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Five candidates in the campaign for the Democratic Party's presidential nomination took the stage October 13. Here are five key takeaways.
Five candidates in the campaign for the Democratic Party's presidential nomination took the stage October 13 at the Wynn Las Vegas for the first Democratic debate of 2016.
Secretary Hillary Clinton, Bernie Sanders, Martin O'Malley, Jim Webb, and Lincoln Chafee shared their views on everything from healthcare reform to immigration.
To help you home in on some of the key takeaways from the debate, we asked several experts to weigh in. Here, they identify five important takeaways:
#1. All of the potential candidates indicated that they will defend Planned Parenthood and attempt to expand access to reproductive healthcare.
“Each candidate will fight Republicans' efforts to defund Planned Parenthood and instead will attempt to expand access to reproductive healthcare," says Joseph M. Mack, MPA, president, Joseph Mack & Associates, a managed care and value-based consultant.
Still, Mack says, "Bernie Sanders is the only candidate that has explicitly stated that he would nominate Supreme Court justices who support Roe v. Wade and the reproductive rights of women.”
#2. Support for the ACA is a given among the candidates.
“Healthcare was almost nowhere to be found in the Democratic debate,” says Sally Poblete, health insurance expert and CEO of Wellthie, a technology company that helps consumers make health insurance decisions. “The lack of discussion regarding the ACA leaves the impression that it’s not a big issue that needs to be fixed or addressed. With a Democratic president, the ACA is here to stay. This should come as no surprise since all five candidates on stage either supported or voted in favor of the ACA’s passage.”
Mack says: “About the only time healthcare was mentioned during the debate was while discussing gun control. All candidates said that more should be done to support mental health so that mentally ill people cannot purchase firearms.”
#3. Candidates expressed support for expanding healthcare access to immigrants.
“The singular issue in which healthcare access was addressed during the debate was during a discussion on immigration reform,” Poblete says. “Hillary was more cautious about offering access to undocumented immigrants whereas Sanders was more supportive.”
#4. Healthcare access and quality emerged as key issues.
It became clear during the debate that each candidate desires to expand access to healthcare services including in rural areas, to require creation of and compliance with various quality standards and to continue the push toward value-based healthcare.
For payers and providers, that means if a democratic president is elected, there will be a continued shift away from fee-for-service to value based care and some type of bundled payment, says Mack.
"Expect to see continued experimentation of commercial ACOs, or private exchanges in which self-insured employers, including hospitals, create their own HMOs and/or partner with national insurers to control the defined contribution costs of insurance," he says. "... The challenge for insurers, and particularly for providers is true cost reduction rather than merely shifting of risk from employers and/or providers to insurers with larger risk pools, and increased value to consumers."
Still, Mack says, questions remain regarding exactly how each candidate would continue the push toward quality. "While each candidate supports using the ACA as a platform for expansion, little is known about how candidates will encourage health innovation and entrepreneurship, and reward value and quality other than that Hillary Clinton and Martin O’Malley have supported various forms of 'report cards' and use of information to measure quality,” he says.
#5. Big pharma may be next target.
On the foot of major stories about pharmaceutical price gauging, Clinton mentioned pharmaceutical companies as an enemy, which Sanders enthusiastically supported by highlighting the power that drug companies currently possess, says Poblete.
Mack expects that, if a Democratic president is elected, he or she would push for more government action to control pharmaceutical prices. He adds that recent polling shows voters’ top health policy priority is expensive prescription drugs.
“All candidates have indicated their desires to reduce prescription drug prices, increase transparency of pricing, increase the cost-effective use of generics, import lower cost drugs from Canada and allow Medicare to negotiate drug prices with pharmaceutical companies,” he says. “Hillary Clinton’s proposals include limiting consumers’ out-of-pocket costs for prescription drugs to $250 a month, or $3,000 a year, and eliminating tax breaks for drug advertising aimed at consumers. Bernie Sanders would require drug companies to publish the portion of their drug development expenses offset by tax credits or paid for by federal grants. Expect intense lobbying against these proposals and opposition by Republicans.”