Most recently, it was Republican candidate Rudy Giuliani, who gave his inaugural health care remarks before a town-hall-style audience in New Hampshire late last month. He said he favors tax breaks—$15,000 for families, $7,500 for individuals, like the plan proposed by President Bush in January—to woo people away from their dependence on employer-sponsored health insurance and purchase insurance on their own. Giuliani asserts that if more people buy health insurance like they do consumer goods, the price of insurance will react to the demands of a marketplace and naturally come down.

Democratic candidates have made their own causes for changing the way employers provide health insurance.

John Edwards says he will require employers to pay the cost of health insurance for employees. Barack Obama talks about “requiring employers to make a meaningful contribution to the health coverage of their employees.”

So are all these candidates really going to upend the employer-sponsored health care system as we know it? Probably not, says Mark Schmitt, a senior fellow at the New America Foundation and writer for the left-leaning American Prospect magazine.

“We don’t have any reason to think this is the plan they’ll propose” if elected president, he says.

The rhetoric espoused these days is less an indication of how presidential politics will translate into presidential policy than it is a reflection of a candidate’s commitment to a cause.

That is why the Business Roundtable, a business lobby group whose members employ 10 million Americans, distributed a press release saying it “welcomes” Giuliani into the health care debate, even though the CEOs of the group’s member corporations—which include IBM, DuPont and Verizon Communications—are “committed to an employer-based system,” says Maria Ghazal, director of public policy for Business Roundtable.
 
More important, the group wants to make health care reform an issue that has significance after election night 2008, which is why the Business Roundtable makes the same statement whenever a presidential candidate gives policy points on health care.

“The bigger message we have is that if the candidates are focusing on and talking about health care and making sure they’re putting this at the forefront of a national debate, we’re happy to support them,” Ghazal says.

Gauging the depth of that focus—and the degree of momentum health care reform will have under a new administration—should be the focus of those policy papers, Schmitt says.

“Giuliani provided very little detail,” he says. “But he provided more than enough to make it clear he has no idea what he’s talking about.”

In a recent New York Times opinion piece, Schmitt argued that presidential candidates should not submit plans filled with policy points but instead should present their basic principles when it comes to health care and leave it at that.

“My position is, you don’t need much more detail than the kind of basic direction they’re going in and a sense of whether they get it or not,” he says.

—Jeremy Smerd