McCain’s Health Plan — “Feeding Health Care to the Big Dogs” Part Two
by Fred Fortin
John McCain is now the third candidate to announce that, if he were president, he would allow people to buy health insurance nationwide — Giuliani and Duncan Hunter (R-CA) being the other two — rather than “limiting them to in-state companies” and also permit people to buy insurance “through any organization or association they choose as well as through their employers or directly from an insurance company.” This approach would leapfrog individual state jurisdiction over health care when it comes to health insurance.
Well that makes the Wall Street Journal happy at least. The same-day editorial made that perfectly clear:
“One major difference among these front runners concerns insurance regulation, and here Mr. McCain comes out on top. Part of the reason coverage costs differ so sharply among states is because some have chosen to impose multiple rules and mandates. Mr. McCain would allow people to purchase policies across state lines, which is currently prohibited.”
I’ve argued before that nationalizing the private health insurance market place would be a big mistake. Such a policy would end up feeding health care to the big dogs — large national and multi-national corporations as well as deposit de facto control of health care into the hands of Washington. The impact would be to continue to distance and marginalize states and local communities from important decisions (and any levers of control they now have) that impact the quality of their everyday lives.
One point I did not mention in my previous post, however, is that the mandates and rules at the state level, that would be essentially trashed under such a scheme, are incredibly important. They level the competitive playing field, ensure financial responsibility and mandate (for the most part) that critical benefits — such as mental health, well child care and prenatal care, for example — are included in all policies. You may be able to buy all the cheap health insurance you want from some national company but what will you get? Not much I think. The simple and hard truth is that the health care we all want is inherently expensive. That is the nut we have to crack.
What’s interesting is how little public attention or controversy this fairly radical idea generates. Maybe we are so used to another big box coming into town and gutting the local countryside that we’re resigned to health care following the same dispiriting course.


