McCain's Approach To Health-Care Reform

Candidate Writes In National Review Online That Restoring Control To Patients Better Solution Than Democrats' Plans

(National Review Online)  This column was written by presidential candidate, Senator John McCain R-Ariz..

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What exactly is the problem with the American health-care system?

The problem is not that Americans don’t have fine doctors, medical technology, and treatments. American medicine is the envy of the world. The problem is not that most Americans lack adequate health insurance. The vast majority of Americans have private insurance, and our government spends many billions each year to provide even more.

The biggest problem with the American health-care system is one of cost and access, and as a result tens of millions of individuals have no insurance. For example, we currently spend for about 2.4 trillion dollars a year on health care. A decade from now that number, under current projections, will double to over four trillion dollars.

The Barack Obama and Hillary Clinton response to these problems is to promise universal coverage, whatever its cost, and the massive tax increases, mandates, and government regulation that it imposes. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We’ll have all the problems, and more, of private health care - rigid rules, long waits, and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

I have a different approach. I believe the key to real reform is to restore control over our health-care system to the patients themselves. To that end, my reforms are built on the pursuit of three goals: paying only for quality medical care, having insurance choices that are diverse and responsive to individual needs, and restoring our sense of personal responsibility.

American families know quality when they see it, so their dollars should be in their hands. When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices. Health Savings Accounts are tax-preferred accounts used to pay insurance premiums and other health costs. They put the family in charge of what they pay for, and should be expanded and encouraged.

Americans also need new choices beyond those offered in employment-based coverage. They want a reformed system so that wherever you go and wherever you work, your health plan goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn’t cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. And if a church or professional organization wishes to sponsor insurance for its members, they should be able to do so. The bottom line: Health insurance would be yours and your family’s health-care plan to keep without worrying that it will go away along with your job.

The value of that credit - 2,500 dollars for individuals, 5,000 dollars for families - would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost. Again, choice and competition are indispensible to real reform that brings costs down and broadens access while maintaining quality.

But we also need to ensure that those without prior group coverage and with preexisting conditions, who have the most difficulty in the individual market, have access to the high-quality coverage they need. As with other problems our nation has faced, states have taken the lead in experimenting with ways to cover the “uninsurables” and give us a window into what works and what doesn’t work. I will consult with the governors to solicit their ideas about a best practice model that states can follow - a Guaranteed Access Plan or GAP - and work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs. The details of a Guaranteed Access Plan would be worked out with the collaboration and consent of the states that wish to participate.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. Right now, there is a different health-insurance market for every state. Each one has its own rules and restrictions, and often guarantees inadequate competition among insurance companies. Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it. We need to break down these barriers to competition, innovation and excellence, with the goal of establishing a national market to make the best practices and lowest prices available to every person in every state.

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in web technology to allow a doctor to practice across state lines, then let them.

Effective reform must also deal with another source of needless cost and trouble in the health care system which comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform, and those reforms should eliminate lawsuits directed at doctors who follow clinical guidelines and adhere to patient safety protocols. If Sen. Obama and Sen. Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers. They can’t have it both ways.

Finally, we must personally do everything we can to prevent expensive, chronic diseases. Our rights in this country are protected by our personal sense of responsibility for our own well being. Cases of diabetes are going up, not only in the baby-boom generation, but among younger Americans obesity, diabetes, and high blood pressure are all on the rise. Parents must impart to their children a sense of personal responsibility for their health, nutrition, and exercise.

We can build a health care system that is more responsive to our needs and is delivered to more people at lower cost. The “solution,” my friends, isn’t a one-size-fits-all-big government takeover of health care. It resides where every important social advance has always resided - with the American people themselves, with well-informed American families, making practical decisions to address their imperatives for better health and more secure prosperity.

[samthetvcat]

-----"I have a different approach. I believe the key to real reform is to restore control over our health-care system to the patients themselves. To that end, my reforms are built on the pursuit of three goals: paying only for quality medical care, having insurance choices that are diverse and responsive to individual needs, and restoring our sense of personal responsibility."-----

It''s really hard to get in the weeds with McLame''s proposals because they''re so like ''rah rah, this is going to be the best thing ever'' without really laying out ALL the relevant factors, unknowns, possible fallout, etc - there''s never any citation of statistics or comparative analysis to countries that work.

His arguments all seem to say ''trust me''. So maybe the question to ask is if medical treatment is a life necessity, what''s to prevent insurance companies from basically ''colluding'' to keep costs high and profits maximized the way gas companies have? Doesn''t McCain''s plan actually give them collectively all the power?

I guess here is where McCain forgot to add that we should just ''trust them too'' (?)

[samthetvcat]

PS Like health insurance is basically a necessity, so that''s one aspect of it which tilts the balance of power to favoring big business. Doesn''t health insurance also have a high barrier to market entry such that the lure of great profits isn''t necessarily going to lead to increased market competition?

[joyous88]

If you like the moron that we have now

than you will love mcbushCain

[imnho]

Savings accouts? This is alice-in-wonderland. Any moderate medical problem will burn through rhw $5000 account like a hot knife through butter. Conventional health plans eill cost more then the revenues raised by his proposals.

[thatanial]

1) cost control and access is what he said the problem is. the $2500/$5000 rebate that goes directly to the insurance companies is his solution. thats the access part. The control part is a bit more complicated but you should be able to grasp it.

a)If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in web technology to allow a doctor to practice across state lines, then let them.
b) deal with another source of needless cost and trouble in the health care system which comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform

c)Finally, we must personally do everything we can to prevent expensive, chronic diseases.

d) he also says that the increased competition from allowing insurance to work in many states, plus vying for each taxpayers rebate, will also work to create better and less expensive ways of practicing medicine.

[thatanial]

I dont know if you guys are just so dishonest you cant take this article at its word, or you guys are really this stupid that you have no comprehension of what you read.

I think its not simply, ''we will give everyone health insurance'' that is the problem. Knowing full well we couldnt afford to just do that.

maybe you fools just love saying sieg heil so much you would think you thought the wrong side one.

[thatanial]

I dont know if you guys are just so dishonest you cant take this article at its word, or you guys are really this stupid that you have no comprehension of what you read.

I think its not simply, ''we will give everyone health insurance'' that is the problem. Knowing full well we couldnt afford to just do that.

maybe you fools just love saying sieg heil so much you would think you thought the wrong side one.

[thatanial]

Savings accouts? This is alice-in-wonderland. Any moderate medical problem will burn through rhw $5000 account like a hot knife through butter. Conventional health plans eill cost more then the revenues raised by his proposals.


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Posted by IMNHO at 09:46 PM : May 01, 2008



we already have HSAs, they are great for child care or other known expenses. It does cover many things and you risk losing the money if you dont spend it. He is talking about EXPANDING them

[thatanial]

Savings accouts? This is alice-in-wonderland. Any moderate medical problem will burn through rhw $5000 account like a hot knife through butter. Conventional health plans eill cost more then the revenues raised by his proposals.


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Posted by IMNHO at 09:46 PM : May 01, 2008



we already have HSAs, they are great for child care or other known expenses. It does cover many things and you risk losing the money if you dont spend it. He is talking about EXPANDING them

[ubrew12]

Article: "We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly."

Yeah. That government monopoly has been such a ''burden'' to the West Europeans, Canadians, and English....NOT!!

I realize the American people have been conditioned to think that government bureaucracies work as inefficiently as Bush has ordered them to be run the last 8 years, but as with all things, if you demand performance, you get it. Thats what people in these other countries do and, guess what, they get what they ask for. Only in America, where Bush has ordered all federal bureaucracies to be run by incompetents like ''brownie'' at FEMA for the last 8 years, do our bureacracies work so abysmally. It doesn''t hurt that corporations in America pay people like McCain to continually spout the fiction that government bureaucracies don''t work.

McCains supply-side faith is evident in this article, as in his suggestion that cutting gas taxes this summer will do anything but put money in oil companies pockets and balloon our national debt. I, for one, have had it up to HERE with supply-side, bootstraps capitalism guys trying to suggest fancy ways ''private'' enterprise can perform an essentially ''public'' service. We''re $10 trillion in debt, Mr McCain. Offering a tax cut at this time is like offering a beer to an alcoholic. Shame on you.

[incog-nito]

Savings accounts or flexible spending plans are A JOKE. You''re forced to to estimate your medical expenses, and if your save too much then you lose that money. Why is the government making people play lottery with their expenses. If you want to give people a break, just GIVE THEM A BREAK. What is so hard about that? Why all the games?

[incog-nito]

As bad as the current system is, McCain''s plan will make it WORSE. If you think things are bad now, individual plans will be veritable nightmare. At least with a group plan there is some protection against premiums being raised at will, against denying coverage because of pre-existing conditions, and against dropping your coverage on a whim. Individual plans offer NO such protection. A self-employed friend of mine had his premium raise twice in six month, for no apparent reason whatsoever. He also had a chronic condition. It''s not expensive to treat, but they put a rider his policy anyway to NOT cover it.

McCain''s tax credit does NOTHING to control skyrocketing costs, which is the real problem. Insurers will continue to raise their premiums and reduce your coverage. What will happen when costs become too high again? Increase the tax credit? Rest assured the insurers will to their best to keep up. In other words, this plan is plain idiotic.

[irliberal]

....and the moral of the story is never to buy a health care plan from a man who sings "Bomb bomb bomb Iran", like it''s a joke.

Vote for this warmongering freak if you want more of the same.

[justsane-2009]

let me see if i have this right--the health care plan that has covered him for most of his adult life is "inefficient, irrational, and an uncontrolled government monopoly?" huh. and it will include "rigid rules, long waits, and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world"? another huh. i for one, am willing to take that chance. after all, he seems to be doing pretty well--cancer survivor and all that. yeah, thank you senator, for looking out for me, but i kind of think that if it''s good enough for you, it''s good enough for me...

[wanabefrench]

So the government is going to help us save money to afford premiums imposed by a private organization? Thank you McCain for acknowledging we need a choice. I can choose to help you make the HMO''s more of a moster or elect someone else. It just became a lot easier for me.Give me universal health care. If a tax has to be paid when I die, tax me NOW, so I can LIVE! Heaven forbid I get a terminal illness. I''d sell every worldly possession and get the heck outta here. Maybe even learn French.

[wanabefrench]

So the government is going to help us save money to afford premiums imposed by a private organization? Thank you McCain for acknowledging we need a choice. I can choose to help you make the HMO''s more of a monster or elect someone else. It just became a lot easier for me.Give me universal health care. If a tax has to be paid when I die, tax me NOW, so I can LIVE! Heaven forbid I get a terminal illness. I''d sell every worldly possession and get the heck outta here. Maybe even learn French.

[brianbwb-2009]

So the corrupt, colluded monopolistic health care and insurance industries can do it better than a government program? The capitalists had their chance to prove such notions, only to creast a worse system that is a disaster.

It is time for an alternative, Tax booze, tobacco, bullets, gambling, legalize and tax hemp, hit oil profits, (or nationalize the oil companies) use the revenue only (and I mean only) for subsidizing public hospitals for those with incomes under $75k per year.

Subsidize med school for those who can''t otherwise afford it, in exchange for a bond to work, at reasonable pay, for four years in the public hospitals. Publish the rates, pricing to be profit neutral.

Put a real competitive player in the game, and force the private businesses to offer better services, lower prices, or fall.

[ranger1948]

I wrote to my senators this morning. I said Americans are tired of waiting for change. I said bush should be impeached and tried for war crimes. I said congress should address the problems the American people are faci9ng here at home. Why is gas 40 cents a gallon in kuwait ? Why aren''t we buying gas from them at a reasonable price. We saved their *****, now they owe us. I told my senators if i didn''t see change by November I

[ranger1948]

I wrote to my senators this morning. I said Americans are tired of waiting for change. I said bush should be impeached and tried for war crimes. I said congress should address the problems the American people are faci9ng here at home. Why is gas 40 cents a gallon in kuwait ? Why aren''t we buying gas from them at a reasonable price. We saved their *****, now they owe us. I told my senators if i didn''t see change by November I

[ranger1948]

I wrote to my senators this morning. I said Americans are tired of waiting for change. I said bush should be impeached and tried for war crimes. I said congress should address the problems the American people are faci9ng here at home. Why is gas 40 cents a gallon in kuwait ? Why aren''t we buying gas from them at a reasonable price. We saved their *****, now they owe us. I told my senators if i didn''t see change by November I

[ranger1948]

Gas is 12 cents a gallon in Saudia and 40 cents a gallon in Kuwait. We saved Kuwaits ***, they owe us . We should be collecrting. There is no reason why we should be paying such high prices for gas.

[omega39-2009]

What a load of garbage. I would love to see one of these bozos obtain affordable medical coverage (not from an employer) for a pre-existing medical condition.

[idnnsg]

"American families know quality when they see it"

Is that so? Then, tell me, why did they vote TWICE for Bush/Cheney?

[joyous88]

this loser has the same plan that buish has,

if you get sick you are fuucked!

you go bankrupt!

thats all these republicons care about

[joyous88]

want four more of the same vote for McBushCain,

PS: If you do not know who I am speaking of ,you

probably belong back in high school.

[eskieville1]

We should have at the very least the same health insurance as members of Congress get! After all we pay for it! Not practical you say? How about Medicare for all and force the insurance copanies to compete to sell us the supplemental policies?

[joyous88]

right on eskieville1!

The senator in your state has socialized health care

and he loves it, he just does not want you to have it.

[bm6005]

Actual repub health plan "Don''t get sick"! If health care in America is so GD good then CONgress will willingly give up their sweet health care plan, right?

[joecoolswat]

ranger1948...You are right, we should be paying a buck fifty...In the UK the governement forced the price up over $4.50+ per gallon, to force people to drive small cars, even though they have huge reserves in the North Sea

[dinkydog1]

Let''s face it big pharma and hospitials can charge you any thing they want and thier''s nothing you can do about it. If you think free enterprise and market forces are going to drive down cost you truly need (mental)health care. Nationalized health care is working better and at a fracton of what we spend all over the world. So far repubs killed all progress and shouted socialism and communism to suggestions of nationalized health care to frighten people into abandoning common sense. Expect more of the same from McCain

[noloyalisti]

Anyone who backs this cowardly neo-con mcBush must be a moron. Let''s give even more money to the oil companies, war profiteers and insurance companies.

Single payer universal health care like the Medicare and VA systems are what we need. Time for insurance company people to look for another job.

[taxguydave]

I''m a licensed health insurance agent. 10 years ago, I bought a group health policy (my state allows self-employed individuals to buy group policies--they aren''t actually cheaper, but they can''t exclude existing conditions, either, and I have both epilepsy and Parkinson''s disease). My premiums then (for me and my wife) were $230/mo. Every year, I am hit with a 20-30% rate increase, even though my care costs them about the same now as it did 10 years ago.

Today, my premiums are over $1400/mo. A $5000/yr tax credit isn''t going to help too much.

And forget about "competition". There has been so much consolidation in the health insurance industry that today there are really only about a half dozen national insurers today. It''s come to the point where all carriers are within $10-$20/mo for comparable policies.

[joyous88]

if you like the bush health plan you will love the

mcbushcain health, because they are identical

just do not ask your senator to use one of their plans, he has socialized medicine, and he loves it

[it_oldtimer]

Thanks, NRO, for providing yet another outstanding reason NOT to vote for McCain.

McCain''s whole argument is so fundamentally flawed in so many different ways I hesitate to waste the time it would take to list them all.

Suffice it to say that it''s obviously been a very long time since John has had any truly meaningful contact with the real world.