Where Do the Candidates Stand on Health Care? Mike Huckabee
If you're a reporter looking for a soundbite on health care, your first-stop candidate should be Mike Huckabee. Huckabee is full of half-joking, big thinking, and cute metaphors for health care. He'll tell you how American's health care system is like an NFL football game -- because "22 people are down on the field who are in desperate need of rest while 70,000 people sit in the stands who are in desperate need of exercise" -- and why kids aren't like dry cleaning -- because "parents can’t drop them off at school and pick them up late in the afternoon well educated, well fed, well exercised and well behaved." He'll give you his opinion on Twinkies (buy them, but just eat the box, because at least you'll get some fiber) and the fried Twinkies at the State Fair. But when it comes to policy, does Huckabee have a plan? Given that Huckabee has recently become a serious contender for the Republican nomination, what might all these references to Twinkies and dry cleaning mean for the future of America's health care system?
Unfortunately, Huckabee's reliance on metaphors and anecdotal information seems to be a facade for his lack of a substantial health care policy. Huckabee has some talking points about health care on his website and even gave a 45 minute speech about health care at the Darthmouth-Hitchcock Medical Center, but he's said amazingly little that comes close to the substantial health care plans put out by some of the other candidates (I've written about Obama's and Edwards' plans, although not perfect, both are substantial and fairly comprehensive). But given the absence of facts, figures, and real policy, what can we deduce about a potential Huckabee plan?
When it comes to some aspects of health care, it seems that Huckabee has his heart in the right place. He'll be the first to tell you that after being diagnosed with Type II diabetes he embarked on a serious diet and exercise program, eventually losing 110 pounds (although this blogger did some serious investigative reporting to show that Huckabee had his stomach stapled, but no matter). He even wrote a book about his weight loss, called Quit Digging Your Grave With a Knife and Fork, and will show his "before and after" photos to anyone who asks. He has plenty to say about preventative medicine, and how disease in the U.S. is systemic. Real preventative medicine, says Huckabee, means a permanent cultural shift when it comes to health, much as our perspectives on seatbelts and smoking has changed in the past several decades. Huckabee's website reads, "The health care system in this country is irrevocably broken, in part because it is only a "health care" system, not a "health" system...We do need to get serious about preventive health care instead of chasing more and more dollars to treat chronic disease, which currently gobbles up 80% of our health care costs, and yet is often avoidable." In Huckabee's Darthmouth speech, he mentions a grab bag of various policies, everything from paid exercise time at work to electronic payment systems to ways to decrease childhood obesity.
Huckabee also gets it right when it comes to talking about the effect of our health care system on the economy, although misses the point completely when it comes to rising health care costs. He writes,
"Our health care system is making our businesses non-competitive in the global economy. General Motors spends more on health care than it does on steel, $1,500 per car. Starbucks spends more on health care than it does on coffee beans. We have an employer-based system from the 1940's, a system devised not because it was the best way to provide health care, but as a way around World War II wage-and-price controls. Costs have skyrocketed because the party paying for the health care - the employer - and the party using the health care - the employee - are not the same. It is human nature to consume more of something that is essentially free."
He's right that affordable and widely available care isn't just good for American's health, but for the health of our economy. After all, when companies like Toyota move plants to Canada just because health care costs are cheaper, you know that something is wrong with the American system. But is the problem that Americans are really consuming too much health care just because it's "essentially free?" With 47 million Americans uninsured, and about a third of Americans uninsured for at least some time between 2006 and 2007, it seems that overusing our "free" health care isn't the issue. And besides, if health care was so free and readily available, wouldn't we actually be taking advantage of preventative care?
Huckabee does give a few hints as to what his plan might look like. He says that "we don't need universal health care mandated by federal edict" and that he "advocates policies that will encourage the private sector to seek innovative ways to bring down costs." When he's President, says Huckabee, "I will work with the private sector, Congress, health care providers, and other concerned parties to lead a complete overhaul of our health care system." However, it's completely unclear what this "complete overhaul" really means, and how he would pay for such a hypothetical plan. He does mention tax credits for low income families (although as I've written before, tax credits don't do much if you're not paying any taxes in the first place), expanded health savings accounts, and "more choices," but offers no concrete details or policies besides a hodge-podge of small scale initiatives towards better preventative care.
But perhaps the real problem here isn't Huckabee's health care plan (or, more accurately, lack thereof) but rather Huckabee himself. The Wall Street Journal, calling Huckabee the "charisma character," defines "trademark Huckabee" as sounding great and explaining little. The Columbia Journalism Review agrees, noting that "vagueness and ambiguity may be just what the candidate wants, and when journalists don’t pin him down or do a little digging on their own to offer more meat, they play right into the campaign script." When local papers like this one write glowingly about Huckabee's health care anecdotes and metaphors, never noting that he has no actual policy, it's the public that really loses.
So maybe it's time for good ol' Mike to get beyond the analogies of Twinkies and Humpty-Dumpty. After all, polls have shown that even half of Republicans support universal care, in addition to about three quarters of Americans in general. If Huckabee is a serious presidential contender, then it's time for him to come up with a serious health care policy.