Health care: Curing what ails us
Judging by the detail and length of each presidential candidate's plan to reform the country's health-care system, there is no simple remedy for the ailing industry.
Which solution is better: expanding public health programs or nurturing the free market?
• Residents on health care
McCain on health care
• More insurance: Use competition to drive down insurance costs, provide every family a direct refundable tax credit of $2,500 for individuals and $5,000 for families to offset the cost of insurance, and would expand the benefits of health-care savings accounts.
• High risk patients: Ensure people with pre-existing conditions would be able to get insurance, work with states to create a Guaranteed Access Plan that would ensure high-risk patients access to health insurance, and work with Congress, state governors and the industry to make sure the plan was well-funded.
• Reducing costs: Lower prescription drug costs with more competition, emphasize prevention and healthy habits in treating chronic disease, reform the payment systems in Medicaid and Medicare, and make more information public, including treatment options and doctor records.
Read more on McCain's platform
Obama on health care
• More insurance: Implement an affordable national health care plan that includes guaranteed eligibility, require all children have health-care coverage and give small businesses a refundable tax credit of up to 50 percent on premiums the businesses pay for their employees.
• Reducing costs: Reduce costs of catastrophic illness care for businesses and workers, invest $10 billion a year over the next five years to move the health-care system to adopt electronic health information systems, and increase competition in the insurance and drug markets.
• New initiatives: Advance the biomedical research field, fight AIDS worldwide, support Americans with disabilities, improve mental health care, protect children from lead poisoning, reduce the risk of mercury pollution and support Americans with autism.
Experts aren't sure either candidate's plan will fix every problem.
Quentin Young, national coordinator for Physicians for a National Health Program, has been pushing for national health insurance for years.
He mentioned a 2005 study of personal bankruptcies that found half of the country's 1.4 million personal bankruptcies in 2001 were caused by medical bills.
"That's one stunning example of the bad effects of the health system that have nothing to do with health care," Young said. "I don't have to make the case that our health-care system is broken. There are 45 million uninsured. There is a very grave, very great human tragedy attached to those numbers."
The members of the program support a single-payer national health insurance system, where one public agency handles health-care financing, while the care is given by private doctors. Everyone would be covered by one plan and could choose any doctor or hospital without penalties.
Young said he's discouraged by both candidates' proposals.
"McCain, his message is really out of date," Young said. "The idea that the market, particularly these days, could improve quality and cost and access is almost silly."
There is no market for health care, he said. When people are in pain or experience a medical emergency, they go to the nearest hospital. They don't shop around, he said.
"They can't take a survey of 10 doctors in their area. It's ludicrous to give that image," Young said. "Some patients might shop around for surgery, but not most. Mr. McCain doesn't seem to care."
Meanwhile, Obama's plan doesn't get close enough to the single-payer plan for Young's liking. Obama is pitching a plan that includes a mix of public and private health insurance.
"What I just described has been tried in a number of states," he said. "In every case, there are more people uninsured today than there were when they initiated the program."
Access to health care isn't the problem -- paying for it is, said Greg Blankenship, president of the Illinois Policy Institute.
The institute believes market-based health care would solve more problems, and backs a strategy that includes a national market.
"Obama's plan seems to want to treat the symptoms of the problem of the high cost of health-care finance," Blankenship said. "Whereas Sen. McCain seems to drill down a bit more and attempt to take on the high cost of health care itself by expanding consumer choices, leveling the playing field between individuals and industry."
The national-market health insurance, as well as breaking state monopolies, is critical to bringing down the cost of health care, he said.
"A national health insurance market could reduce number of uninsured by 12 million. That is a major plank in the McCain program," he said.
"We've seen a number of ideas behind the Obama plan attempted in other states, and what we've seen is the cost of health care skyrocket ..." Blankenship said.
Sun-Times News Group
