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McCain’s Health Care Reform, Is it “Change” and Can it Work?

by Malorye Allison

It was the briefest mention possible, but at least John McCain did touch upon health care in his acceptance speech last night at the Republican National Convention.

McCain spent a bit more time bashing Obama’s approach then discussing his own: “My health care plan will make it easier for more Americans to find and keep good health care insurance. His plan will force small businesses to cut jobs, reduce wages, and force families into a government-run health care system where a bureaucrat stands between you and your doctor,” he said.

The “c” word was used liberally throughout his speech, such as when he declared that, “We need to change the way government does almost everything.”

At a glance, McCain’s health plan is indeed the more radical of the two, because he’s aiming to reform the tax code and his approach could impact the longstanding employer-based health insurance system. Currently, employers who pay for their workers’ health insurance can exclude every dollar of that from employee income and payroll taxes. This translates to a massive tax break for those workers.

MCain’s uniform tax credit system means everyone gets the same break – a $2,500 credit for individuals, and $5,000 per family.

So, the first question is, if McCain wins, can he possibly get support for this when the Democrats want something so very different? As, the ReformPlans Comparison Grid shows. the two candidates are at polar opposites on the specific steps to reform health care. Obama has shown some flexibility on how he approaches health care reform, but many of the Democratic lawmakers are still emphasizing the steady expansion of public programs. A significant number of those lawmakers would love to have a single-payer program.

Is compromise possible? Or under McCain, would we just see more of the same dreadful impasse?

Finally, neither McCain nor his rival has really explained how they are going to make health care more affordable for anyone – patients, employers, or the government.

Recently Aon Consulting Worldwide released data that health care costs will increase about 10.6 percent over the next 12 months. The good news was that this is the smallest increase in years. But the bad news is that there is rising evidence that we have squeezed most of the benefits out of all those little fixes – disease management, wellness, and generics drugs.
Meanwhile, growth in Medicaid costs is eating up state budgets.

Pretty soon, we need to address the root problems here. The U.S. health care system must be re-engineered so there is a real correlation between spending and value. Only someone brave enough to wrestle with that problem is going to have any effect.

Unfortunately, health care seems to be totally eclipsed by the economy and Iraq right now. We must hope that some of the rumblings from people like Senate Finance Committee Chairman Max Baucus and the Bipartisan Policy Center are signs of real determination to keep this issue alive.


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