The Alan Katz Health Care Reform Blog

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Posts Tagged ‘Health Affairs’

McCain and Obama Health Plans More Attitude Than Policy

Posted by Alan on September 16, 2008

Experts are weighing in on the health care reform proposals put forward by presidential candidates Senators John McCain and Barack Obama. That they’re finding them inadequate is not surprising. They are, after all, campaign promises, not legislation. Nonetheless, they offer an important glimpse into how the candidates approach the issue.

Most recently, the Health Affairs blog features an analysis of the McCain plan by professors at the University of Michigan and another on the Obama reform proposals by a authors affiliated with the American enterprise Institute, Project HOPE and a volunteer adviser to the McCain campaign.

The conclusion of each article is that each proposal is inadequate, too expensive (either for consumers or the government), and could do more harm than good. In other words, no surprises. What they fail to note is that the health care reform proposals, as they stand now, are more about attitude than policy. They do a much better job of outlining the preferences and approach of the candidates than they do in creating a workable structure to improve America’s health care system.

Senator McCain focuses on portability of coverage for those who have it; or Obama  on access. Senator McCain’s plan would cost far less than Senator Obama’s, although the Democrat’s plan would bring far more people into the system than the Republican’s.

What they tell us is that Senator McCain prefers solutions that empowers consumers to make their own health care decisions while Senator Obama is comfortable with a more forceful (some would say intrusive) role for the federal government. Interestingly, both are looking to chip away at the current employer-centric American health care system with Senator McCain shifting more toward individual coverage and Senator Obama introducing more government intervention.

There are some surprises in each plan. Senator McCain would allow carriers to seek approval of their plans in one state and sell them in others. Republicans usually support state rights yet this proposal would prevent a state from taking steps to protect their citizen’s interests regarding health care coverage. In fact, it would empower health insurance companies to shop the country for the most lenient regulators and regulations. Meanwhile, Senator Obama has repudiated advocates of his own party who call for a government-run, single payer health care system. This no doubt disappoints many of his most ardent supporters, including many of the unions supporting him, but it does recognize the reality that Americans are uncomfortable turning their health care over to the government.

Either Senator McCain or Senator Obama is going to be President of the United States in four months. Health care reform will be high on their “Things To Do” list. Voters should analyzetheir campaign promises, but need to take consider them in the context of reality. Attitude influences policy, but it’s not the same thing. The health care reform debate will be long and the compromises numerous. Neither candidate will be in a position to impose their reform plan on Congress. That’s a good thing.

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