As can be seen throughout the media and on a growing number of blogs, the Democratic candidates' health plans is drawing a lot of attention. There is, however, one word that is drawing this attention more than anything else - "Universal". The meaning of the word, in this usage, is to mean that everyone will be covered. However, both candidates miss that mark and instead redefine it in significantly different ways.
Going back over the basics of their plans they are very similar: Both want to offer plans similar to the Congressional insurance plan (no specific information found about the coverages). Both want to expand Medicaid and SCHIP. They will both give subsidies and tax credits to help people afford the premiums. And both will force the removal of "pre-existing condition" clauses. These plans are an attempt to make insurance coverage more affordable and available to everyone.
Unfortunately, because insurance companies are for-profit and beholden to their stock holders to keep increasing those profits, these plans will never push the citizen payout to zero (at least not without bankrupting the government [further] and making it a short lived program). This means that there will be those who: can't afford one more bill, don't believe that the insurance companies that have screwed so many people over time and time again deserve their hard earned money, or are healthy and never see a doctor anyway who don't think they need to pay for health care when they can buy something they want/need. These people will not automatically be covered under the cores of these candidates' plans.
This is where Barack Obama has chosen to redefine "universal" to mean "universally available". He has said that he will make it affordable enough that anyone who wants insurance can get it easily. To make it even easier, he intends to set up a national institution to allow people to compare coverage side by side and get the plan that best suits their needs, if any. But he does not provide insurance to everyone. He has said in debates, speeches, and interviews that he doesn't want to fine people who can't afford it. And when someone uninsured does show up at a hospital or doctor's office needing care, they will likely face fines or have to pay back premiums - to keep everyone else's premiums down.
Hillary Clinton, however, does go another step. She believes that in order for her plan to be "universal", everyone has to pay for an insurance plan. This is how she changes "universal" to "universally enforced". She as yet has not explained how this will be enforced, but if her interview with George Stephanopoulos is any indication, if someone doesn't choose their own plan, one that matches the premium the government believes they can afford will be chosen for them and they will have to pay for it (either through garnished wages as former Senator Edwards proposed or fines/taxes - again, a very vague, dodgy answer).
Unfortunately, both candidates miss the real problem - although Obama comes closer in some of his related proposals (see the Providers heading on my previously linked chart). The problem isn't just getting insurance. I have insurance, and half the time I feel I would be better off without it. The problem is quality of insurance. It's all well and good for me to be able to say I have insurance, but if my deductible is $2,000+, I'm still bankrupt at my first medical emergency.
Just to throw some real numbers in here, lets say my premium is $200 per month (lower than what I expect the lowest rate they will get for middle income earners) and the limit of my health care needs is going to see a doctor once a year for an annual physical. I just wrote a check for $2,400 to an insurance provider (plus $20 to my doctor, who gets maybe $50-$100 more from the insurance company). Now, taking the long view, that $2,300+ is supposed to go to help Joe down the street when he is diagnosed with cancer and has to get treatment, but 1) there are, roughly 250 more "me"s than there are Joes (otherwise this would be an idiotic business model), and 2) Joe's coverage has an upper limit of (for the sake of argument) $500,000, even though his treatment is going to cost $1,000,000.
No matter which candidate wins the debate over this, who do you think is the real winner?
P.S. Don't even get me started on the Republicans' "plans"