Obama, McCain Shift The Health Care Debate

(National Review Online)  This column was written by Michael Tanner.

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For some time now, the debate over how best to reform the American health-care system has been dominated by the question of "universal coverage," how to provide health insurance to those without it. That remains the battle cry of Sen. Hillary Clinton, who promises to provide "health insurance for every single American."

However, if John McCain and Barack Obama become the candidates for president this fall, we may see a subtle but useful shift that could actually lead to improving how health care is provided in this country. Both McCain and Obama recognize that the key question in health-care reform is not coverage, but cost.

Clinton and Obama have clashed over the question of an individual mandate (requiring every American to purchase insurance). Hillary supports such a mandate, claiming that it's the only way to ensure universal coverage. Obama opposes one, arguing that "the reason people don't have health insurance is not because they don't want it, it's because they can't afford it." Instead of a mandate, therefore, Obama would focus on a combination of cost cutting and subsidies to reduce the price of insurance. While he believes that his proposal would greatly increase the number of Americans with insurance, he admits it will fall short of 100-percent coverage.

John McCain also steers clear of attempts at universal coverage. "Bringing costs under control is the only way to stop the erosion of affordable health insurance," McCain says on his website. A McCain spokesman adds, "You worry about the uninsured, but they are a symptom of a larger problem. Unless you do something about cost, you are chasing your proverbial tail."

Obama and McCain are reflecting a growing consensus among health-care experts that the continued growth of health-care spending is unsustainable and that something must be done to bring costs under control. The United States spends roughly 17 percent of its Gross Domestic Product on health care, far more than any other country, and that is projected to rise to 20 percent of GDP by 2015. While that spending has undoubtedly helped buy the highest quality health care in the world, the distribution of costs has clearly made care unaffordable for many businesses and individuals. Nor should we forget that the skyrocketing cost of government health-care programs like Medicare and Medicaid is threatening to bury our children under a mountain of debt and taxes.

That is not to say that Obama and McCain agree on how to reduce health-care costs. Obama would rely much more on the heavy hand of government. Among other things, he would impose caps on insurance premiums and price controls on drug companies. He would have the government establish national practice standards for doctors. And, he would create a National Health Insurance Exchange as a sort of clearinghouse to make it easier for businesses and individuals to shop for the best insurance.

McCain, in contrast, would attempt to promote greater competition among private health insurers. He would allow people to buy insurance plans across state lines, which will help drive down rates. And he would try to shift away from our current employment-based insurance system toward a system where individuals purchase and own their own insurance plans. He would do this by replacing the current tax break for employer-provided insurance with a refundable $2,500 tax credit for individuals, and $5,000 for families. The idea is that once people start to buy their own insurance, they'll be in a position to insist on lower prices and higher quality - just as they do with every other product they buy.

Both Obama and McCain would take other steps as well, including encouraging greater use of generic drugs, promoting the use of electronic medical records, emphasizing prevention, and providing incentives for more integrated medicine - treating illnesses rather than symptoms. Studies suggest, however, that savings from these proposals may be less than either candidate has hoped.

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Candidates' Health Care Proposals
WebMD Details The Health Care Proposals Of The Presidential Candidates

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Overall, McCain has the better proposal. Obama's plan, with its heavy reliance on government, leads to the same problems that bedevil universal healthcare systems all over the world: limited patient choices and rationed care. McCain's proposal is much more consumer centered and taps into the best aspects of the free market.

But regardless of who becomes president, we can expect major changes for the American health-care system. And it's a good sign that we're beginning to debate the right things.
By Michael Tanner
Reprinted with permission from National Review Online

[willbarefoot]

If either plan is going to work they are going to have to address the following issues.
1) People with existing health problems have difficulty buying insurance at any price.
2) As people age the premiums become too expensive to afford.
3) Government mandates such as putting mental health coverage on an equal footing with other health care benefits increases the cost for everyone.
4) The health care industry competes for patients on the basis of comfort and convenience which often raises the price.

[rowdytexan2]

A universal health care plan is going to have to be mandated one way or another. And EVERYBODY is going to have to share in the cost of it, just as everybody has to share in the cost of the auto insurance mandate.

The ticker on this one is implementing regulation of the insurance industry''s profiteering off the suffering of American citizens and bringing health care to costs and salaries. That''s why they need to just get insurance companies out of the picture and develop a national health trust. But of course when that was tried in the 90''s the republicans blocked all avenues of funding it, and cried socialism, socialism! And the gullible public bought it.

[rowdytexan2]

First of all, it is really humorous that they''re presenting this like it''s going to be a battle only between Obama and McCain since Mr. Obama is not the candidate yet.

The second irony of this article is that in the first debate, Hillary Clinton was the one who addressed the cost of health care and stated that the cost should be regulated so people could afford it.

McCain and Obama are in fact several months behind Hillary on this issue.

[liny516]

First, thank you CBS for sticking to the issues that America really cares about in this campaign. Continue to put out these type stories.

Second, the two candidates have different positions that americans should examine and determine what best fits their lifestyle. This is what they should base their votes on, not race, ***, or religion.

[Marie Zarankevich]

The health care and housing markets are showing us that our "Thing" is about to fall apart. Simple greed has taken us to our knees. The rich get richer, and the poor now just die in the emergency room, waiting for an intake nurse. Will we understand the dynamics when nobody can afford a place to live who doesn''t already own their own island? What planet are they planning to take all their wealth to, when this one dies? Shame on everybody.

[usa_911]

Thank you for another corporate biased article, designed to guide people to McCain in November. It is all encapsulated in the second to last paragraph, where Obama''s plan relies "heavily on government" (which we have all been convinced by the media is a bad idea), and leads to "problems" just like those bad national health care systems in Europe and Canada.
And then finally the "limited choices" and "rationed care" fraud. We have both limited choices and rationed care now with our corrupt insurance system. Only now over 47 million citizens of our "democratic" nation are rationed out of the system entirely.
And the band plays on...

[clifden6]

Senator Obama''s approach may appear heavy handed in dealing with the US private sector health care system, but how else to deal with a greedy, maximum profit, minimum medical care private sector approach. They need shock treatment like Senator Obama''s approach,basically give them a deal they can''t refuse.

Obama would rely much more on the heavy hand of government. Among other things, he would impose caps on insurance premiums and price controls on drug companies. He would have the government establish national practice standards for doctors. And, he would create a National Health Insurance Exchange as a sort of clearinghouse to make it easier for businesses and individuals to shop for the best insurance.

[clifden6]

This is one example where a government, the French government is outperforming the US private sector.
HEALTH CARE UNDER FRENCH NATIONAL HEALTH INSURANCE
The United States has traditionally looked to the United Kingdom, its cultural parent, when studying alternative social and political models. Health care is no exception.The French health system is a model no less worthy of study than the British, Canadian, or German systems. Fee-for-service reimbursement, total freedom of provider choice, an important private forprofit hospital sector, and patient copayments exemplify a principle of "liberalism" that some Americans find missing in the British and Canadian systems.However, a principle of "solidarity" nourishes a national health insurance system that provides nearly universal coverage, and stringent government price controls keep price levels well below those of the United States.There are four major differences between the two systems (US vs. France): the French system covers more than 99 percent of the population; the prices of health services in France are lower than in the United States; the volume of most services is higher than in the United States; and French health care spending per capita is lower than in the United States.

[confused101a]

Posted by brianbwb at 04:33 AM : Mar 14, 2008
Because they cannot do worse than the corrupt private sector, and if they do, at least we can hold them personally responsible with their jobs, because we can control the money trail.
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Posted by random_radar at 01:52 PM : Mar 13, 2008
Why do people think the government will provide better health care at lower cost? The government never does anything better at a lower cost. It just forces you to pay for the lousy job it does.
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ainttaken & brianbwb you are both wrong. random_radar understands that you can not control Congress, and they can''t control anything.

[brianbwb-2009]

"Why do people think the government will provide better health care at lower cost?" Posted by random_radar

Because they cannot do worse than the corrupt private sector, and if they do, at least we can hold them personally responsible with their jobs, because we can control the money trail.