This side-by-side comparison of the candidates' positions on health care was prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc. and is based on information appearing on the candidates' websites as supplemented by information from candidate speeches, the campaign debates and news reports. The sources of information are identified for each candidate's summary (with links to the Internet). The comparison highlights information on the candidates' positions related to access to health care coverage, cost containment, improving the quality of care and financing. Information will be updated regularly as the campaign unfolds.
| |
Rudy Giuliani |
Mike Gravel |
| Party Affiliation |
|
|
| Stated goal |
- Transform the way health insurance coverage is provided by using free-market incentives that will also reduce costs and improve quality.
|
- Universal coverage through a health-care voucher program permitting choice of provider.
|
| Date plan announced |
|
- No formal plan announced.
|
| Overall approach to expanding access to coverage |
- Provide individuals without employer-based coverage a health insurance tax deduction to subsidize their health insurance premiums and provide lower-income families a tax credit to help subsidize their premiums. Tax changes are intended to shift millions from employer-based to individual insurance.
|
- A universal health care voucher program whereby the federal government would issue annual vouchers to individuals based on projected health care needs. No requirements for employer-based coverage would be imposed, and Medicare/Medicaid would be phased out over time.
|
| A. Requirement to obtain or offer coverage |
- No provision. Opposes government mandated insurance coverage.
|
- Opposes mandates on employers or tax incentives related to coverage.
|
| B. Expansion of public programs |
|
- Supports phase-out of Medicare and Medicaid over time.
|
| C. Premium subsidies to individuals |
- Provide a refundable tax credit to low-income individuals that could be coupled with Medicaid coverage and employer contributions.
|
- Vouchers would be age and risk adjusted.
|
| D. Premium subsidies to employers |
|
|
| E. Tax changes related to health insurance |
- Simplify HSA regulations.
|
|
| F. Creation of insurance pooling mechanisms |
|
|
| G. Changes to private insurance |
- Permit individuals to purchase insurance across state lines.
|
- Permit the purchase of additional coverage by individuals beyond coverage provided under a voucher.
|
| H. State flexibility |
- Provide states with block grants to encourage innovation, reduce health costs, enroll the eligible uninsured in public plans, and address adverse selection issues.
|
|
| Cost containment |
- Supports medical liability reform.
|
- Anticipates savings of 30% of current spending from reductions in administrative costs from single payer.
|
| Improving quality/health system performance |
- Proposes that “health insurance should be redefined to cover wellness as well as sickness.” Promote healthy lifestyles and tie federal Medicaid payments to a state’s success in promoting preventive care and tracking obesity in children.
|
- Allow all individuals free choice of provider.
|
| Other investments |
|
|
| Financing |
- Not specified. Says that health care reform can be achieved “through tax cuts, not tax hikes.”
|
- Not specified but anticipates that savings from the voucher program can finance universal coverage without additional costs.
|
