The Democratic Race for President and Chronic Illness Care

The disease management care blog was trapped in airports over the weekend thanks to a vexing snow storm that snarled air traffic. The ubiquitous news monitors helped distract me from some of the misery thanks to slightly less miserable rebroadcasts of the recent Obama-Clinton debate.

So that readers of the disease management blog don’t need to subject themselves to the same drudgery, here is an efficiently recreated representative sample of what the candidates are a) saying and b) what we're hearing in this and other settings.

What they said:

Clinton: "This is a significant difference. You know, Senator Obama has said it's a philosophical difference. I think it's a substantive difference. He has a mandate for parents to be sure to ensure their children. I agree with that. I just know that if we don't go and require everyone to have health insurance, the health insurance industry will still game the system. Everyone of us with insurance will pay the hidden tax of approximately $900 a year to make up for the lack of insurance. And you know, in one of our earlier debates, John Edwards made a great point. It would be as though Social Security were voluntary. Medicare, one of the great accomplishments of President Johnson, was voluntary. I do not believe that is going to work. So it's not just a philosophical difference. You look at what will work and what will not work. If you do not have a plan that starts out attempting to achieve universal health care, you will be nibbled to death, and we will be back here with more and more people uninsured and rising costs."

Obama: Number one, understand that when Senator Clinton says a mandate, it's not a mandate on government to provide health insurance, it's a mandate on individuals to purchase it. And Senator Clinton is right; we have to find out what works. Now, Massachusetts has a mandate right now. They have exempted 20 percent of the uninsured because they have concluded that that 20 percent can't afford it. In some cases, there are people who are paying fines and still can't afford it, so now they're worse off than they were. They don't have health insurance and they're paying a fine. In order for you to force people to get health insurance, you've got to have a very harsh penalty, and Senator Clinton has said that we won't go after their wages. Now, this is a substantive difference. But understand that both of us seek to get universal health care. I have a substantive difference with Senator Clinton on how to get there.

What I heard:

Clinton: Obama you ignorant upstart blah blah Blah blah blah blah Blah Blah BLAH blah blah Blah blah mandated coverage blah Blah blah blah blah Blah Blah BLAH blah blah Blah I’ll print money if that’s what it takes to cover the chronic condition management programs blah Blah blah blah blah Blah Blah BLAH blah blah Blah blah blah blah Blah blah blah blah Blah Blah BLAH blah blah Blah blah blah blah Blah blah blah blah.

Obama: Hillary you slanderous has-been blah Blah blah blah blah Blah Blah BLAH blah blah Blah blah blah blah Blah blah I’ll print money if that’s what it takes to cover the chronic condition management programs blah Blah blah blah blah Blah Blah BLAH blah blah Blah blah blah blah Blah blah blah blah Blah Blah BLAH blah blah Blah no mandated coverage blah blah.