of equal high quality."
• In his own words: The failure to provide "a high-quality . . . system is not the result of a lack of resources, only the lack of political will."
• Learn more about Sharpton's view on health care.

* The cost projection for the candidates' plans come from an examination by Kenneth Thorpe, a professor at Emory University in Atlanta.

Mark Francis Cohen is a freelance writer in Washington, D.C.