The Candidates on Health Care
October 7, 2015
The Opinion Pages | EDITORIAL
The Candidates on Health Care
By THE EDITORIAL BOARD OCT. 2, 2015
While the Republican presidential candidates have been busy railing against
Obamacare, the two leading contenders for the Democratic nomination have staked
out radically different ideas on how to improve the American health care system.
Hillary Rodham Clinton has proposed adding useful consumer protections to the
Affordable Care Act. Senator Bernie Sanders wants to create a single-payer system
that would essentially expand Medicare to cover people of all ages.
Senator Sanders’s bold call for “a fundamental transformation of the American
health care system” would look more like the plans in many other industrialized
nations that often achieve better health outcomes at lower costs. His home state of
Vermont flirted with the idea, but it dropped its plans because of fears that the high
costs would harm the economy. A national program could be more cost-effective, but
it has no chance of surmounting opposition from Republicans and from health care
industries that fear their profits would be cut.
Mrs. Clinton vigorously defends the Affordable Care Act and its reliance on
private insurance, but she would make important changes to protect people from copayments
and deductibles that have been rising faster than their wages. She would
create a new tax credit of up to $5,000 to help families pay high out-of-pocket
medical costs and would require insurers to cover three visits to the doctor each year
before people start paying to meet their deductible.
Both Mrs. Clinton and Mr. Sanders have taken strong stands against the
sometimes exorbitant prices for prescription drugs that manufacturers set with no
reasonable justification. Both would authorize Medicare to negotiate with drug
companies to drive down prices — a move now prohibited by law, at Republican
insistence — and both would allow Americans to import cheaper drugs from other
countries. Mrs. Clinton would cap a patient’s out-of-pocket drug spending at $250 a
The leading Republican candidates are unanimous in calling for repeal of the
health care reform law — Donald Trump has called it a “catastrophe,” and Jeb Bush
labeled it a “monstrosity.” Yet they are remarkably tongue-tied on how they would
In the Sept. 16 debate among 11 Republican candidates, the issue came up only
obliquely. None of the Republican candidates have endorsed government negotiations
with drug companies; they believe private negotiations and competition among drug
companies are working just fine to curb drug costs.
Of the Republicans, only Senator Marco Rubio has sketched out an alternative to
the current health system. He would rely on tax credits of unspecified amounts to
help people buy private insurance — an approach that is comparable to what the
Affordable Care Act does now but that would most likely be less generous. He needs
to flesh out his plans and his competitors need to devise serious alternatives of their
own so that voters can see how they compare with a reform law that is working
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A version of this editorial appears in print on October 3, 2015, on page A22 of the New York edition with the
headline: The Candidates on Health Care
© 2015 The New York Times Company