I’m sure some of my colleagues who know more about healthcare policy than I do will weigh in, but in the meantime, I thought I’d mention that Rudy Giuliani’s healthcare proposal seems remarkably (and predictably) thin.
Rudolph W. Giuliani on Tuesday called for transforming the way health care coverage is provided in the United States, advocating a voluntary move from the current employer-based system to one that would grant substantial tax benefits to people who buy their own insurance.
The proposals by Mr. Giuliani, a Republican presidential candidate, set the stage for a contentious battle with the Democratic candidates over health care, a defining domestic issue this campaign season.
In his speech here, he excoriated Democrats for advocating a “socialist” solution to solving the problem of the nation’s 44.8 million uninsured, saying the party’s candidates encouraged a “nanny government” by proposing a greater government role in health care.
Instead, he proposed tax exemptions of up to $15,000 per family, allowing individuals to direct that money toward the purchase of health insurance and other medical spending.
First, Giuliani seems far more enthusiastic about bashing Democratic plans than he does promoting his own policy ideas, which should probably offer everyone a big hint about the merit of his proposal. Indeed, Giuliani repeatedly referred to the plans offered by Edwards, Obama, and Clinton as “European” and “socialist” in nature. It was as transparent a lie as any candidate from either party has offered this year, though few in the media seem anxious to call him on it. (Note to Giuliani: liberals tend not to like the Dems’ plans because they’re not socialized medicine.)
Second, the “plan,” on the merits, doesn’t seem to address any of the problems with the existing system. It’s closer to Bush’s “ownership society,” though without the charm.
In proposing a tax exemption of up to $15,000 for a family and $7,500 for individuals, Mr. Giuliani said that money could be used by consumers to buy an insurance policy of their liking. The money left over, he said, could be put into a “health savings account” to be used to pay for deductibles or other uncovered medical expenses.
For middle-class families with serious healthcare costs, a $15,000 tax-exemption is a bit of an insult, and indicative of a candidate who doesn’t understand the scope of healthcare costs.
[H]e offered no assurances that insurance companies would not “cherry pick” by insuring only healthier people, or by charging much higher rates to more vulnerable people — like those with chronic diseases.
Instead, he said, moving to a market system would create incentives for people to remain healthy.
Currently, he said, “there is no incentive to wellness.”
Um, Rudy? People don’t want to be sick. That’s an incentive. For that matter, there’s nothing in Giuliani’s vague proposal to guarantee people the kind of preventative care they need.
Giuliani’s speech offered very little in the way of specifics. He said his goal was to outline his “vision,” with more details to come in the fall.
Keep that in mind in the coming months. Edwards and Obama have unveiled very specific healthcare proposals; Giuliani has offered a vague press release. Will reporters tell voters that Giuliani has “a healthcare plan”? Probably, but they’ll be wrong.
It’s hardly a “plan” at all. It doesn’t guarantee coverage for the uninsured, it does little to tackle rising costs, there’s nothing on community ratings and pre-existing conditions, and Giuliani can’t explain how much his vouchers and tax refunds would cost.
There’s just not much here — kind of like the rest of Giuliani’s vapid and ill-considered policy platform.