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March 15, 2007

Advising A Presidential Candidate

Dawn forwarded this email that was sent to everyone in her program:
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"KaiserEDU.org invites undergraduate and graduate-level students in all disciplines to submit an original essay for the website's first competition. Students are asked to submit entries by March 30, 2007 in response to the following topic:

You have just accepted a job as a senior adviser to a Presidential candidate* for the 2008 election. Your first task is to prepare a memo for the candidate outlining your recommendation for the candidate's health plan. Your memo should discuss what the centerpiece of the candidate's health plan should be, why this issue is important to the voters, the potential challenges that your candidate may face in promoting the plan, and how it would be communicated to the public. Your candidate can have any political affiliation you choose. Please be original. This memo should describe what you would recommend to your ideal candidate. Remember, the candidate is extremely busy so brevity and conciseness are important.

*does not have to be based on an actual candidate"
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I didn't write an essay, but I thought it was a very interesting question. These are my thoughts:

It would really depend if the candidate was a real contender, or whether the campaign is about bringing issues to light. If the candidate was a real contender it would also depend on whether your allegiances are first with the candidate or with the issue of health care reform. This is primarily because solid health care reform policy, regardless of its scope or depth, would be a tremendously difficult and complex issue to communicate -- good policy isn't always easy to sell to a sound-bite culture. Selling stricter regulation (a good start) would be hard to center your stance around, much less a government subsidized heath care plan or universal health insurance.

If you are only able to make substantial changes if elected, should you really try to explain what you intend to do in office while campaigning, or should you campaign around popular catch-phrase issues that might help you get elected, but also might differ from the policy that you would really like to push through? Most people of course go for the latter...for very pragmatic reasons. Most people, myself included, wouldn't know where to start with health care reform, but, to some extent, we are entrusted with deciding its course through deciding the candidates we elect. Many, if not most politicians don't know what to fix either. The health care reform ideas from people who know what to fix -- health care professionals and analysts, and policy experts -- often don't see the light of day for political reasons. And special interest money often sways a candidates policy decisions more than research anyway. Most candidates really don't tell us what they are going to do once elected, and the majority of the public doesn't know what would benefit them. So how do we make a decision as voters? We lack the expertise, and our vote is a blind shot since the candidate we vote for might be (read: probably is) misrepresenting him/herself.

Americans fancy themselves as independent though, so the one issue that would benefit patients most - much tighter industry regulation - would probably be hard to sell as part of a campaign platform. Americans don't want to feel "regulated." Republicans, not likely to campaign for strict regulation, would find it easy to attack a Democratic rival as "big government liberal" if they campaigned for more regulation. So Democrats campaign for "Universal Health Insurance" -- a friendlier sounding term than regulation, but an impossible task in one term as President.

Since I would be advising an "ideal candidate," I would probably make my centerpiece focusing on pharmaceutical reform. The public might react better to regulation of pharmaceutical companies than to regulation of the health care industry as a whole. I would campaign that the health care industry is not a consumer driven industry, but is an industry driven by necessity. In a consumer economy you can't severely overcharge for a product or else people won't buy it. When people are sick they will pay whatever it takes to get better, or make the person that they love better. It's not that we want to take away consumer choice in health care with regulation, we want to ensure that no matter where a person receives service, that it will be quality service and reasonably priced. And once pricing is under control in the health care industry "Universal Health Care" might actually be an attainable task.

| By Joshua Daniels | 09:37 PM

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