In a heated debate Monday at the Columbia University Medical Center, health care experts Elise Gould, who advocates for the Democratic presidential campaign, and Robert Goldberg, who favors the Republicans, addressed the role of health care in the coming election.
The event was advertised as a forum on the differences between the health care policies of Senators John McCain (R-Ariz.) and Barack Obama (D-Ill.), CC ’83. But in light of the current financial crisis, the discussion shifted to the interplay between health care and such economic hardships as unemployment and rising taxes.
First to speak was Gould, an economist specializing in health and labor at the Economic Policy Institute and an adjunct professor in the Johns Hopkins Department of Applied Economics. She supported Obama’s plan to build large insurance pools in the form of a national health insurance exchange, a structure she assured would be “capable of absorbing” the 45 million uninsured masses.
“We ration in this country,” she said in response to claims that such a plan would be too restrictive. “We ration by income.”
Goldberg, vice president of the Center for Medicine in the Public Interest, of which he is a co-founder, stressed the individual’s right to choose a specific type and level of insurance. In light of the perception that Medicare, which Goldberg found unstable, would be required as part of Obama’s national exchange, he said, “I want to be able to choose my doctor. I wouldn’t have my economist pick my house.”
Like big government, Goldberg claimed, increased oversight of the health care industry would sacrifice free market competition at an unreasonable cost. Gould denigrated this argument as unfounded. Of McCain’s health care plans, she said that “he wants to replace employer-based coverage with a nationally deregulated individual insurance market.” This, she said, would offer tax credits in the amount of about $5,000 per capita, yet fall short of the subsidies employees currently gain through employer-based insurance.
Throughout the evening, audience members were allowed to text questions to moderator Sreenath Sreenivasan, who is dean of student affairs at the Graduate School of Journalism. Most questions concerned the burden of dealing with specific medical areas in which insurance can be complicated, as well as with financial security. In response to students’ financial concerns, Goldberg referred to his daughter, age 23, who hopes to open her own business. “Does she want to spend $12 million on a health care plan or on her new business? Why not a health savings account instead? She should be able to ‘shop’” for an ideal plan,” he said.
The audience’s reaction to Gould was somewhat warmer. “Ms. Gould produced her information in a way that was much more approachable,” said Yvonne Cole, research coordinator of psychiatry.
But both panelists’ focus on questions of current economic relevance resonated with most of their listeners. Regarding small business owners hurt by the economic crisis as well as people who pay out of pocket when their coverage is insufficient, CUMC nurse practitioner Rebecca Greenleaf said, “It’s a really serious problem.”
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