In the primary elections for governor, abortion seemed the defining issue between Democrats Stewart Hanson and Pat Shea, education reform a key difference between Republicans Mike Leavitt and Richard Eyre.
Now in the early stages of the final match-up between Hanson, Leavitt and Independent Party candidate Merrill Cook, health-care reform is emerging as an issue that clearly sets the candidates apart.Cook, who in previous campaigns for public office pushed for less government, says Utah has a unique opportunity to solve its own health-care crisis. And he suggests, as a trial, expanding the state's Workers Compensation Fund into a health insurance fund to cover, on a voluntary basis, all the small businesses and their employees who want to join.
It would be a major step in health insurance reform, inserting the state government into the process that now is either handled by the federal government via Medicare or Medicaid or by private insurance companies.
Leavitt is vehemently against it, saying there's no way he as governor would do such a thing. Leavitt prefers a private enterprise solution, saying if elected he'd get all the sectors of the problem together - insurance companies, hospitals, doctors, malpractice attorneys and patients - to work out compromises and other agreements. "In my campaign I have not attempted to develop the comprehensive health-care program Utah needs," says Leavitt. At this time, he says he "doesn't have the knowledge and expertise to do so." Although he pledges to do it once in office and after further study.
Hanson says he also would wait until he's in office to put together a plan that would cover everyone not currently covered by health insurance, a plan that would control costs, let patients choose their primary care physician, emphasize preventive medicine and make sure coverage is portable from one job to the next. Hanson doesn't specifically say, as Cook does, how he'd accomplish this, although he has an eight-page position paper that outlines the problems and areas he wants covered in a state plan.
While Hanson is involved in the debate, the real battle over health care is shaping up between Leavitt and Cook.
Leavitt is an insurance executive, CEO of the family business, the Leavitt Group, which owns 35 agencies throughout the Mountain West.
Cook is already running TV commercials criticizing Leavitt's insurance ties, saying you can't expect a man who has accepted campaign contributions of at least $70,000 from insurance interests (Leavitt disputes the amount) and is an insurance company owner himself to objectively reform the health insurance industry.
Cook says Leavitt's "insurance company-based" solution "is nothing more than a continued subsidy of the insurance industry . . . that just pours more dollars down a flawed system. It's a bonanza for the insurance industry that is pouring a fortune into Leavitt's campaign."
Leavitt says Cook's health insurance fund is akin to socialized medicine, a system that will collapse under increased claims and no accountability, a system "that could bring this state and its taxpayers to their knees."
Hogwash, says Cook. Yes, it's new, but not experimental. If his health fund works on a voluntary basis - and he believes it will - controlling costs and providing at least minimal coverage, then it could be expanded to a mandatory pay-or-play type of system where businesses would pay 5 percent of payroll into the fund. It is a system that is working well in Hawaii today, says Cook. "In Hawaii, health-care costs are 8 percent of income, where in Utah they are 11 percent." Under pay-or-play, small businesses that don't now provide private health insurance to employees must either do so or pay into the state's fund, from which the employees would then be covered.
Cook says that Oregon, Wisconsin and Minnesota also have state health insurance plans, all a bit different, that are working.
The only thing that all three candidates agree on is that Utah has to solve its own health-care problem. If not, the federal government will step in sooner or later with some kind of mandatory system.
"I think I can get all these groups together," says Leavitt. "Because they will be looking over their shoulders down the track and see the (federal) train coming, they all will be willing to give a bit to reach a good solution."
In the GOP primary, Leavitt was apparently able to convince voters that Richard Eyre's education voucher system - where parents would get a voucher that could be spent in any public school - was dangerous to public education, an unproven idea that could harm schools. Now with Cook on the other side of the health-care reform issue, there is a defining issue in the final race as well. Time will tell on which side of the issue voters will fall.