Tim Johnson of ABC News Won the Republican Presidential Debate on Healthcare Last Night

[courtesy of California Progress Report]

By Anthony Wright
Executive Director of Health Access California

In the Republican presidential debate last night, Dr. Tim Johnson of ABCNews won the section on healthcare, of which none of the candidates had an adequate response.

Dr. Johnson's set-up piece made the point that the Republican plans more perhaps more radical than the Democratic plans, in that they attempted to shift people away from group coverage--largely through the employer-based coverage that people have now--into the individual market, via Health Savings Accounts, etc.

Dr. Johnson further gave facts about how individual coverage is more expensive and less efficient--partially because of administrative costs, the inefficiency of having to sell the products one at a time, the lack of any economies of scale, and the inability of the purchasers to leverage their market power to get better cost and quality. He didn't land the most obvious punch--that many of the Republican candidates, as cancer survivors, would be unable to buy coverage in most states, including New Hampshire (and California), because of their "pre-existing conditions."

It's probably the most important distinction between how the two parties view health care. One direction is to expand subsidized group coverage, through employers, public programs, or even a single-payer system. The other is to shift more people in the individual market, leaving consumers at the mercy of the insurers. Giuliani wanted to shift around 17 million to about 50 million buying coverage as individuals-- I am not sure those 30+ million would prefer that approach.