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Thursday late: the Health Care Debate
posted at 2008-02-08 00:51 | Last modified 2008-02-08 00:58
Tonight was #2 in UNC-TV’s three-part series of gubernatorial candidate forums. The topic this time was health care. Dems Bev Perdue and Richard Moore went first, sharing about half an hour, followed by the four GOP hopefuls – Fred Smith, Bob Orr, Pat McCrory, and Bill Graham.
I was looking forward to this debate in particular because the topic just doesn’t lend itself to generalities. Not that there was any shortage of them, of course. But it was pretty easy to tell who’s been studying this issue in-depth, and who hasn’t. It was also a good measure of candidates’ ability to put complicated policy issues into terms voters can relate to, which is a bit tougher to quantify.
Since there were tons of reporters in attendance, I’ll stick to the cliff notes.
Dems:
Perdue did a better job on this one, I think. Then again, as chair of the state Health and Wellness Trust Fund, she should’ve – and health care is probably one of her strongest issues. What worked best for her was her ability to talk about health care challenges in terms of the people they affect, rather than as abstract ideas or numbers on a balance sheet – something Moore often struggled with.
Perdue says the most pressing issue facing the state is the growing number of uninsured residents. She says the state has to make sure all its kids are insured – she and Moore agree on that – but she goes further than Moore in arguing that low-income working parents should be covered, too, in order for the kids’ coverage to be effective. (I did a segment on the uninsured for our recent Health Care series, and I can vouch that a lot of researchers agree with her.)
Which isn’t to say Moore did badly, because he didn’t. There were moments that went really well for him, like his anecdote about being an overweight kid. But he spent a lot of time talking about financing packages and leverage and incentives (okay, he IS the treasurer), and not much time talking about how it all affects the 1.4 million people in this state who can’t even afford to go to the doctor.
It wouldn’t be a Moore-Perdue debate without a few sharp elbows, of course, but the jabs were mostly on-topic fouls, with one big exception. At the (very) end of their segment, after staying pretty much on message, Perdue suddenly zinged Moore on a lawsuit filed against him on behalf of the state employee’s pension fund. (I’d love to know how that played with viewers, coming at the end of an otherwise empathetic performance. )
GOP:
Wow, what a range. Aside from common conservative catchphrases like “personal responsibility” and “market-driven,” there wasn’t much in common. If you can still afford your insurance, you probably liked Smith or McCrory, both of whom touted personal responsibility above all else. If you can’t, you probably liked Orr or Graham, both of whom pointed out it’s tough to “take responsibility” for your own health when you have no access to doctors, medication, or preventive care.
Orr: Won this round, in my opinion. He’s obviously put a great deal of thought into this issue, and the details took center-stage in his response to just about every question. Some of his positions were a long way from boilerplate conservatism, like his support for restoring the mental health trust fund, or his stand against rules saying school lunches should be a profit-making venture. Others were closer to home, like his advocacy for market solutions to the problem of the uninsured. Still, he went well past platitudes, and I’d bet he appealed strongly to voters who care about this topic. (NB: And he never even mentioned the Constitution, not even once.)
Graham: Also did well for the most part. He had a lot of well-thought-out proposals, including community risk pools that would let non-employer groups buy and offer coverage. He talked a lot about redistributing risk, prevention, and early detection. He even name-checked “coal-fired power plants” as one reason for asthma. But one of his big proposals – adding screening programs at rural hospitals – is already largely in effect.
Smith: A little uneven. His authoritarian delivery and vague language still don't always help him, but some of his business-owner anecdotes were pretty effective. His best moments came off-message: talking candidly about using it or losing it, or about avoiding the potatoes at his barbecues. Aside from a plug for regular check-ups, though, he was all about personal responsibility, but still didn’t offer much for folks with conditions exercise and diet alone can’t fix.
McCrory: Sounded more mayoral than gubernatorial tonight. For example, when asked about fixing the mental health care system, he responded that it’s working fine in Charlotte, but didn’t even acknowledge that it isn't working so well for the rest of the state. He was a lot harder-edged tonight than in previous appearances– no smugness here – but also more politicized and perhaps less credible. He says the big challenges facing the health care system are illegal immigrants and malpractice suits (a lot of studies don’t agree with either claim, incidentally), and said he’d be a good role model (a la Huckabee?) for personal responsibility for health.
That’s enough for tonight. WUNC Health Reporter Rose Hoban will have a story on the debate Friday; I’ll add a link to it here as soon as I get one.
Comments? Drop me a line.
