Trailhead: A campaign blog.

Swift Boat Watch: Health Care for America NOW!

See all Swift Boat Watch entries here.

Who They Are: Health Care for America Now

Purpose: To support quality, affordable health care for all Americans.

Director: The national campaign manager is Richard Hirsch, previously executive director of Citizen Action, an organization that helped the poor find insurance in New York state.

Funding: The organization has received a $10 million dollar grant from the Atlantic Philanthropies as well as $500,000 a piece from their 16 steering committee members, which include MoveOn.org, the Center for American Progress Action Fund, and the recently targeted community-organizing group ACORN.

Cost: $1 million, part of a larger $4.3 million dollar ad buy that will air similar ads against congressional candidates.

Where It Ran: The ad aired on national cable and major markets in Ohio for two weeks starting Oct. 8.

Claims: The ad is narrated by a woman with cancer who says that John McCain’s health care plan could cause 20 million people lose their employer-provided health insurance plans. Those with existing conditions like her, she says, would not be able to get a new plan.

Accuracy: John McCain’s health care plan would give families a $5,000 dollar tax refundable tax credit to purchase health insurance while reducing incentives that encourage employers to provide their employees with coverage. The main thrust of the ad – that 20 million people would lose their insurance if John McCain’s plan were instituted – is supported by a recent paper published in the journal Health Affairs and a follow-up report (PDF) by the Economic Policy Institute. These studies argue that, with fewer tax incentives, fewer businesses will offer insurance plans. The Commonwealth Fund has documented the difficulty of finding health care individually after losing an employer-sponsored plan and the Kaiser Family Foundation including in the case of breast-cancer survivors (PDF) and other individuals with pre-existing conditions. However, another recent study (PDF), by the health system consultant HSI, argued that McCain’s plan would in fact reduce the number of uninsured people by 20 million. And a Tax Policy Center report (PDF) lands in the middle, agreeing that McCain’s proposal would cause 20 million to lose or leave their employer-sponsored program but saying also that overall the proposal would decrease the number of uninsured by one million as 21 million bought non-employer-sponsored plans, including some of those who lost their employer-sponsored plans.

Factcheck.org has examined McCain’s proposal and found a consensus among health care experts that McCain’s proposal would most likely cause employers to reduce the coverage offered. Their report also stated that while some would benefit from the adjustment of incentives, the old and unhealthy would probably get the short end of the stick, as Jane Bryant Quinn argued in Newsweek.

Swift Boat Rating:
Several studies state that around 20 million people could lose their employer-sponsored coverage, though the ad doesn’t mention that many would likely get non-employer plans. That being said, many health care experts agree with the assertion that McCain’s plan would make it harder for people like the woman portrayed in the ad to secure health insurance.
Background: Health Care for America Now is a coalition of non-profits and public officials. Obama has signed their statement of principles.

Swift Boat Watch: Service Employees International Union

See all Swift Boat Watch entries here.

Who They Are: Service Employees International Union

Purpose:  To promote the interests and values of laborers. In this election, they support Barack Obama.

President: Andy Stern

Funding: According to FEC reports, a lot of funding comes from group employees themselves, including Anna Burger and Andy Stern, who each contribute around $300 a month. Other funding comes from the union's two million members.

Cost of the Ad: $1 million

Where It Ran: Pennsylvania and Wisconsin, Oct. 6 through Oct. 10, 2008.

Related Groups: To see SEIU connections, check out this graphic from the Center for Investigative Reporting.

Claims: John McCain's health care plan will raise taxes and deny coverage for pre-existing conditions such as cancer. McCain will also tax health benefits.

Accuracy: The nonpartisan Tax Policy Center found that McCain's health plan would not raise taxes for most families and that it would most negatively affect high-income earners. McCain's Web site states that those with pre-existing conditions will "get the high-quality coverage they need." But it doesn't say how that will happen. The McCain plan will encourage people to buy health insurance plans from private companies instead of through their employer, and these private companies would all have different rules about pre-existing conditions. McCain proposes a family tax credit of $5,000; the average cost of health care for a family of four was $12,100 in 2007. If an employee does not purchase an employer-sponsored health care plan, employers could opt to pay the health benefits—an average of $8,800—to the employee as wages. Families could use this extra income to make up the difference between the tax credit and insurance premium. But McCain would remove the tax exemption from this amount, which would then be taxed as income.

Background: SEIU has historically been one of the most active groups in presidential elections, and spent $12 million in 2004. According to the FEC, SEIU has spent nearly $20 million to support Obama and almost $2 million to oppose McCain as of Oct. 9.

Swift Boat Rating:

It's fair to say that McCain will tax health benefits, but the other two claims are a bit off. McCain's plan does not regulate private companies' stances on covering pre-existing conditions—it would leave that up to each individual company. Nor would his plan raise taxes for middle-class families—the $5,000 tax credit would be enough to subsidize the majority of health care plans.

Fudge Cycle

First, Dr. David Gratzer, the author of the City Journal article Giuliani drew the numbers from and an adviser to the Giuliani campaign, acknowledged that they were outdated and “crude.” Then his source for the numbers, a health research organization called The Commonwealth Fund, accused Gratzer of misusing the data. In other words, no one was willing to stand behind the numbers. Both the Washington Post’s Fact Checker and PolitiFact.com, two watchdogs for the lies, damned lies, and statistics of the 2008 presidential candidates, roundly rejected Rudy’s statement.

At the time, the Giuliani campaign itself issued a not-quite-defense of the statistic: “The citation is an article in a highly respected intellectual journal written by an expert at a highly respected think tank which the mayor read because he is an intellectually engaged human being.” But on Friday, Giuliani reiterated his support for the numbers as “absolutely accurate,” if a little dated: “Even if you want to quibble about the statistics, you find me the person who leaves the United States and goes to England for prostate cancer treatment, and I'd like to meet that person,” he said.

Rudy does have defenders other than himself. The Cato Institute’s Michael Tanner argues in National Review today that Giuliani’s numbers are problematic, but that his overall point stands. “Beyond the debate over numerical minutiae,” Tanner writes, “the basic fact is that Britain’s system of socialized medicine is bad for your health.”

But then why use such murky numbers? As Tanner himself notes, the stats on non-prostate cancers support his point much better. It illustrates a larger point about Giuliani that Slate’s John Dickerson has made before: that his greatest strength is his willingness to make highly questionable statements with utter conviction. It’s an approach that has gotten Rudy in trouble before, like when he said he’d pay for tax cuts with more tax cuts. But getting in trouble with fact-checkers is different from getting in trouble with Republican voters. From the perspective of the polls, what he says seems less important than how loudly and how often he says it.

Health Conscious

The politics of illness is particularly sensitive in this election, with so many candidates and their spouses battling one disease or another. Fred Thompson announced in April that he had been diagnosed with lymphoma but that the cancer was in remission. Before that, Elizabeth Edwards revealed that her cancer had returned but that her husband's campaign would continue. And now Rudy Giuliani, pushing his health-care plan in New Hampshire, is rolling out a new radio ad discussing his experience with prostate cancer, which he defeated in 2000.

"I had prostate cancer, five, six years ago," Giuliani says in the spot. "My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England, only 44 percent under socialized medicine."

It feels icky to discuss life-threatening illnesses in PR terms, but it's no accident that Rudy chose to weave his own story into his message about health care. We're used to seeing warrior Rudy, victory this and security that. We're not used to seeing vulnerable Rudy.

Of course, there's good vulnerable and there's bad vulnerable. In Thompson's case, people initially wondered if he would be able to launch his campaign. In Edwards' case, allies speculated that he would drop out. But Rudy's case is—forgive me for saying it—a good one, at least from the political angle. For one thing, he beat the cancer. (Look out, Islamofascism.) But more importantly, it softens him up. As Elizabeth Edwards might say, he has stared the worst in the face and not blinked.

This sort of human touch—candid without being cheesy—is just what Rudy needs. For him, religion is private, and the same seems to be true for other personal and emotional issues. But personal narratives matter to voters. We know he's willing to put people in a hospital. It's also good to know he's been there himself.