[Vision2020] Obama's Health Plan Works in the Bay State; McCain's is a Disaster

[nickgier at adelphia.net]

Good Morning Visionaries:

This was my radio commentary for KRFP yesterday, and it will appear in The Idaho State Journal this Saturday.  McCain can't really be serious about this health plan.

I'm voting for Obama because he is a pragmatist.  A left-wing ideologue would simply shut down the insurance companies, which incur three to five times the administrative costs of Medicare.

McCain supports ideologically based positions on foreign policy, the economy, abortion, and health care without regard for the consequences.  All it takes is for someone to cry “socialized medicine,” and meaningful health care reform goes down the tubes.  Let’s hope that the American electorate is wiser this time.

Even though Mitt Romney was the governor who proposed the Massachusetts plan, he conveniently returned to GOP ideology when running for president.  In a recent Wall Street Journal op-ed, Romney is again taking credit for his original pragmatism on health reform.

Nick Gier

See also my column "America's Health Care is a National Disgrace and an International Embarrassment" at www.home.roadrunner.com/~nickgier/health.htm.

OBAMA’S HEALTH PLAN WORKS IN THE BAY STATE;
MCCAIN’S WOULD BE A DISASTER

By Nick Gier

Massachusetts’ health care reforms are working well, and except for its mandate of universal coverage, they are almost identical to Obama’s plan.  During the past two years, the Bay State has reduced the number of its uninsured by two thirds and has cut its ER costs by $72 million.  The average total cost per person has been less than predicted.

Because health insurance is mandated for all (Obama would require it only for children), 40 percent of the newly insured in Massachusetts have, without state subsidy, bought coverage from their employers.  It is really is a no brainer: universal coverage reduces the health costs for every individual.

Following Massachusetts, Obama would set up a national health insurance exchange where small businesses and individuals would save money by pooling their numbers. Obama would also provide more money for Medicaid and the Children’s Health Insurance Program, the expansion of which McCain recently voted against.

Under Obama’s plan, people would continue with their current insurance plans, and, if they change jobs, they would be guaranteed portability and coverage for pre-existing conditions.  The uninsured would be given income based subsidies to buy private insurance, or they would join a national plan based on an extension of Medicare.

Obama would mandate that all companies offer their workers health coverage, but small businesses, depending on their size, would be exempt or would get tax credits for up to 50 percent of premiums paid.  Big companies that do not offer coverage would pay a payroll tax to finance the extended Medicare program.

While Obama would keep the employer-based system in place, McCain would dramatically weaken, if not destroy, employer plans by taxing employee premiums, which have been tax-free since the 1950s.  This would trigger a huge tax hike and generate $360 billion in revenue per year.

McCain's plan would return all this money as tax credits so that people can buy private insurance on the open market. Single individuals would get $2,500 each and families would receive $5,000.  The cost to the U. S. treasury, using 134.2 million as an estimated number of 2008 tax returns, would be $509 billion. 

In addition to the extra $149 billion needed to fund McCain's tax credits, families would still have to come up with the difference between the $5,000 they receive and the average $13,000 that families pay for private insurance. 

McCain claims that he is offering Americans “more choice,” but there will be far fewer options, other than the emergency room, for those who are poor and sick.  There are actually more choices in Obama’s plan, which he says will cost $50-65 billion a year (critics say $200 billion), but it will cover tens of millions more at a high level of care.

McCain's quips that a government bureaucrat will control your health care under Obama, but complicated federal rules will be needed to prevent you from using the tax credit for other purposes.  McCain taxes Americans at a tune of $360 billion, but he gets meager results from using an unregulated insurance industry that denies care to many people,and incurs administrative costs three to five times higher than Medicare.  

McCain would also allow insurance companies to sell policies across state lines.  Without the minimal state insurance requirements that Obama would put in place, these companies would flock, just as companies do when they register their ships in Liberia, to states with the worst medical consumer protection. Furthermore, healthy people will buy out-of-state plans at reduced rates, leaving large state insurance pools with less healthy populations.

McCain’s plan would not force insurance providers to accept pre-existing conditions.  McCain has had several bouts of melanoma, so how would he fare if he were forced out into the private market for health care?  

McCain does propose a "guaranteed access plan" based on programs now operating in 34 states.  But as health care expert Jonathan Oberlander observes: "State high-risk pools ironically suffer from the same problems: high costs, limited benefits, and pre-existing conditions exclusions."

Perhaps McCain realizes that his health care plan will not make it through a Democratically controlled Congress, so he offers a wild free-market plan to please the GOP party faithful.  McCain's would obviously not improve access to quality medical for millions of Americans, nor would it change our standing last among the civilized nations of the world.

A main source of information was Jonathan Overlander, "The Partisan Divide—The McCain and Obama Plans for U.S. Health Care Reform," The New England Journal of Medicine (Aug. 21, 2008).