Sen. McCain's Guaranteed Access Plan
Remarks By John McCain On Health Care On Day Two Of The “Call To Action Tour”
www.JohnMcCain.com
Lee Moffitt Cancer Center & Research Institute, Tampa, FL
April 29, 2008
As President, I will meet with the governors to solicit their ideas about a best practice model that states can follow — a Guaranteed Access Plan or GAP that would reflect the best experience of the states. I will 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. These programs reach out to people who are at risk for different diseases and chronic conditions and provide them with nurse care managers to make sure they receive the proper care and avoid unnecessary treatments and emergency room visits. The details of a Guaranteed Access Plan will be worked out with the collaboration and consent of the states. But, conceptually, federal assistance could be provided to a nonprofit GAP that operated under the direction of a board that included all stakeholders groups — legislators, insurers, business and medical community representatives, and, most importantly, patients. The board would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.
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.
http://www.johnmccain.com/Informing/News/Speeches/2c3cfa3a-748e-4121-84db-28995cf367da.htm
Comment:
By Don McCanne, MD
This speech was promoted as a major policy address that would flesh out Sen. McCain’s proposal for health care reform, according to his campaign spokesman Jeff Sadosky. Until now, the only real substance of his proposal was to offer a tax credit, $2500 for individuals and $5000 for families, to purchase health plans in a competitive, deregulated private insurance market. Most of the rest of his proposal is simply rhetorical fluff.
What would appear to be new is his proposal for a Guaranteed Access Plan (GAP). He would establish nonprofit GAPs with stakeholder boards that would provide oversight “in ridding the market of both needless and costly regulations.” Unfortunately, those needless and costly regulations have not been adequate to prevent the explosion in the growth of underinsurance products that currently are exposing insured individuals to unaffordable out-of-pocket expenses for health care. By further reducing regulatory oversight, his proposal would make health care access even less affordable for the majority of Americans.
All of the candidates have been guilty of promoting rhetorical fluff as if it provided the substantial, effective policy reform that we desperately need. This includes measures such as electronic medical records, integrated information technology, disease management, wellness programs, tort reform, innovative payment systems, nebulous administrative efficiencies, and so forth. Some of these policies, if properly structured, might have a beneficial impact on our health care system, but none of them seriously address the two crippling problems in health care today: failing to provide everyone with access to comprehensive health care services, and failing to make that health care affordable for each individual with needs.
The proposals of Sen. Clinton and Sen. Obama fall far short of making health care affordable for everyone, and, as a result, would leave many without access to the care that they need simply because of the financial barriers to care. With continued excessive escalation of health care costs, their proposals would likely result in further deterioration of affordability and access.
In contrast, Sen. McCain would free up the market to allow private insurers to create plans with premiums that we can afford. The only tradeoff is that we’ll have to pay out-of-pocket for most of the health care that we might need.