McCain's Healthcare Plan: More Of The Same, Boring Stuff
by nycweboy1, Tue Apr 29, 2008 at 07:48:41 PM EDT
I had a chance this morning to catch part of John McCain's speech in Tampa, while getting the family car checked out, and posted this originally on my blog while watching. I've written a lot about health care since I began blogging, partly because I worked for a time in medical advertising, and partly because of the experience I had growing up with my Mom, a healthcare educator with considerable depth of knowledge in the field. I encourage anyone looking to find out more about the proposal to click on the various links, which provide a wealth of additional detail and data.
McCain has clearly learned something about the rhetoric of the healthcare debate; to his credit he did a compelling job laying out the problem - he was more frank than I've seen Republicans be about admitting that the uninsured are a real and significant problem (the right has wasted a lot of energy disputing the notions of 47 million uninsured, trying to blame the lion's share on illegal immigration and temporary unemployment, to no avail). He also emphasized - just as rightly - the challenges of rising costs and access to healthcare, and how insurance serves as the way into the system, which hurts people without coverage.
Which is what makes his proposed "solution" so ludicrous.
I was actually worried, as he laid out the problem, that McCain had actually had a "come to Jesus" moment during his time off and moderated his initial proposal, made months ago. I needn't have worried: McCain is still pushing the notion of some combination of increased health savings accounts and tax credits to individuals ($2,500 to individuals, $5,000 to families) as a means to reduce costs of insurance. This, he says, will stimulate such a level of increased competition for coverage, that insurance costs will drop, and everyone, like magic, will be insured.
Let's just steamroll through this, shall we? Here's what's wrong with the proposal:
- It's not true. Pretty much every analysis of tax relief plans says that few people will really buy insurance because of it.
- It's not true. There's nothing to suggest that $2,500 or $5,000 for families would remotely cover the actual cost of insurance.
- It's not true. The plan does nothing to control actual health care costs, which McCain himself now says is the biggest problem our system faces. It's also not true that insurance will guarantee access, as high deductible, low cost plans with catastrophic coverage caps will probably leave people as bad or worse off than they'd be without.
- It's not true. Health Savings Accounts do not, as McCain claims, increase customer awareness, understanding, or choice. Armed with a portion of their income (hint: that's reducing take home pay) to spend only on healthcare, people mostly try to get by on as little as possible, and still lack the information needed to really make informed choices.
- It's not true. None of this, ultimately, solves a problem that McCain himself touched on only briefly: the notion that these limited insurance products bought in the individual market could remotely cover the "incredible, innovative technology" that McCain says is the hallmark of our system. It's the very existence of these high end, super expensive, often experimental technologies that we have a system where costs are so out of line. And until we can manage expectations better, Americans remain convinced that somehow any procedure, no matter how expensive, should be available to them.
- It's not true. Perhaps the biggest lie, though, is McCain's claim that employer based plans would "largely" be unaffected by his tax proposal; in fact, the plan significantly reduces tax coverage for so-called "gold plated" plans for executives, and that, combined with rising insurance costs for most employers, would drive employers out of insurance at a faster rate than they have been in the past few years.
The point, though, is that this is the real definition of boring: McCain's plan was pretty much DOA when he proposed it, and it's just deader when he repeats it: if McCain plans to lay out the problem as well as he did today, then more than a few people will notice... his plan doesn't actually address the problems he brings up. Moreover, talking about this really only helps Democrats, who've made healthcare a far more central component of the election debate, and have more credibility on the topic. McCain is bucking almost all of the right to pull this issue to the fore, when many conservatives would say there's not a problem... or at least not one that government can solve.