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Column: McCains Health Care Plan Is Rhetoric

This story was written by Robert Nelb, Yale Daily News

For any astute policy analyst, convention-watching can be particularly painful. Buzzwords replace real issues and the truth depends on whos talking. Perhaps this is just politics as usual, but the lack of reality in todays rhetoric is a disturbing trend that concerns us all.

In Denver, Barack Obama at least tried to describe what he means by change, but in Minneapolis, John McCain embraced platitudes and politicking with open arms. I was shocked by McCains blatant misrepresentations of Obamas positions on taxes and energy, but as a student of health policy, it was his two sentences about health reform that really made me cringe.

McCain began by describing his plan as one that makes it easier for more Americans to find and keep good health care insurance. When one looks into the details of the McCain health-care plan, however, the reality is anything but easy. The central tenet of McCains health plan is the elimination of federal subsidies for employer-sponsored health insurance, on which 160 million Americans currently rely to get their health-insurance coverage. In its place, McCains plan gives families tax subsidies to encourage them to buy insurance on their own without much help from the government. Placing a larger burden on individuals may reduce government spending on healthcare, but it wont make the process any easier. According to a recent Kaiser Family Foundation poll, as many as four out of five Americans feel that buying individual health insurance would be more difficult than getting it from their employer.

Meanwhile, McCain characterized Obamas health policy plan as one that 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. This may sound a lot like the Republican attacks in 1994, but Bill Clinton and Barack Obamas health plans are anything but the same. Unlike the 94 Clinton plan, Obamas proposal has as its first principle that you can keep the plan you have if you want no one is forced to do anything. Rather than implement a government-run system for all, Obama takes an incremental approach, expanding existing programs and allowing families to access to the Federal Employees Health Benefit Plan, a menu of private health-insurance options with a comprehensive set of benefits that members of Congress currently enjoy. In short, Obamas plan isnt some foreign form of socialized medicine; it is an incremental solution that builds on what already works well in America.

Overall, McCains statement was so badly twisted that it may be more accurate if it were reversed: Obamas plan would make it easier for more Americans to find and keep good health insurance (since it allows people to keep the care that they have), while McCains will likely cause many businesses to drop health-insurance coverage and will force families to deal with HMO bureaucrats as they fend for themselves in the private health-insurance market (since it cuts subsidies for employer-sponsored health insurance and doesnt fully fix the individual health insurance market).

Perhaps I am too idealistic, but should we not hold our leaders accountable when they lie to us like this? Instead, the polls suggest McCain is benefiting from his misrepresentations. McCain has somehow become a candidate of change as well, and skinning a grizzly bear has suddenly become a more important qualification than graduating magna cum laude from Harvard Law. Its OK if someone wants to vote for McCain because of his policies or his record, but please dont vote for a four-term Senator because you think that he can bring a fresh face to Washington.

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Now that Im back at Yale, it is tempting to become cynical about politics, but in this upcoming eletion, the stakes are too high to stay silent. I look forward to writing this column for its third year to do my part to promote informed debate about public-health issues in New Haven and around the world. Together, we can bring a dose of reality to todays rhetoric and make the world a healthier place.

Robert Nelb is a student at the School of Public Health.