Which Gubernatorial Candidate Truly Offers Universal Kid Care?
As I mentioned earlier when talking about the races this year, I am totally open to conversations/corrections, or what have you with the campaigns themselves. Shortly after posting my comparison of the kid's health care plans from the two Gubernatorial candidates I had a sit down meeting with an acquaintance who worked on the Perdue health care plan. While I consider this person a friend and he was very helpful in learning and discussing the state of health care in North Carolina - I'm still undecided, impartial, and not 100% satisfied with either candidate's ideas.
That said, there are several things I would like to talk about related to children's health care, which are positives for the Perdue campaign. And, there is one thing I would like to talk about which is a negative (for me, not for everyone) for the Perdue campaign.
First things first. Although these campaigns have been slinging-the-mud, this conversation had none of that. It was very much based on what Perdue was doing right, not what Moore was doing wrong.
The first thing that Perdue is doing right is offering a sliding scale program for kids above 300%.Richard Moore's health care plan cuts off his plan at 300% of poverty as defined by the federal government. Unfortunately, we have another 60,000 children who are uninsured that come from families which make over 300% of the poverty level. Of those, we have:
| Income to Poverty Ratio | Total N | Insured | Uninsured |
| 300% to below 400% | 251,000 | 219,000 | 32,000 |
| 400% to below 500% | 178,000 | 169,000 | 9,000 |
| 500% and above | 423,000 | 404,000 | 19,000 |
I wondered how those numbers compared based on percentage. For instance, are those kids uninsured over 300% a small percentage? Do their parents have the resources but don't believe in buying insurance?

So, the percentage of kids uninsured in the 300% to 400% range is identical to the percentage of kids who are uninsured in the 200% to 300% range. Obviously, these aren't people who are making it and choosing not to have health care for their kids. Richard Moore makes the following observation.
Another 38,000 come from working families earning between 200% and 300% of the federal poverty guidelines. These families are struggling to make ends meet and simply cannot afford coverage. The remaining uninsured are in families with incomes above three times the federal poverty guidelines, but have not purchased health insurance for their children.
That phrase is read by me as meaning that everyone over 300% can afford health insurance, we aren't going to help them. I would argue that at the very least 400% is where one would want to make that assumption - if at all.
Second, to give Perdue her due, although I have problems with the underlying premise of her plan (see below), she is not afraid of the word "universal". From her plan we find the following uses of the word, some of which I like, the first of which pisses me off.
Maybe in some far-off utopia, someone can simply draw up a plan for universal coverage on paper and expect it to somehow just happen.
...
1. Universal Coverage for Children. The next step for expansion of health coverage in North Carolina is clear: we need to extend the full coverage umbrella to encompass all children in our state.
...
2. The Challenge of Covering Uninsured Families. The fourth and biggest step toward universal coverage for children involves extending coverage to their parents.
...
I am thrilled that after all these years of our hard work a consensus in our state is finally emerging in favor of universal coverage for children.
...
When that 125,000 boost in parent coverage is combined with the extension of a universal coverage umbrella for our 250,000 to 300,000 currently uninsured children, we will have covered over 400,000 of our currently uninsured population.
...
By that time, we may be greeted by a new day in Washington with serious action on the universal coverage front for all uninsured adults.
Man, that first quote still pisses me off. But, okay, there is something good for the Perdue campaign, they are not afraid to up the ante and say they will make assistance available for kids above the 300% poverty level and they are not afraid to talk about Universal Health Care...most of the time.
It still sticks in my craw, this quote.
Maybe in some far-off utopia, someone can simply draw up a plan for universal coverage on paper and expect it to somehow just happen.
That is followed later in the roadmap proposal by this quote.
I believe North Carolina’s progress in these early days of the 21st century can be measured by how far we travel down the road to affordable and quality health care for all our people. That is why North Carolina’s next Governor must be committed to that goal regardless of what happens or does not happen in Washington.
Are you familiar with weasel words?
The problem I have with this language, with this idea of pursuing "what we can get away with", but not truly universal health care, is this. It gives away the moral high ground.
Folks, we are right on this issue. Every man, woman, and child deserves health care, not health insurance - but HEALTH CARE. They deserve to have preventive care, they deserve to have a family doctor, they deserve to be treated like a human being, and they deserve to have all of this without losing their house or having to choose between food and medicine.
We. Are. Right.
So, it sickens me to see candidates that I will have to vote for weaseling around this subject, unwilling to come out with their heads high and to fight for what is right, not what is easy. It reminds me of the way I tell the Three Little Pigs story to my kids. In my version, the mother pig tells the baby pigs that nothing good ever comes easy; and, that you have to do the right thing, even if it means a lot of hard work.
Why am I not supporting either of these candidates right now? Because they aren't willing to do the hard work of fighting for what is right. Can we blame Beverly Perdue for wanting to play it somewhat safe? Certainly not as safe as she could play it, but can we blame her for not wanting to become "Hillary Perdue" and to have her health care plan labeled "Beverly Care"?
Yes. We can. Because that is what Democrats have been doing for as long as this writer has memory, playing it safe. I'm sick of it. We watch Republicans attack gays, attack African-Americans, attack anyone with brown skin. We watch them demean the mentally ill, we watch them throw children into the bin while proclaiming themselves "Pro-Life". And, what do we do?
We play it safe. Well. I'm sick of it.
Richard Moore gets no pass from me on this either. Draw the analogy for me Mr. Moore, who gets thrown under the bus and who doesn't? Does a family that makes 500% the poverty rate but is self-employed with preexisting conditions qualify for your help? Not based on your plan. Not even if the premium BCBS is offering is $3000 a month, just for the father with preexisting conditions?
If our candidates want to propose ONE THING that is bold, here it is.
No preexisting conditions. Promise to outlaw the practice of fixing rates based on preexisting conditions. One pool, everyone pays, everyone is insured.
Both candidates used the word "bold" to describe their plan. Let me summarize my feelings on this issue.
- Beverly Perdue offers coverage assistance to more children than Richard Moore.
- Beverly Perdue is willing to take ownership of the words Universal Health Care, if not the ideal.
- Both of these candidates will make fine governors, better than any Republican.
- Neither of these candidates has offered a plan for children that is "bold".
In the near-future I will be doing another write-up on these plans. You see, the roadmaps that have been released count on NC Kids Care, which doesn't really exist yet, and S-CHIP, whose funding has not been finalized. Additionally, these plans have different premium/copays that we need to compare. So, when the bills have been paid and the numbers released, I'll come back to this issue.
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The only thing as confusing as highway funding in NC...
is this stuff. If it were simple, I think people would realize they are getting screwed!
One of the pitfalls of childhood is that one doesn't have to understand something to feel it. - Carlos Ruiz Zafon
Excellent post, Robert.
Every time you write about health care, I learn more in five minutes than I get from the mainstream media in a month of Sundays.
I've never seen you write about Pre-Existing Conditions before and am very glad you've focused on that. It boggles my mind that we live in a world where the free-market extremists set the healthcare agenda. Their bottom line: if someone somewhere can't make money doing a certain thing, that certain thing shouldn't be done.
And they wonder why we call them the Party of Greed.
"If boiling people alive best served the interests of the American people, then it would neither be moral or immoral." Max Borders, Civitas Institute
Thanks.
I would support the type of "pre-existing conditions" they use in some European models. Where everyone starts out with the same premium, but if you can show you are trying to take care of yourself, the premium drops. If you partake in preventive care, your premium drops. Where staying well is the point, not being treated for being sick.
One of the pitfalls of childhood is that one doesn't have to understand something to feel it. - Carlos Ruiz Zafon
That makes so much sense
I think it gave me a migraine! :-D
Be the change you wish to see in the world. --Gandhi
Excellent Analysis, Robert.
And you're right - this is one where WE ARE RIGHT. And we have the means to make it happen.
So as progressives, as democrats, as human beings, we should be pushing our candidates out of the safe zone, and into the making it happen zone.
Great job.
Be the change you wish to see in the world. --Gandhi
Safe zone.
What we have to do is convince them that our ideals ARE the safe zone. People agree with our ideas when they are presented as part of a strong, clear message.
One of the pitfalls of childhood is that one doesn't have to understand something to feel it. - Carlos Ruiz Zafon
Just remember....
that North Carolinians WANT Universal Health Care.
One of the pitfalls of childhood is that one doesn't have to understand something to feel it. - Carlos Ruiz Zafon
Those health care "a" words
"access" and "affordable" are disturbing. The big guys and policy makers just do not get the definition of affordable for a median-income family, and they don't get the definition of accessable for an hourly wage earning family.
I was blown away during the SCHIP discussions to read that there are grown people who live in America in 2007 who think you can "clearly afford" to pay $1000 a month of a $45k/year income and still feed, house and clothe your kids. The ignorance was just baffling.
That's the affordable part.
The accessable part is even less understood. I'm sure policy makers sincerely believe that health care is accessable when a $30k household has an insurance policy with a $20 co-pay and 80% coverage of billed expenses.
Problem is, for someone who spends nearly every dime they get every week on food, rent, utilities and gas, coming up with $20 + 20% of the bill when junior has a fever and needs medicine at the end of a week isn't just hard... it's just NOT DOABLE. So no matter why the fever is there, junior gets Ibuprofen, a cold cloth, tea and crackers and gets to stay home alone to sweat it out while mom or dad calls every hour to see how she's doing. That's just the way it is.
Dont forget
Access isnt just an insurance issue. Access is often a doctor issue. We often forget that in rural areas there are a tiny amount of doctors, and some of those doctors wont take specific insurance plans. Access also means expanding medical coverage to rural areas by bringing more doctors to rural areas and creating more hospitals in rural areas.
"Keep the Faith"
Good point
See? I hadn't thought about that aspect because I live in a little town with several family doctors and dentists pretty evenly dispersed throughout.
And the stories my folks tell about finding doctors who take Medicare. ack. Seems like they no sooner find one just moved to town ... then the next year or two they get the call ... "we're regrettably no longer serving Medicare patients."
These discussions ought to be had with the people who live these issues of access and affordability everyday, otherwise, while Republicans look like they just could not care less about Junior's, mom's or grandma's health, even Democrats with plans are going to look like ignoramuses to everybody in NC who doesn't live in town, doesn't have widely accepted insurance and doesn't have a healthy upper-middle-class income. I could be wrong, but my guess is that's well over half the population.
Any universal health care plan must also
check the spiraling cost of visiting a doctor. $1000 a month for premiums is just to much. While doctors should be paid for the training they receive, enough is enough.
The ENTIRE health care system needs to be revamped.
Really, it needs to be throw out and a clean sheet of paper started. One that first and foremost addresses how we are going to get new health care providers. The biggest problem I see with any universal health care is if the costs for becoming a doc is still staggering, but we cap how much someone will pay for services, why in the world would you want to become a doc?
1. make becoming a doc manageble
2. make the cost of visiting a doc affordable
3. make visiting a doc available to everyone
4. formulate a plan that encourages research for the new procedure
5. provide places for people to go visit the doc
6. kill, maim, destroy any malpractice lawyer.
7. repeat 6.
8. make the plans understandable and fair across the board.
9. repeat 6.
10. all docs must accept any health care program out there.
guess thats it for now.....
Parmea
You keep writing about malpractice issues as though they are a key driver of health care costs. (Three of your 10 items focus on that very small piece of the puzzle.) They are not a key driver of costs, not by a long shot. Problems associated with malpractice insurance and claims are negligible in comparison to the profits made by insurers (middlemen) who essentially add NO value to the entire healthcare picture.
Repeat after me: Health care for all is the answer. Single payer. One risk pool.
"If boiling people alive best served the interests of the American people, then it would neither be moral or immoral." Max Borders, Civitas Institute
More doctors.
I just spoke today with a friend of mine. She has two kids and during her residency in the NICU she worked an average of 100 hours per week. One-Hundred. That is the usual. Why? There are dozens of great applicants that turned away from UNC each year, and dozens more from Duke and ECU. So, why don't we have another Medical school in Charlotte? We need more medical professionals.
BTW, I agree with Anglico, your obsession with malpractice lawyers tends to suggest to me that you've been listening to too much AM talk radio. Insurance companies, that do nothing but shuffle paper, are earning record profits. Pharmaceutical companies are earning record profits. Meanwhile, we have more uninsured every year, more underinsured every year. It's not a mystery where the cash is going.
We do need to scrap this system, but we won't.
One of the pitfalls of childhood is that one doesn't have to understand something to feel it. - Carlos Ruiz Zafon
This is the info we need to use in making decisions on who to su
port.
Thanks for writing about the two candidates.
How about we all write to them about these questions that Robert eloquently raised?
Ask them to refine their positions?
I shall be sending this out to my health care interest group--- ihave collected more than 25 friends who are willing to get info and write to our state legislators, knowing that I will send them worthwhile info that will give them more than we get from the newspapers.
So I really appreciate this blog. many many thanks.