Giuliani wades deeper into healthcare policy

Rudy Giuliani expands the policy debate on the Republican side of the presidential race today, becoming the first major GOP contender to offer a detailed plan to address an issue that polls consistently show ranks high among voter concerns: healthcare.

As Newsday's Craig Gordon reported while on the trail with the former New York mayor Monday, the contours of Giuliani's proposal have been apparent, but the particulars will be provided as the candidate continues stumping in New Hampshire.

To varying degrees, the major Democratic candidates have been ahead of the Republican pack in offering specific ways they would attack healthcare problems, especially the complex challenges of controlling costs and providing insurance for the almost 45 million Americans who lack it.

In line with the parties' differing philosophies, the Democrats envision a more aggressive role for the federal government in pursuing these goals. Giuliani, in making the preliminary case Monday for his prescription, asserted that the way to repair the healthcare system "is by relying on American principles, not Cuban and European principles, like the Democrats want to do."

That, of course, overstates the distinctions while linking the Democrats to left-wing filmmaker Michael Moore, whose new documentary "Sicko" touts the quality and availability of medical services in Cuba. Giuliani's rhetoric notwithstanding, no Democrat is promoting "socialized" medicine as practiced by Fidel Castro's government.

A less partisan, more carefully calibrated overview of the basic differences between the Democratic and Republican approaches to the healthcare issue can be found in this recent column by The Times' Ron Brownstein.

Among the other top Republicans, John McCain has pledged to outline his healthcare plan later this summer. Fred Thompson, obviously, won't be detailing his thoughts on the subject until he finally officially enters the contest. Meanwhile, the most interesting waiting game on this front involves Mitt Romney.

Just last year, as his tenure as governor of Massachusetts neared an end, Romney significantly burnished his political credentials by presiding over passage of a sweeping, innovative law requiring all state residents to obtain health insurance. Those who can afford coverage and don't get it face penalties on their state income taxes. Those who need financial help to pay for insurance get it from the state, with the size of the subsidy determined by whether they are below or just above the federal poverty level.

The law did not require a tax increase and Romney sang its praises in a 2006 commentary piece in the Wall Street Journal that was headlined, "Health Care for Everyone? We've found a way." As a presidential candidate intent on wooing the GOP's conservative base, however, he has been reluctant to extol the legislation or offer it as the approach he would adopt as president.

-- Don Frederick