You would think that John McCain would have gotten it right on his health care plan for the country, after his own experience with four malignant melanomas and multiple surgeries. You would think that experience would have inspired him to propose a plan that covers everyone, and do so affordably, both for the individual and for our country. You would think that health care would be a high priority for him, and that even if economics is not his strong suit, he would have done his homework.
McCain’s central idea for health care reform is his solution for every issue: let the markets determine the outcome, with unfettered competition as the driver. Ironically, he continues to tout this philosophy even as Wall Street crumbles around us, and financial companies look for bailouts from the government.
McCain would raise taxes for working people, by taxing their health insurance benefits. This would lead to younger healthy workers opting out of employer insurance, which would raise employer health insurance costs for the remaining workers, leading to more and more employers terminating coverage for their employees. Working individuals would be thrust into the private insurance market.
Navigating the private insurance market is not only daunting, but it can be dangerous for your health. Age and health status are factors the insurance companies look at to determine whether they will take the risk of insuring an individual, and they try to weed out anyone who is sick or likely to get sick. They want your premiums, but they don’t really want to pay out any money for health care. So workers who now have insurance in group plans through their employers will have to fend for themselves in the private market, and may not be able to get insurance.
McCain wants “to restore control over our health care system to the patients themselves,” and he thus proposes a tax credit of $2,500/ person for the purchase of health insurance. When cheaper policies cost $6,500/person and carry deductibles of $1,000, with co-payments every time you try to access benefits, $2,500 is a paltry sum if you actually have to use your insurance. This is health insurance in the private market: increasing costs for fewer benefits.
McCain also proposes decreasing the regulation of health insurance, allowing people to buy insurance from companies that don’t operate in their states. This would benefit only the insurance companies, who would be able to avoid state legislation requiring certain necessary health benefits, like mammograms. And doctors would have even more paperwork, more administrative costs, and more headaches than they do now, as they try to deal with even more insurance companies.
Health care costs would rise because of increased administrative costs for private insurance companies, as it is more expensive to underwrite policies for individuals than it is for groups. We already spend $350 billion in unnecessary administrative costs because of the private insurance industry.
Four economists reported their analysis of the McCain plan in the journal “Health Affairs,” concluding that it would radically transform the U.S health insurance landscape, with little impact on the number of the uninsured, while raising costs, reducing benefits, and leaving people with fewer consumer protections.
The problems with our health care system are extremely serious. Projected health care spending for 2008 is almost $2.4 trillion, which is close to $8,000 per person. This represents 16.6 percent of the gross domestic product in the United States. In spite of our spending on health care, which is twice that of any other industrialized country in the world, 46 million Americans remain uninsured. Many more are underinsured and have to pay so much in out-of pocket costs that they forego needed health care, even though they have health insurance.
According to a Commonwealth Fund study, there was a 60 percent increase in the number of the underinsured between 2003 and 2007. The underinsured tend to defer preventive care, choosing not to get mammograms or have their cholesterol checked. Underinsured adults with chronic conditions are not filling their prescriptions. Being underinsured affects personal health, as well as the cost of providing health care in our country, since not getting needed health care only means bigger health care bills down the road when the problems are more serious.
I agree with Senator McCain that it is time for a radical change in our health care system, and I agree that health insurance should be divorced from employment. But radical reform is useful only if it addresses the problems in our current health care system, and McCain’s plan does not do that.
A national single-payer health program, administered by the government rather than private insurance companies, would cover everyone, provide more comprehensive benefits, and do so without raising health care costs. With the $350 billion saved in administrative costs, everyone could have health insurance coverage. And national health insurance has a proven track record in other countries, where health care costs are lower and people live longer. Single-payer health care reform is the only meaningful reform, and is now supported by 15,000 members in Physicians for a National Health Program.