Tuesday, August 14, 2007

No, but seriously, what is your proposal for health insurance?

It's way past official Giuliani simply does not care about health reform. Because anyone who understood the magnitude of the health care disparities in this country would not seriously believe that a plan like this could make a significant impact on the number of uninsured Americans. Then again, it is not designed to - the plan "does not even cite universal coverage as a goal." Giuiliani's plan strikes out right there and not just in the opinion of raving Leftist ol' me, but in the opinion of all 69% of Americans who agreed in November of 2006 that the government has a responsibility to guarantee coverage for everyone. Yet another example of how far out of the mainstream so-called-moderate Republicans truly are when it comes to social policy. And tactically speaking, If Giuliani manages to wrest the Republican nomination away from Romney, any Democrat who runs against him should be making health care the strongest part of their campaign.

That crucial flaw bracketed momentarily, Giuliani's plan does not aspire to alter the current market-based system much at all. It comes down to a Health Insurance Credit and a tax deduction for low income families. Both of those proposals, fortunately, would alleviate some of the tremendous burden that poor Americans face when purchasing health care - although we have to hope that Giuliani is more generous with the eligibility on those than he was with, say, welfare, food stamps, subsidized housing and essentially every major social service offered in NYC under his mayorship.

All the same, what Giuliani is offering fails on two critical counts - highlighted by Matt Miller's recent piece in Time. First, for whatever aid it provides them with, Giuliani's plan still holds out that " individuals' buying their own solo health insurance can be the answer to the problem of the uninsured." Without any new mandates, health insurance companies are still free to reject clients with a history of illness (and these are the men and women who need insurance most) or to cheat their poorest customers out of any real coverage by offering plans with low premiums but through-the-roof deductibles that render the plan useless. Secondly, Giuiliani does not "support limiting a family's annual exposure to medical costs to some reasonable percentage of its income." In fact,

Giuliani actually boasts of an approach certain to hurt people. His health-care tax deduction, he gushed in Iowa recently, "allows you to go out and buy cheaper and cheaper policies [because] you can have higher and higher deductibles." When Americans earning $25,000 a year get sick and end up paying $10,000 or more in hospital charges, their "affordable" insurance courtesy of Giuliani will become a ticket to bankruptcy.

Avoiding political hyperbole is nice, but any critical analysis of what America's Mayor has put on the table for health care reform makes it clear: Giuliani does not care about poor and sick Americans.

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