Governor’s Debate: Health Care
The Health Care debate between Jack Markell and John Carney started abit late on Friday morning — a good thing, since I was running really late. The auditorium was pretty much full (but not as many folks as at the Education debate), and this crowd was abit more sedate.
The News Journal has written this event up, so I won’t go over all of that ground, but it was interesting to me that Markell was abit more aggressive in this round. He started right out noting that Carney had served on health-care related commissions and task forces for almost a decade, but coverage of Delawareans continues to deteriorate, and costs continue to spiral upward. Markell set up his theme — that the health care situation in DE needed to be dealt with quickly and decisively, and that the era of incremental changes on the way to a larger goal was no longer a functional approach. Carney, then, spent the rest of the debate trying to tell the audience that his plan was not incremental steps — but he couldn’t avoid the step-by-step narrative that he’d already set up. In my opinion, Markell ended up looking like the guy ready to take some political risks to get to long-term solutions, and Carney was extending the work of his commissions and committees. Carney had the advantage, I think, of having many of his colleagues from some of these commissions and committees in the room.
Several of the major features Markell’s plan seem to resemble the Massachusetts plan implemented almost 2 years ago. While the MA plan has enrolled something like 300K people into its multiple plans, the adoption rate has been higher than expected, significantly increasing the insurance subsidy costs. And those costs will continue to increase as care costs rise. The insured are expecting a 10% increase in premium costs this year. And not everyone has insurance — 20% or so of the uninsured currently have waivers from the mandate requirement while the state figures out how to pay for them, too. The MA plan doesn’t do much to address cost containment of care, either.
Markell does account in his plan for full enrollment of all 100k+ Delaware’s uninsured. It is less clear about medical cost containment, relying on broad initiatives (wellness, info technology, pharmaceutical cost negotiation) that may reduce overall system costs over a long horizon. And given how fast medical costs do increase, it seems fair to want to know how by how much these initiatives will slow those increases. You can’t tell — really — how the state subsidy gets paid for. Those of you with better info should chime in on this.
Carney’s plan showcases the idea of being the first start to provide universal subsidized access to preventative and primary care to the uninsured. He thinks that this will start small and grow, meaning that it won’t need a great many funds early on. He focuses on wellness programs and educating Delawareans in options to take better care of themselves. His plan to pay for this (or even to get to full service universal care) is really murky (and non-existent on his web site). Again, those of you with better info should chime in on this.
Markell’s program presumes to get everyone insured who does not have insurance, but am not sure how he incorporates the lessons learned from the MA implementation. Carney’s program could be the beginning of a Road Map to Single Payer, but once he gets his primary and preventative care program up and running it is not clear what he does next — if anything.
What do you think? Does either plan have advantages that I am not accounting for here? What do you think of the approaches by either candidate to pay for their plans? Is there an ideal plan plan out there? And if there is — this is critical — how does it get paid for?
Tags: Governor Debate 2008, Health Care, Jack Markell, John Carney
Great blogging C.
Nice write-up. Made me feel like I was there.
“Several of the major features Markell’s plan seem to resemble the Massachusetts plan implemented almost 2 years ago.”
“Seem to resemble.” I love it.
C’mon, Dave — how come you didn’t stick around to discuss the health care proposals of your candidate for Governor?
Yeah. This is an awesome and interesting post and I hope we can go through every issue comparing the two candidates all the way through the primary. This is what blogging is for. Kudos !
“C’mon, Dave — how come you didn’t stick around to discuss the health care proposals of your candidate for Governor?”
That’s all you’ve got? Anytime one of the many shortcomings of the career bureaucrat or the corporate millionaire is pointed out, you’re going to bring up our lack of a candidate, as if that makes the two D’s any better?
FSP,
I think Cassandra’s point is – What dish did you bring to the dinner? Or are you just here to throw food?
Nice point Selander. I brought Delacare to the dinner which has cost containment, universal coverage, health care courts, costs no more than we are spending now and requires personal responsibility. Without those things no plan is complete.
I look forward to the education debate this week at DSEA, all three will be on stage.
Have a good day.
Does Dave clap for Protack? Does Dave wish Protack had clap?
“I think Cassandra’s point is – What dish did you bring to the dinner? Or are you just here to throw food?”
Well, I just presented the main dish three days ago on my site. So I’m missing your point.
And I should have added Protack’s government-controlled health “plan” to the other two, but I forgot he existed there for a while.
Well, I just presented the main dish three days ago on my site. So I’m missing your point.
No you’re not. If you had responded to this post with some reference to your previous post (is this the one that said that the debate was Thursday night?), with something other than snark, you likely would not have gotten the snark back (speaking for myself, of course).
Besides this post was not made in response to yours, it was not a prebuttal of an event that you didn’t have info on yet.
Add something if you got it but don’t get all drama queen on us when your snark gets dealt with as, well, snark.
And I should have added Protack’s government-controlled health “plan” to the other two, but I forgot he existed there for a while.
Just like Strine and Celia.
Snark’s fine, cassandra. Just bring something a bit better than “the GOP has no candidate.” Maybe I expect too much from you.
“Just like Strine and Celia.”
Yeah. I sometimes forget they exist, too.
It is interesting looking at WHO sponsored the so called debate. Delaware (Corporate) Public Policy, Astra Zeneca and the administrators of Christiana Care! Not the doctors, nurses, and other health care professionals who know incrementalism is a joke! Who know that none of these plans force the insurance companies to deal with folks with pre-existing conditions! That none of these plans are universal, or will save one dime to taxpayer! These jackals are terrified that single payer has now gone mainstream in Delaware. We have so many candidates running who support it, we have citizens up and down this state who know the difference between the SICKO for profit system, both Carney and Markell want continued, and we have the top labor organizations, and 20 Statewide groups, plus 18 legislators already signed on. The insurance industry is treating single payer just like Delmarva Power is treating wind power…they and their surrogates and lobbyists will play any trick in the book to keep our jobs in Delaware, bring more in, truly cover every man woman and child from cradle to grave. Yup, the insurance companies and their candidates are seriously concerned. Just like DPL is seriously concerned. Are you going to permit corporates to continue to steal our hard earned dollars? Notice they all are attempting to confuse the public, by calling their plans “universal”, yeah they are universally behind the corporate for profit sick system brought to you by Richard Nixon.
Just bring something a bit better than “the GOP has no candidate.”
You want better snark, bring better snark. Where we differ is that it wouldn’t occur to me to expect better from you.
Help yourself to the last word.
The reason I expect better snark from you is that it doesn’t get much worse.
Laughing at you for covering for Markell’s virtual plagiarism is many rungs higher on the snark ladder than your pitiful response was.
I’ll no longer expect much, which means you are now a full-fledged member of Delaware Liberal.
Congrats.
Wow! Brava, Cassandra. How do I become a full-fledged member of DL? Afterall I pointed out how Dave didn’t answer the McCain health report post. I’m so jealous!!!!
I used to think Dave was ‘all about’ the GOP, or even ‘all about’ Sussex politics. Now I suspect its just ‘all about’ Dave. He reminds me of Hillary only with a smaller ass.
Sussex their last stronghold is getting more democratic every day! If they repub’s dont reorganize and rid themselves of their “ole” time greenville party control…there is no question they are doomed. Why don’t they listen to good republicans like Tyler Nixon, and others?
I agree with the stream line Delawareans the debates were another M.C. Yammer event not to be confused with real politics…(Markell,Carney)
Yes, the M.C. Mickymouse Club Debates are not Democratic. Only contributers are included. Good insurance salesmen though….