Twelve Questions About Health Care for Tonight’s Debate

There’s more to talk about than taxing benefits

We’ve been pleased to see that health care returned to the candidate’s stump speeches this weekend. Maybe voters are beginning to understand at least one aspect of the health reform debate: John McCain’s plan to tax the value of the health insurance benefits that nearly two-thirds of all employers provide for their workers. But there are many more health care topics in the reform mixture, and most have barely been discussed. Not by the candidates. Not by the media.

No doubt health care will come up at tonight’s debate, which will focus largely on domestic issues. So in the true town hall meeting spirit, we offer a few questions that voters might ask:

For John McCain:

1. Why shouldn’t all Americans have health care as good as you have had in the military and in the Senate?

2. If, as you’ve said, families should make decisions about their own medical care, what should be done to stop managed care organizations from making health care decisions for patients when they decide which treatments and procedures they will pay for?

3. How will your Guaranteed Access Plan for those with serious medical conditions work any better and insure more people at a reasonable cost than high risk pools in many states have done up to now?

4. Name two safeguards to protect policyholders you would implement if, as you propose, insurance is to be sold across state lines.

For Barack Obama:

5. How would you bring insurance to poor children now on Medicaid who will turn eighteen and age off the program, and whose parents have no money to buy an insurance policy?

6. Why should people who are disabled and who qualify for Social Security disability payments have to wait two years before gaining coverage under Medicare?

7. How can you achieve universal health insurance coverage without requiring everyone to have it?

8. You have said that insurance companies should be required to take everyone even if they have preexisting conditions. Name two ways you would be willing to compromise on this point when the insurance companies flex their lobbying muscles.

For both candidates:

Controlling the seemingly uncontrollable rise in medical costs has hardly been mentioned during the campaign. We realize it’s a hot potato, but it’s the issue that will make or break health care reform. So we would like to know:

9. If your very similar cost-containment proposals, which some observers call cost-containment lite, don’t work, what’s your plan B?

10. Should we stop paying for new medical technologies if there’s no evidence that they work and if they costs too much by some objective standard?

11. How would you overcome political resistance to establishing a federal agency that evaluates the evidence, costs, and benefits of new drugs that come on the market?

12. What steps would you take to reign in hospital costs, which account for about one-third of health care expenditures?

Your answers will go a long way to helping voters understand how your administration will shape health reform.

Has America ever needed a media watchdog more than now? Help us by joining CJR today.

Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.