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Dueling med plans

McCain's offers consumers more long-term choice

Rocky Mountain News

Published October 13, 2008 at 1:26 a.m.

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If there's one issue Coloradans have been intently listening to in the season of never-ending political debates - besides the economy, of course - it's probably health care.

A new Census Bureau report, after all, reveals that nearly one in five Coloradans under age 65 lack health insurance. The number jumps to 35 percent when only counting the Hispanic community.

And while that doesn't mean every one of those residents is in financial straits because of health care costs, one catastrophic medical crisis can send a family to the poorhouse.

Both political parties and their candidates are quick to agree that America's health care system is fractured. Both John McCain and Barack Obama are touting preventive care and better information technology to cut costs, and have proposed safety nets (though markedly different) to cover the hard-to-insure, such as patients with pre-existing conditions.

That's where the agreement stops.

How can voters wade through the health care rhetoric to pick the best offered solution? If you're uninsured, your focus is on securing adequate coverage. If you're insured, you want to know whether proposals will ding your wallet or the quality and scope of your coverage.

In either case, you probably value some degree of choice. If that's a high priority, we'd recommend John McCain's plan. Barack Obama's plan extols choice, too, but over time leads in another direction.

McCain's health care proposal hinges on a $5,000 tax credit for families ($2,500 for individuals) under which individuals could either keep their current insurance or go out and buy coverage, even shopping across state lines to get the best rates.

And under McCain's plan, if you don't spend the entire allotted amount on coverage, the remainder can be deposited in Health Savings Accounts (which McCain wants to expand).

The Obama plan, meanwhile, gives birth to a bouncing new bureaucracy: the National Health Insurance Exchange, which would offer private policies and a public insurance plan "based on benefits available to members of Congress" - generous benefits, in other words. All wanting insurance in the public plan would have to be covered under the same premium, without regard to lifestyle choices such as smoking that increase health risks. Obama's plan purports to maintain personal choice - and to some exent does at first - but a growing entitlement program will almost certainly crowd private insurers out of the market.

Over time, for that matter, some federal entity would have to decide what would be added and subtracted by the public plan - in order to control costs, among other reasons. Former Sen. Tom Daschle, a longtime universal health care proponent and Obama adviser, has touted his idea for a Federal Health Board to make those sensitive choices. That also makes us nervous.

Just as McCain and Obama were asked in the second debate whether health care is a right, responsibility or privilege, taxpayers should ask whether the dueling plans are wise, workable and winners for themselves and the economy.

Comments

  • October 13, 2008

    7:09 a.m.

    Suggest removal

    peachy0301 writes:

    Two things your article is missing - of the 1 in 5 Coloradans how many : 1) don't have it because they chose not to have it and 2) are illegal immigrants?

  • October 13, 2008

    7:53 a.m.

    Suggest removal

    roger44 writes:

    It mentioned the rate is 15% higher counting Hispanics. But you can bet it's much higher for the illegal ones. The candidates can push all the plans they want, have to get them by congress. Truman asked for a plan in 1945, and they still sit on their duffs. Eisenhower deported 1.2 million illegals in the 50's, we could ship out 5 million and bet that would help. but no one has the courage to suggest we do that.

  • October 13, 2008

    9:36 a.m.

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    paulhsiehmd writes:

    peachy0301 asks an excellent question:

    I don't know about CO in particular, but at the national level the commonly quoted figure of "45 million uninsured" is a huge exaggeration.

    If you take away those who voluntarily choose not to purchase insurance, those who are eligible for various assistance program but don't enroll, those who are illegal immigrants, etc., then that number goes way down from 45 million to 8 million.

    Two sources:
    http://www.westandfirm.org/blog/2008/...
    http://www.freemarketcure.com/uninsur...

    In other words, the problem is being exaggerated by more than a factor of 5.

    Also, the US government counts you as "uninsured" for a given year (such as 2007) if you have a single day of no health insurance for that year, for example if you are between jobs. That's like counting someone as "homeless" if they had to crash at a friend's place for a couple of days while moving between apartments.

    There are genuine problems with the current health care system.

    But forcing everyone into a government-run medical system to "solve" the problem of the uninsured would be like forcing everyone into government-run housing projects to "solve" the "problem of homelessness".

    For more information on free market health care reforms, see Freedom and Individual Rights in Medicine (FIRM):

    http://www.WeStandFIRM.org

    Paul Hsieh, MD
    Sedalia, CO

  • October 13, 2008

    10:23 a.m.

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    KelcyCo writes:

    Unless you are rich enough to self-insure then you don`t voluntarily choose not to have health insurance. You make choices to spend the money elsewhere, in the overwhelming majority of cases it is because you have no choice and you are making a bet that you will remain healthy and not be in an accident.

    What is not discussed here is where is business heading with regards to insurance. Big business has already gone to court and won the right to cut retiree health insurance.....on the basis that they are covered by Medicare (but not for the co-pays and cost shares). They have been making noise about how the cost of health insurance for their employees are dragging down their competitiveness in the world market. They want to dump it but at the moment can`t get away with that. Most are instead passing the annual ridiculous increases to the employees. You already see interviews with employees who cannot afford their portion of the insurance costs and are going without. As those costs increase then more and more people will do this.

    We are being driven to this discussion rather than facing it head on. We need to discuss and resolve it rather than having it hit us from behind.

  • October 13, 2008

    12:24 p.m.

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    Magie writes:

    I feel like a rare occurrence - an insured hispanic. And I happen to love my insurance by the way - both my husband and I are insured under the plan he gets through his employer. We pay about $3,510 a year and his employer covers an additional $8,554 - So what will happen under McCain's plan? are we going to have to pay taxes for the $8,550 that his employer is covering? I did not see that part in the article; I guess it had to be biased enough to be posted on the McCain website.
    While I empathize with the uninsured, I feel McCain's plan will have a negative impact on all of us who have insurance through an employer, and I am pretty sure that accounts for more that $45 million americans

  • October 13, 2008

    1:04 p.m.

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    amaikovich writes:

    According to statistics, 8.7 million children (under the age of 18) are uninsured. And with the current economy, this number is going up...not down.

    Is anyong arguing that the kids are choosing to be uninsured?

    Once we get the kids insured and some preventive medicine for them, then we can talk about choices for everyone else.

  • October 13, 2008

    1:11 p.m.

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    gary writes:

    If you want choice and want to keep your current insurance...

    Then you will want McCain's plan.

    If you want your insurance determined by the government..

    Then you will want Obama's

    Obama's will turn into a complete government run health program.

    I am going for McCain's

    Nuff Said!

  • October 13, 2008

    1:55 p.m.

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    WasADemNotNow writes:

    Magie,

    McCain's plan also gives you a $5,000 tax credit... and since the $5000 is more than your cost of the health insurance (and way less than McCain's income tax on the "extra income" would be), you would be free to put the balance in a medical spending account that you could use to pay co-pays, deductibles, for prescriptions, medicines, medical equipment, dental care, etc.

    And if you can find medical insurance that is cheaper and better suits your needs in another state, you would be able to opt out of your employer's insurance and have the money sent directly to the insurer rather than take the full tax credit (you would still get the balance of the credit if you spent less than $5000).

    There is significant choice and flexibility in McCain's plan... and nothing but government bloat, restrictions and potential for abuse in Obama's.

    And McCain's plan calls for the minimum employer-sponsored plan to be no less than what Congress gets! (Now if we could just get the same pensions!)

  • October 13, 2008

    2:36 p.m.

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    socrates writes:

    A tax credit doesn't do a hell of a lot of good if you don't itemize or have enough income to benefit from a credit.

    Tax credits just don't do much for the folks that are working three jobs and trying to pay for health care at the same time. Or don't have health care now because it's too expensive.

    I guess those just aren't the people McCain (and the Rocky Mountain News) are used to talking to.

    Obama's plan is better.

  • October 13, 2008

    3:37 p.m.

    Suggest removal

    Suzy writes:

    In response to Magie: You would not have to pay taxes on the $8554 - your employer would continue to be able to deduct that cost on his tax return.
    In response to Socrates: You don't have to itemize to benefit from a tax credit and this is a REFUNDABLE tax credit meaning even if you have no tax liability you still get the $5000! Moreover, any part of the $5000 not spent on health care could go into a Health Savings Account which is sort of like a Roth IRA for health care (can be invested and grow over the years with zero taxation when you withdraw it). McCain's plan is better in my opinion.

  • October 13, 2008

    6:55 p.m.

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    HopiMedicineMan writes:

    Everyone has a right to a doctor. Doctors have no rights.

  • October 14, 2008

    8:37 a.m.

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    amaikovich writes:

    This is a very difficult topic for a layman to understand.

    However, what we all understand is the current healthcare system doesn't work. A few years ago, I might have said it worked for those with jobs that provided healthcare, but it's even broken for them, with rising payments and an almost total lack of preventive healthcare services. The numbers of uninsured, including children, continues to rise.

    So who to believe will at least start to improve the situation? Republicans have never supported any healthcare reform before this election. Ever. The Democrats have at least attempted some type of healthcare reform for the past two decades...always thwarted by Republicans. Maybe it's just me, but if we're actually going to try to accomplish something this time, I'll put my faith in Senator Obama. I note how Senator McCain never mentioned his plan during the Repubican primaries, only now pitching it to the general electorate.

  • October 14, 2008

    9:22 a.m.

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    conniesz writes:

    I know families who choose not to pay for health insurance because they would rather have a bigger house, nicer car, expensive vacation, you get the idea. These people will tell you they are not taking a risk with their children's health because they know good and well that we don't let people die in the streets. If you don't have insurance and find yourself in need of medical care you cannot afford - have no fear, you will be treated.

    This thinking raises the cost of health care for all of us. I want to see a mandatory plan - you MUST have insurance. I do not necessarily want the government to be the insurer of choice though - I'd rather see some competition out there, but I do want to see a requirement that if you get a paycheck, x number of dollars will be directed to the insurance plan of your choice - NOT OPTIONAL!

    I am tired of paying more for my own coverage so people can choose not to be covered themselves. It's either mandatory coverage or we need to harden ourselves and start letting people die in the streets - because if we don't we will stay in the same position we're in today - which means we are, in effect, paying for all the uninsured anyhow.

  • October 14, 2008

    9:27 a.m.

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    Jefgirl50 writes:

    It's all about priorities. The cost of catastrophic health coverage is the same amount as cable TV, yet people will opt to have television coverage over health coverage. I don't have a health plan at work. I have to study, plan, and save to subsidize the insurance I pay for now. It comes in priority right after home and food. I go to the 9Health fair, watch what I eat and I don't smoke. Would it be easier for me if government picked up the tab? Sure! And they could deliver milk to my porch every morning...and pay for my heat and gas for my car. At some point, you can't deny calling it socialism...they'd base my care on my age among other things, tell me what kind of car I have to drive, and where I have to set my thermostat. You can't get from the government anything for less than you can get it for yourself...but it takes tenacity, free thinking and hard WORK..or take the easy route and blame the government if we get sick. My parents alway taught me to save for a rainy day. A rainy day would include plans for a car wreck or a health issue. I like the idea of a tax rebate...hopefully that means I would get a tax break because I pay for my health insurance and the people who choose cable TV won't need the break.

  • October 14, 2008

    11:59 a.m.

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    conniesz writes:

    WasADemNotNow, you are wrong. Under the McCain plan employers would no longer get a deduction for providing insurance to their employees - and the cost of that insurance would be included as part of the employee's salary - hence paying taxes on the insurance as those dollars would simply become ordinary income spent on insurance.

    Now, the tax credit (2500 for an individual, 5000 for a family) would go directly to the insurance company of your choice, and would reduce your insurance bill by that amount (good luck finding any kind of reasonable family plan even close to $5K).

    Basically McCain's plan only works for people who really don't need it anyhow. It does nothing to help insure the working poor.

  • October 15, 2008

    8 a.m.

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    norcalco writes:

    conniesz, you are wrong...

    I just searched on google for health plans for a family of 4. Plans from $275-$700. Lots of choices.

    Also, SPENDING is the problem for the "working poor". How much money have they spent this year on lattes, cigarettes, alcohol, and junk that could have gone toward their health care. I personally know whiners with no health care that BLOW money on unhealthy living, yet they want HEALTH care. Funny...

    The $5000 McCain plan will help. Obama's plan is socialism. I just spoke with a Canadian this week about government health care. Do you want to wait 6 months for MRI results?? If so, vote Obama.

    norcalco