ROCHESTER — Republican presidential candidate and former New York City Mayor Rudy Giuliani said health care costs can be brought down in the same way as the cost of electronics.
It would take more people opting out of employer-paid insurance, thereby forcing the insurance companies to come up with different products and allowing competition between companies nationally for the newly created market.
At a health care forum in Rochester Tuesday morning, Giuliani laid out his initial thinking on health care reform. The centerpiece was the ability to exclude $15,000 in income from taxation for any family — or $7,500 for any individual — who will pay their own health insurance costs.
"We have to change how we view health care in this country," Giuliani said. "We have to do it the American way — not the Canadian way or the English way or the French way or the Cuban way — and that is not a single-payer system that is government controlled."
The former New York City mayor said countries using single-payer systems are moving toward the American way of doing things because their health care systems "are cracking."
"In Canada what they have is a health care waiting system," he said, pointing to a situation in which a patient was put on a six-month waiting list for an MRI.
Giuliani repeatedly referred to the plans put forth by Democratic presidential contenders Hillary Clinton, Barack Obama and John Edwards as "socialized medicine." He also pulled out figures on survival rates for prostate cancer, a condition Giuliani had six years ago, as an indication of how ineffective the universal health care systems in other countries are.
While the five-year survival rate in the U.S. for that type of cancer is around 85 percent, he said, in France it is just above 62 percent and in England it is below 45 percent.
"I don't know about you, but I don't want a health care system where the survival rates are less than half," Giuliani said.
The only answer, the mayor said, is for Americans to create a large market of consumers who will purchase their own health care insurance specifically tailored to their needs. They will be able to use the tax savings he is proposing to help pay for that insurance.
Ultimately, Giuliani believes this large competitive market will drive down the cost of health insurance so that it is more affordable for the almost 45 million people without health care coverage.
"That's how market economics works; when you do it for yourself, it helps others," he said. "There is a calculation that happens in an American system and that calculation is that first you make a big profit on one sale, then you sell it for less to more people."
Giuliani also noted that personally purchased health insurance would be portable and tailored to fit individual needs. It would take about 20 million to 30 million Americans to withdraw from their employer-paid health insurance and purchase their own policies for there to be a marked decrease in health care costs for everyone, he said.
And instead of getting insurance that pays for everything, Giuliani anticipates that those who withdraw from employer-paid programs would choose plans that don't pay for every little thing and, therefore, cost less.
"That is what insurance is," Giuliani said. "Car insurance is really insurance, homeowner's insurance is really insurance.
"When you buy car insurance you don't expect it to pay for your oil changes," he said. "When you buy homeowner's insurance, you don't expect it to pay for every little repair."
Giuliani told the approximately 200 people who gathered to hear him speak in the Governor's Inn Tuesday, that he and his team are still working out the details of his health care plan and will come back with those details and cost justifications in about three or four months. The plan laid out in Rochester was simply a statement of the principles Giuliani stands by, he said.
"This is what I stand for," he said. "If you don't believe in something you can't lead.
"You've got to stand for something," said the former mayor. "I learned that from Ronald Reagan."