I've heard people say the McCain health care plan looks pretty good. It may look better than what we have now, but it's going to be an utter failure for anyone without a substantial income. Coupled with the disproportionate rise in premiums and inflation, even families with fairly substantial incomes will feel the sting within a year or two. In the short term McCain's plan is not unattractive, but that is all he cares about. He wants his ideas to look good right now so that he can become POTUS. After he's in the Oval Office there won't be any reason for him to be concerned about the long term consequences of his ideas.
This plan is okay in the short term, and horrible in the long run. I had not written about it before because there are just so many vacuous ideas to cover coming from McCain's campaign. After hearing a couple of Republicans, and one staunch Democrat, say good things about this health care plan, I decided my silence on the subject was counter productive. What follows is a list of links that reference the problems with McCain's health care plan, and his campaign's philosophy on it, along with synopses and relevant quotes from these articles.
Source Number One:
McCain's Radical Prescription by Faiz Shakir, Amanda Terkel, Satyam Khanna, Matt Corley, Ali Frick, Benjamin Armbruster, and Igor Volsky
I. Their Introduction:
McCain envisions a system where most Americans shop for health insurance on their own in a highly deregulated market, which would charge higher deductibles and co-payments and provides less coverage. Ultimately, McCain's vision places the 158 million Americans who receive their health care through their jobs in danger of losing coverage. McCain replaces the current tax breaks for employer-sponsored health insurance with a one-size-fits-all tax credit of $2,500 for individuals and $5,000 for families, equalizing the tax treatment of employer and individual plans and enticing healthy workers to buy cheaper but less substantive insurance in the individual market place. But the departure of healthy workers from employer insurance pools would drive up average health costs, forcing more workers to opt out entirely. The entire employer health insurance system could unravel, "ending this as an option for Americans who prefer it," as the Center for American Progress Action Fund noted. Among those who would lose their health care are fifty-six million Americans with pre-existing chronic health conditions. Thus, McCain, a cancer survivor, would be unlikely to get coverage under his own plan if he did not have government-provided insurance. The McCain plan offers a simple prescription for Americans: don't get sick.
II. The plan offers less coverage:
"Plans in the individual insurance market cost less but also cover less, and furthermore, provide inadequate safeguards against insurers who refuse to cover patients with pre-existing illnesses, deny coverage outright, or engage in other discriminatory practices." Why less coverage in the individual insurance market?
A. Some companies disqualify based on medication risks.
B. Sometimes because of dangerous professions.
C. Coverage is advertised as cheap, deceptively, and more coverage costs more.
D. Private market coverage not as well covered by state laws.
E. Long term conditions cause premiums to skyrocket in private market.
III. Increased Costs
A. The tax credit grows slower than inflation, costs more over time
B. $3.6 trillion in employer tax breaks would be redirected to individual tax
breaks, which the public still pays for that in the end.
C. The plan would generate $20 billion in new administrative costs, a 20
increase in administrative costs
D. McCain's plan allows insurance companies to ignore state regulations
IV. Most Needy People Left Uninsured
A. High risk pools would leave sickest Americans uninsured ($7-10 billion defrayed cost proposal inadequate)
B. High risk pools cost a fortune, and would simply not be funded
Source Number Two
Health Care Policy and Marketplace Review by Bob Laszewski:
However, the real question is, will McCain's plan give people enough to be able to afford health insurance? With the average cost of employer-provided family health insurance at $12,000 a year, a $5,000 tax credit will often come up way short—especially for higher age people and those who don't have the benefit of an employer contribution. High deductibles and HSA plans will help but families who don't have employer contributions should be prepared to pay at least a few thousand extra dollars.
and
If McCain were to be successful in moving the system from the employer to the individual with his individual tax credit proposals, the employer arguably would have a smaller incentive to continue providing these benefits. Many employers might simply say, "Here's the money I was paying—go find your own coverage." It may just be easier for the employer to drop the coverage and give the employee the cash value of the health benefits.
The employer would also have the new advantage of having the difference in wages go up each year by the wage rate while the employee saw his health care costs rise at the rate of health care inflation—which has averaged two to three times more.
McCain does not have a mandate to buy insurance for individuals or employers. So, people can still opt to go without coverage.
Again, the big question is how does McCain see his individual health insurance market working. How will he deal with age rating, medical underwriting, and pre-existing conditions? If McCain does not develop an individual health insurance market everyone can access, no matter how old or how sick they are, his plan will fall way short. He needs to detail his "risk adjustment bonus" scheme for older and higher cost families.
Three and Four (on ridiculous notions)
Who's Afraid of the Uninsured? by Ezra Klein and
Conservative Policy Advisor Steps In It On Health Care by DemfrcomCT
Both of these articles commented on the remarks of John Goodman, president of the National Center for Policy Analysis and one of the men responsible for crafting John McCain's health care plan.
Goodman:
Mr. Goodman, who helped craft Sen. John McCain's health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)
"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.
"So, there you have it. Voila! Problem solved."
Klein in response:
If you can't afford a doctor, but the census bureau stops describing you as uninsured, voila! Your problem is solved! And if you're getting your wages garnished because you fell ill and had to be rushed to the emergency room but the census bureau puts you in a different category, voila! You problem is solved! And if you have cancer, and you go to the ER, and they refer you to a hospital for scheduled treatment, and the hospital turns you away because you don't have insurance, I bet they can call John Goodman and, voila! Problem will be solved.
This is what we call a Kinsleyan gaffe: A mistake that reveals the truth. John McCain's health care plan is, by the admission of his own advisers, not particularly interested in the problem of the uninsured. It doesn't try and cover them or address their plight, and for a very simple reason: Conservatives in general are not interested in the problem of the uninsured. And why should they be? Health care is a market good, and not everyone can afford every market good, and if you distort the market thus to ensure universal access, you'll probably do more harm than good. There's even an "Anti-Universal Coverage Club" over at Cato for conservative brave enough to admit this truth. "To achieve 'universal coverage,'" they say, "would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention. In a free country, people should have the right to refuse health insurance.
DemfromCT:
U.S. hospital ERs overwhelmed, one-day study finds
The report from the House of Representatives Oversight and Government Reform Committee, released to coincide with a hearing on Monday, shows emergency rooms in Washington and Los Angeles operating over capacity on an ordinary day. None could have handled a surge of new patients.
But never mind all that. The idea that a stroke of a pen, an executive order, could in any way address the health care issues this country faces by reclassifying the problem away is the most remarkable piece of nonsense governing since George W. Bush was President.
Third Bush term, indeed. How on earth can we survive 4 more of the previous 8 years? Millions of Americans won't. And that is a national disgrace.
Number Five
McCain's Lies of Omission by Jason Rosenbaum
John McCain in Wisconsin, yesterday morning, September 19:
I'll give every family in America a $5000 refundable tax credit to buy their own health insurance policy and let them choose their own doctor. This will make insurance affordable to every American. We'll double the child exception from $3500 to $7000 to help families pay for the rising cost of living. Under my plan, a married couple with two children making $35,000 will get $5000 to pay for health insurance and additional medical expenses. This family would get another$1050 from my child exemption. That adds up to over $6000. That's a lot more than what any hard-working middle class family gets under the Obama plan.
Richard Kirsch, National Campaign Manager, Health Care for America Now, in response:
When the average family health insurance plan runs $12,000/year, how does Senator McCain suggest that family of four earning $35,000/year find $6,000 or $7,000? In addition, McCain’s assertion that his plan would let you choose your own doctor is a complete fabrication. Not only would his plan continue to let the insurance industry call the shots and limit your choice of doctors, but McCain’s inadequate tax credit would push people into bare bones plans with even more restrictions on whom they can or can’t see.
Senator McCain also plans to get rid of the exclusion for employer-based health coverage, shift the tax burden onto the employee, and eliminate state protections. How exactly does any of this make health insurance more affordable?
McCain’s health care plan is a sham. But he wouldn't understand that because he doesn’t have to navigate the independent, unregulated, bureaucratic insurance market.
See, Senator McCain enjoys the government health care he keeps attacking. He has coverage through the Veterans Administration, which is government run, socialized medicine. He’s covered under the Federal Employees Health Benefit System, which is government paid for, regulated private insurance. And as a senior citizen, Senator McCain is eligible for Medicare which is government health insurance. All these allow McCain to "see [his] doctor fairly frequently" as he told reporters in March.
And yet he believes none of these solutions are right for the rest of America, many of whom can’t afford to see their doctor at all.
Number Six
Note To CBS News: Yes, John McCain's Health Care Plan Does Raise Taxes by James Kvaal and Ben Furnas, senior fellow and research associate at the Center for American Progress Action Fund.
First, the McCain plan will eventually result in higher taxes on most households with health insurance through their jobs. That’s because the McCain tax credit will grow only with inflation. Current tax benefits grow with premiums, which increase three or four times faster than inflation.
Second, the McCain plan will result in higher taxes for some households right away. Families with higher incomes and more expensive insurance plans are most likely to get hit by higher taxes.
Third, the full impact of the McCain plan is difficult to calculate because the McCain campaign is trying to have it both ways on a critical question at the heart of his health care plan: whether it imposes payroll taxes (as well as income taxes) on health benefits.
As originally announced, McCain seemed to impose both income and payroll taxes on health benefits. That would mean that typical middle-class families would pay higher taxes within a year or two.
Now the McCain campaign is apparently saying that they will impose only income taxes on health benefits. If that’s right, then – as CBS reports – most families will see tax cuts in initially. However, because the credit would still quickly fall behind premiums, the plan would still increase taxes on most families eventually. Moreover, McCain’s would cost an additional $1.3 trillion — a massive cost which the McCain campaign has not acknowledged.
Making families pay more for their health care is not some accidental quirk due to the details of the McCain plan. It is a key part of the conservative ideology to shift costs onto families, which they believe will reduce wasteful health care spending. But it is more likely to leave families struggling with higher and higher health care costs and forced to skip care they need.
In Conclusion:
This entry represents my best effort on a Saturday morning to clarify exactly what John McCain's health care plan entails. I plan to cover the Democratic health care initiative in the same fashion, but not until next Saturday. I am hardly an authority on health care or insurance coverage. I do know, from what I've read, that there is nothing exciting about John McCain's proposal. In fact, it won't help people like me at all. I am certain there are better sources of information than the ones I have provided, but I did what I could with the resources at hand. I believe very strongly that Barack Obama intends to push through a health care plan that will be far superior to the Republican's ideas.
I have heard from members of my own family, my friends and people I care about that John McCain's health care plan doesn't look too bad. I believe it looks terrible. I would not have any form of health insurance under McCain's proposal. I have preexisting medical conditions coming out of my ears. I am self employed as a writer (that means broke most of the time), and disabled from multiple horrific injuries to my shoulders, knees and back. I could not maintain my silence on the subject any longer simply because I don't know that much about the topic. Here's what I know: McCain's plan would screw my chances of consistently receiving health care. That's the part that matters most to me, because I am selfish and I want to live a quality life, not just exist in misery.
Thank you very much for your time. I realize this is mostly all quotes, but that's the only way I could present it. I hope this helps somebody. I barely had an inkling of the details on this subject until I did the research this morning, and I am glad I did.
Happy Saturday.
Vote Obama!