ELECTION 2008
These articles, on various health care and health policy issues at stake during the 2008 presidential election,
were collected by the editors as a free service to interested readers.
Voters and Health Reform in the 2008 Presidential Election
Most voters favor major changes in our health care system. Registered voters who plan to vote for Senator Obama place higher priority on increasing coverage for the uninsured, and Senator McCain’s supporters give higher priority to health care reforms that would not raise taxes.
N Engl J Med 2008;359:2050-61 (DOI: 10.1056/NEJMsr0807717), November 6, 2008
Waste, We Know You Are Out There
Henry Aaron argues that to cut waste in health care, the first step should be heavy investment in research on what works and what doesn’t, and at what cost. The second step would be to extend insurance coverage to the uninsured.
N Engl J Med 2008;359:1865-7, October 30, 2008
Reproductive Freedom and the Next President
Dr. Eli Adashi and Darrell West discuss how the national debate about “reproductive freedom” has evolved to include the use of human embryos for stem-cell research, the assurance of access to family-planning services and comprehensive sex education, and the Partial-Birth Abortion Ban Act.
N Engl J Med 2008;359:1867-9, October 30, 2008
Moving Forward on Reproductive Health
Reproductive health policy has been mired in debates over abortion and sexuality, leaving unresolved a cluster of reproductive health problems. Dr. Allan Rosenfield, R. Alta Charo, and Dr. Wendy Chavkin argue that reframing this cluster of issues in terms of public health might lead to real progress toward improving women’s health.
N Engl J Med 2008;359:1869-71, October 30, 2008
Three “Inconvenient Truths” about Health Care
Major U.S. health care reform will not be an option much longer — it will be a necessity. Victor Fuchs presents three “inconvenient truths“ about cost reduction, medical advances, and insurance coverage.
N Engl J Med 2008;359:1749-51, October 23, 2008
Slowing the Growth of Health Care Costs — Learning from International Experience
The United States spends twice per capita what other major industrialized countries spend on health care. Karen Davis writes that a series of coordinated policy changes has the potential to substantially bend the curve of projected health care spending.
N Engl J Med 2008;359:1751-5, October 23, 2008
Primum Non Nocere — The McCain Plan for Health Insecurity
Dr. David Blumenthal argues that the central purpose of John McCain’s health policy is to reduce the role of insurance and make Americans pay a larger part of their health care bills out of pocket. This plan would risk the viability of employer-sponsored insurance and the welfare of chronically ill Americans in pursuit of a radical vision of consumer-driven health care.
N Engl J Med 2008;359:1645-7 (DOI: 10.1056/NEJMp0806563), October 16, 2008
Symptomatic Relief, but No Cure — The Obama Health Care Reform
Barack Obama has laid out a vision for reform that promises health insurance for (nearly) everyone, with coverage as good as that enjoyed by members of Congress. Joseph Antos argues that the Obama plan offers a host of policy proposals that address the symptoms but not the underlying disease that afflicts the health care system.
N Engl J Med 2008;359:1648-50 (DOI: 10.1056/NEJMp0806561), October 16, 2008
Health Care in the Next Administration
In this symposium, senior health policy advisors to the presidential candidates — Gail Wilensky for Republican John McCain and David Cutler for Democrat Barack Obama — discuss the candidates’ positions on health care reform. Watch the video and contribute your comments.
N Engl J Med 2008;359:e17 (DOI: 10.1056/NEJMp0807567), October 9, 2008
Access to Quality and Affordable Health Care for Every American
Americans deserve leadership for real health care reform that provides access to high-quality medical care and ends spiraling costs. Senator John McCain writes that our challenge is to protect and improve the care that doctors, nurses, and hospitals deliver, while increasing the availability and affordability of health insurance.
N Engl J Med 2008;359:1537-41 (DOI: 10.1056/NEJMp0807607), October 9, 2008
Modern Health Care for All Americans
Doctors and other health care providers work in extraordinary times and have unrivaled abilities, but increasingly our health care system gets in the way of their sound medical judgment. Senator Barack Obama writes that reform must emphasize prevention, not just treatment of the sick; reduce medical errors and malpractice claims; and make the practice of medicine rewarding again.
N Engl J Med 2008;359:1537-41 (DOI: 10.1056/NEJMp0807677), October 9, 2008
Still in the Game — Harnessing Employer Inventiveness in U.S. Health Care Reform
The pressures employers face have worsened as health care costs have grown faster than wages. Dr. Robert Galvin writes that although the business community has been a reluctant actor in this arena, it remains skeptical that its interests will be served by solutions arising from the provider community or from increased government control.
N Engl J Med 2008;359:1421-3, October 2, 2008
Campaign Contributions, Lobbying, and the U.S. Health Sector — An Update
The 2008 U.S. presidential election is already the most expensive ever, with overall fund-raising surpassing that for the 2004 contest and the Democrats holding a large lead in the money race. Dr. Robert Steinbrook writes that it is remarkable that the health sector has reversed a long-standing pattern of favoring Republican candidates.
N Engl J Med 2008;359:1313-5, September 25, 2008
Speaking Truth to Power — The Need for, and Perils of, Health Policy Expertise in the White House
The expert adviser must both “speak truth to power” and aid in the exercise of power. Jacob Hacker questions whether the adviser’s talents can really be used, or be useful, in the bare-knuckles world of American politics.
N Engl J Med 2008;359:1085-7, September 11, 2008
Shattuck Lecture: Health of the Nation — Coverage for All Americans
In the 2008 Shattuck Lecture, 13 distinguished panelists address the need for universal health coverage in the United States, pressing challenges to the U.S. health care system, and possible solutions, in a seminar moderated by law professor Arthur Miller. Watch the video and see comments from over 700 readers.
N Engl J Med 2008;359:777-80, August 21, 2008
The Partisan Divide — The McCain and Obama Plans for U.S. Health Care Reform
There is broad agreement that the U.S. health care system requires reform. Jonathan Oberlander writes that Democrats and Republicans remain sharply divided over how to reform it.
N Engl J Med 2008;359:781-4, August 21, 2008
Health of the Nation — Coverage for All Americans
Given the divergent views of the two major parties on health care, there is reason to be pessimistic that we will see meaningful health care reform in the next administration. The editors write that it would be a mistake to rely on government alone to solve the crisis, and that meaningful health care reform will require a concerted effort by all the major stakeholders in our health care system.
N Engl J Med 2008;359:855-6, August 21, 2008
Planning for the Future — Long-Term Care and the 2008 Election
Long-term care affects a large portion of the population, it is expensive, and it requires a unique partnership between government and citizens. David Stevenson writes that, nonetheless, the candidates in the 2008 presidential race have been virtually silent about long-term care policy.
N Engl J Med 2008;358:1985-7, May 8, 2008
1994 All Over Again? Public Opinion and Health Care
Lawrence Jacobs writes that the current moment in U.S. health care reform is eerily reminiscent of the lead-up to the 1992 election. Despite unusually broad agreement that health care arrangements need reform, there is no convergence on proposals for reform.
N Engl J Med 2008;358:1881-3, May 1, 2008
Does Preventive Care Save Money? Health Economics and the Presidential Candidates
A popular component of the candidates’ plans for controlling spiraling health care costs involves greater promotion of preventive health measures. Joshua Cohen, Peter Neumann, and Milton Weinstein write that sweeping statements about the cost-saving potential of prevention, however, are overreaching.
N Engl J Med 2008;358:661-3, February 14, 2008
Market-Based Failure — A Second Opinion on U.S. Health Care Costs
U.S. health care expenditures rose 6.7% in 2006. Robert Kuttner argues that the extreme failure of the United States to contain medical costs results primarily from our unique, pervasive commercialization.
N Engl J Med 2008;358:549-51, February 7, 2008
The Amazing Noncollapsing U.S. Health Care System — Is Reform Finally at Hand?
For roughly 40 years, health care professionals, policymakers, politicians, and the public have concurred that the U.S. health care system is careening toward collapse. Lawrence Brown asks, if the consensus is so incontestable, why has the system not already collapsed?
N Engl J Med 2008;358:325-7, January 24, 2008
Presidential Politics and the Resurgence of Health Care Reform
Health care reform is back in vogue as the 2008 election approaches. Jonathan Oberlander writes that the issue is playing out very differently in the parties’ presidential primaries.
In an interview, Oberlander discusses the health care plans of the presidential candidates and the striking differences between the two parties’ approaches to health care reform.
N Engl J Med 2007;357:2101-4, November 22, 2007
Learning from Failure in Health Care Reform
Jonathan Oberlander writes that just a year after its introduction in September 1993, the Clinton Health Security Act was dead in Congress. What happened to the Clinton plan, and what lessons can today’s reformers learn from its failure?
In an interview, Oberlander discusses the pitfalls of the Clinton health care plan of 1993, the obstacles to reforming the U.S. health care system, and the outlook for the future.
N Engl J Med 2007;357:1677-9, October 25, 2007
Photo courtesy Cynthia Johnson/Time & Life Pictures/Getty Images.
If the United States is to come close to universal coverage, personal responsibility will need to play a larger role than it did in the mid-20th-century welfare state. Dr. M. Gregg Bloche asks if there is room for a new compact between citizen and state along these lines.
N Engl J Med 2007;357:1173-5, September 20, 2007
Photo of John McCain courtesy AP Images/Mary Altaffer. Photo of Barack Obama courtesy www.barackobama.com.
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