Election Issue: Health Care Remains A Thorny Conundrum

This story was written by Adam Sullivan, The Daily Iowan

The victors in next month's elections will undoubtedly be pressed to make key decisions on heated health issues, experts say.

The topics have concerned Americans in recent elections, and this year is no different. While health policies have sometimes been overshadowed by economic, environmental, and national-defense interests, the issues remain prominent.

Continued growth in Medicaid expected

Medicaid expenditures in Iowa last year totaled more than $2.3 billion. Fiscal 2008 expenditures are expected to top that figure by more than $200 million, according to a report from the Iowa Department of Human Services.

And Medicare growth isn't expected to stop. The more than 300,000 Iowans with Medicaid benefits is expected to grow 3.5 percent by fiscal 2009.

Iowa Department of Human Services spokesman Roger Munns said Iowa historically has a reputation of allocating necessary money to Medicaid, a program that gives health-care coverage to qualifying low-income citizens.

"This state has a long and proud tradition of making funds available for health care for vulnerable people," he said.

A report released last week suggests lawmakers will be challenged with taming Medicaid spending in the coming years.

The Centers for Medicare & Medicaid Services estimates that Medicaid expenditures will outpace the growth of the U.S. economy in the next decade. Spending on Medicaid will continue to grow at 8 percent annually, while the projected growth rate of the economy is around 4.8 percent, according to the report.

Nationally, the U.S. Department of Human Services estimates Medicaid spending will exceed $647 billion a year by 2017.

High cost, special interests keep thousands uninsured

Roughly 300,000 Iowans are without health-care coverage. Despite Iowa's uninsured percentage being relatively low - the national average is 15 percent - experts say there's work to be done.

Cost is the biggest barrier to health care, experts said.

The United States ranks near the bottom in infant mortality and care accessibility among industrialized nations, said Kevin Leicht, a UI sociology professor.

"But we spend the most on health care per person," he said.

University of Iowa sophomore Marian Fukuyama doesn't have health insurance. She said her family canceled its insurance plan because it was so expensive.

"I'm prone to being sick a lot," she said. "I find it really difficult. I have a $60 prescription every month. If I had insurance, it would only be $4."

Andrew Mertens, who works for Health Care for Iowa, a division of Service Employees International Union, said the country's health-care system is at a "breaking point," with many at risk of losing health-care coverage.

"We're seeing millions and millions more falling uninsured every single year," he said. "It's an issue that politicians are ready to take on and reform a system that is at it's breaking point."

However, a shift in national health-care policy may not be swift, Leicht said.

"We're not going to have an election and have a new health-care system by summer," he said. "The way health care is delivered represents a series of interests that are very hard to change."

There isn't a consensus among voters on what route health care should take. Many with employer-provided health care could be reluctant to any major changes, he said.

Women's health issues in the background

Two of the justices sitting on the Supreme Court - John Paul Stevens and Ruth Bader Ginsburg - are 75 or older. The net president is likely to make at least one Supreme Court appointment during his four-year term. The justices could be pressed with the decision to overturn or uphold the landmark Roe v. Wade.

Still, a woman's right to choose isn't necessarily a huge pull in this year's election, said Tracy Osborn, a UI assistant professor of political science.

"I do think that people are aware of [probable changes in the Supreme Court]," she said. "But they're probably equally dispersed on both sides."

However, women aren't unconcerned with health issues.

"I think it's health care in general that people are concerned about," Osborn said. "But I don't know that the average voter thinks of it in terms of gendered health care."