As Democratic voters take part in state primaries to choose a presidential candidate, the healthcare issue looms as large as ever. GEN recently asked Senators Barack Obama and Hillary Rodham Clinton about their plans for improving healthcare access and delivery in the U.S. and for supporting both basic and applied biotechnology research. Their responses appear below.
The Republican candidate for president, Senator John McCain, declined to take part in our roundup article.
Describe your plan to improve healthcare access and delivery to Americans including those 46 million plus who are uninsured?
Senator Hillary Rodham Clinton I will establish the American Health Choices Plan, which will ensure that every American has quality, affordable healthcare. The plan will offer the same private, health-plan options that members of Congress have, as well as a new public program option similar to Medicare. Citizens will be able to choose either of these plans or keep the plan they already have.
Under the American Health Choices Plan, all parties in the health system will be asked to make constructive contributions to the new system. Insurers will no longer be able to discriminate and cherry-pick the most attractive populations to insure; they will be subject to guarantee issue-and rating-reform requirements. Not only will major employers be required to help finance healthcare, but individuals will be expected to contribute also.
In return, the federal government will ensure that the premiums are affordable through thoughtful value-based purchasing approaches such as: information technology, e-prescribing, and chronic-care management as well as through tax credits that ensure that no American has to pay a premium above a certain modest percentage of their income.
Senator Barack Obama I will sign a universal health bill into law by the end of my first term in office. My plan will ensure that all Americans have healthcare coverage through their employers, private health plans, the federal government, or the states. This plan builds on and improves our current insurance system, which most Americans continue to rely on, and creates a new public health plan for those currently without coverage.
Under my plan, Americans will be able to maintain their current coverage if they choose to, but for those without health insurance, I will establish a new public insurance program and provide subsidies to offer care for those who cannot afford insurance. My plan also includes a mandate that all children have healthcare coverage by expanding eligibility for the Medicaid and SCHIP programs. All employers will contribute toward health coverage for their employees or toward the cost of the public plan.
A typical family will save up to $2,500 each year under my plan. We will realize tremendous savings within the healthcare system by improving efficiency and quality and reducing wasted expenditures system-wide. Specifically, these savings will result from investments in health information technology, improvements in prevention and management of chronic conditions, increased insurance industry competition, reduced industry overhead, the provision of federal reinsurance for catastrophic coverage, and reduced spending on uncompensated care.
How do you see biotechnology improving healthcare and the development of new medicines?
Senator Clinton The biotechnology industry has already brought over 250 new medicines to market, and many more are under development. By taking advantage of advances in areas such as systems biology, genomics, and molecular diagnostics, the industry will be able to detect diseases earlier, reduce adverse side effects, and reduce the time and cost associated with clinical trials.
In order to insure that America maintains its biotech advantages, I will initiate an aggressive set of policies including increased funding at NIH, a permanent R&D tax credit, and a workable and balanced science-based pathway for FDA approval of follow-on biopharmaceuticals, which will encourage and reward innovation of new products, as it helps ensure competition.
The biotech industry will also improve healthcare and access to it through its ongoing commitment to international initiatives. I will support such efforts through incentives for biotech firms that develop new diagnostics, therapies, and vaccines to address unmet needs in global health as well as support thoughtfully structured “advance market commitments” for vaccines to prevent diseases of the poor such as TB and malaria.
Senator Obama As a result of biomedical research, the prevention, early detection, and treatment of diseases such as cancer and heart disease is better today than at any other time in history. I have consistently supported funding for the NIH and the NSF. I strongly support investments in biomedical and biotechnical research as well as medical education and training in health-related fields, because it provides the foundation for new therapies and diagnostics. I have been a champion of research in cancer, mental health, health disparities, global health, women and children’s health, as well as veterans’ healthcare.
As president, I will work to ensure that we invest in advanced biotechnical research to ensure we are exploring new medical treatments and that the U.S. leads the world in this type of innovation. My administration will ensure that we translate scientific progress into improved approaches to disease prevention, early detection, and therapy.
How much of an increase would you like to see in the federal budget for basic scientific research, and which areas of basic research would you specifically target?
Senator Clinton I intend to double research funding at the NIH, the NSF, the DOE’s Office of Science, the NIST, and the DOE over a 10-year period.
I believe that we also need to provide greater support for young researchers at the beginning of their career, increase our investment in high-risk, high-return research, and encourage multidisciplinary research and education. For example, by investing in research at the intersection of nanotechnology and biology, we may be able to develop smart anticancer therapeutics that can deliver drugs only to tumors while minimizing side effects.
Senator Obama I support doubling the federal basic scientific research budget, and I believe we should target investment to those areas that have lagged behind in annual funding increases in the congressional appropriations process.
Where do you stand on the issue of federal funding of embryonic stem cells for research and new drug development?
Senator Clinton I will lift the current ban on ethical stem cell research. In 2001, President Bush issued an executive order banning federal funding for some of the most promising avenues of stem cell research. Last year, he again vetoed legislation to open up new lines of embryonic stem cells for federal funding. Every day, we are learning more about the opportunities this kind of research offers.
Senator Obama Despite recent advances pointing to alternatives like adult stem cell and cord blood, embryonic stem cells remain unmatched in their potential for treatment of a wide variety of diseases and health conditions. I have been a long-term supporter of increased stem cell research. I introduced legislation while a member of the Illinois Senate that would allow embryonic stem cell research in Illinois. Additionally, I have cosponsored legislation to allow greater federal government funding on a wider array of stem cell lines.
Also, I believe we need high ethical standards that allow for research on stem cells derived from embryos produced for in vitro fertilization; embryos that would otherwise be needlessly destroyed.