HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Wednesday, May 7, 2008

McCain's Rhetoric on Health Care

The New York Times reports and critiques on McCain's discussion of the two Democratic presidential candidates. MIchael Cooper and Julie Bosman write,

Senator John McCain has been repeatedly suggesting that his Democratic rivals are proposing a single-payer, or even a nationalized health care system along the lines of those in countries like Canada and Britain.  The suggestion is incorrect. While both Senator Barack Obama of Illinois and Senator Hillary Rodham Clinton of New York are calling for universal health care and an expanded role for government, they stop well short of calling for a single-payer plan.

Mr. McCain has made the assertion several times in recent days, even as he and the Republicans have made repeated calls for accuracy on the campaign trail. They have been complaining indignantly that the Democrats were grossly distorting his position by suggesting that he favors a “100-year war” in Iraq, when he has simply said that he would be fine with stationing troops there for 100 years as long as there were no more American casualties.

Yet on repeated occasions, Mr. McCain, of Arizona, has inaccurately described the Democrats’ health care proposals, using language that evokes the specter of socialized medicine . . . .

“But before you decide to sign on to that kind of a program, go to Canada, or go to European countries that have government-run health care systems,” he continued. “My friends, they don’t work, they’re inefficient, and they end up in a two-tiered system where the wealthiest can afford to pay for their own health care and those with low income sometimes wait six or eight months for a routine kind of treatment. And that’s what I’m not going to let happen to the United States of America.” . . .

Language, of course, is a potent weapon in the battle to shape policy. And Mr. McCain’s effort to cast the Democrats’ plans as a government takeover is just the latest example in a long tradition of using similar language to characterize proposals to change the health care system, said Robert J. Blendon, a professor of health policy and political analysis at Harvard.

“In the campaign, what Senator McCain tries to appeal to is a general antigovernment feeling, a sense that we shouldn’t be doing things too big,” Professor Blendon said. “In a sense he’s appealing to a value that may or may not relate to the policies being discussed by either of the candidates.”

The only Democratic presidential candidate to propose a true single-payer, Medicare-for-all type of health plan in this election cycle was Representative Dennis J. Kucinich of Ohio. Mr. Obama’s and Mrs. Clinton’s plans do not call for a single-payer system like Canadians have, or a government-run national health system like the British have.  Both candidates have called for universal health coverage, with Mrs. Clinton saying she would require everyone to have insurance and Mr. Obama saying he would mandate coverage for children. Both would maintain the existing private insurance system, providing government subsidies or tax credits to help the low-income uninsured afford premiums. And they would give consumers a new option to buy insurance from the federal government, with policies along the lines of Medicare. . . . 

Mr. Bounds said that Mr. McCain’s characterization of the Democrats’ plans was completely reasonable. “While their proposals may not outline one to the finite extent, they clearly suggest that the movement toward a single-payer system is in their overall interests,” he said.

Democrats and Republicans view health care differently, polls suggest. Surveys have found that the most significant health concern voiced by Democrats is expanding coverage for the uninsured, while Republicans and independents are more focused on bringing down health care’s cost.

Even the phrase “socialized medicine” means different things to members of each party. A telephone survey conducted earlier this year by the Harvard School of Public Health and Harris Interactive found that 70 percent of Republicans thought that “socialized medicine” would be worse than the current system, while 70 percent of Democrats thought that it would be better.

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