Why it matters:
To assist an aging population increasingly reliant on costly prescription drugs, Congress passed a massive Medicare reform bill in 2003 that could cost taxpayers some $400 billion over the next decade - and possibly up to $2 trillion in its second decade. The new entitlement does not address the perennial problem of providing coverage to the estimated 44 million Americans without health insurance - and the many more who are underinsured. As healthcare costs continue to escalate, the next president will face the difficult task of balancing distinct priorities: expanding coverage, lowering costs, and preserving choice.
Where they stand:
Carol Moseley Braun
Braun favors an ambitious overhaul of American healthcare, advocating a single-payer healthcare model in which the US government pays all healthcare costs, funded by income-tax revenue. Single-payer advocates say this model, used by Canada, saves money by lowering administrative costs and preserves patient choice, while ensuring universal coverage to all citizens.
George W. Bush
By passing a major Medicare reform act that includes prescription-drug benefits for seniors, Bush gained a Republican advantage for an issue traditionally owned by Democrats. A top Bush healthcare priority is preserving and expanding patient choices. He claims that the better choices provided by healthy competition, coupled with medical liability reform, will lower costs. Bush has proposed $117 billion in various initiatives to assist those who lack good coverage.
Wesley Clark
Clark pledges to expand health coverage to 32 million Americans who are currently uninsured, including all children and college students who lack health insurance. Though his effort stops short of universal coverage, Clark dedicates part of his 10-year, $695 billion plan to help struggling families pay expensive premiums as well as assist citizens at risk of losing coverage. He claims his emphasis on improving care and managing costs will result in better quality, lower-cost healthcare for all Americans.
Howard Dean
Dean's healthcare vision reflects his record as governor of Vermont. He touts expanding coverage to Vermont's citizens and an early-childhood development program called "Success by Six," which emphasizes community-outreach worker visits to new parents. He proposes an $88 billion-per-year plan modeled after the healthcare system currently offered to federal employees and members of Congress. In addition, Dean emphasizes help for small businesses to offer insurance to their employees. He wants to fund his plan by repealing Bush's tax cuts.
John Edwards
Edwards has put forward a plan that offers targeted help for those most in need of adequate health coverage. In addition, he wants to insure every American child and cut costs and improve quality for all. Under the Edwards plan, parents have a responsibility to insure their children. He claims his effort would cover an additional 21 million Americans at a cost of $53 billion per year, while cost-containment measures would save $17 billion per year.
Dick Gephardt
Gephardt is promoting a plan he claims will achieve near-universal coverage and stimulate the economy. It would use existing private and public structures to extend coverage to 97 percent of the uninsured. The plan requires all employers to provide health insurance for their workers, and gives them a 60 percent refundable tax credit to help them pay for it. Additionally, his plan would reimburse state and local governments for 60 percent of health insurance costs for their employees. Total cost: $692 billion from 2005-2007, funded by eliminating Bush's tax cuts.
John Kerry
The centerpiece of Kerry's plan is allowing every American access to the healthcare plan currently offered to federal employees and members of Congress. He has outlined steps to expand healthcare coverage to 96 percent of all Americans, including nearly all children. He claims his reforms will cost an average of $72 billion annually for the first five years, while saving an estimated $150 billion over 10 years. He favors a strong patient's bill of rights and supports Americans buying lower-cost prescription drugs from Canada. Another top Kerry health priority is higher funding to fight AIDS worldwide.
Dennis Kucinich
Kucinich is a strong critic of what he calls today's "profit-driven system," and he proposes a single-payer plan to deliver universal coverage, publicly-financed and privately delivered. He endorses the Canadian healthcare model and claims that the lower administrative costs of a single-payer plan, coupled with bulk purchasing, would more than offset its costs.
Joe Lieberman
Lieberman offers many programs to lower medical costs and expand health coverage, the boldest of which is a new universal health insurance program for kids, called MediKids. He's also proposing methods to ensure that no worker who becomes unemployed loses health coverage. Lieberman claims his effort would cover more uninsured Americans than any other non-single-payer plan and would be the most cost efficient, averaging $53.4 billion over the first five years, and actually saving states an estimated $400 billion over 10 years. Lieberman calls Bush's Medicare reform bill an "important beginning," but pledges to fix its "shortcomings."
Al Sharpton
The centerpiece - actually, the only piece publicized on his website - of Sharpton's healthcare vision is an endorsement of a proposal by Rep. Jesse Jackson Jr. to make a healthcare amendment to the US Constitution. In his view, this amendment would legally guarantee "healthcare of equal high quality" to every American.
