John McCain Describes His Health Plan; In Reality A Non Health Plan

Stanley Feld M.D., FACP,MACE

Politicians give me a headache. John McCain revealed his healthcare plan last week. His healthcare plan is just as poor as Hillary Clinton’s and Barach Obama’s. He goes further than President Bush in shifting the healthcare premium payment from the employer to the employee. This action is just what the large corporations want and the employees don’t want.

“Mr. McCain’s health care plan would shift the emphasis from insurance provided by employers to insurance bought by individuals, to foster competition and drive down prices. To do so he is calling for eliminating the tax breaks that currently encourage employers to provide health insurance for their workers, and replacing them with $5,000 tax credits for families to buy their own insurance.”

Five thousand dollars in tax credits will not help people who can not afford the average $12,000 healthcare insurance premiums for a family of four.

Businesses have been trying for years to relieve itself of the obligation to provide healthcare insurance to employees. The defects in the HSA are clear from my last blog entry. HSA’s will do little to Repair The Healthcare System. The healthcare insurance industry still controls and captures the healthcare dollars. It still sets the premiums for healthcare coverage.

Mr. McCain seems to have no idea of the problems in the healthcare system. The government should create new rules to change the incentives of the stakeholders. The rules must create incentives for the consumers and physicians and not be punitive. One hundred and fifty million people presently have some form of healthcare insurance provided by their employers. Nonetheless, those insured employees can not afford the deductible they are required to pay while receiving less coverage at higher costs.

“Mr. McCain had previously described aspects of his health care plan but on Tuesday offered new details on how to cover people with existing health problems, in a nod to the growing concerns about the difficulties that many sick, older and low-income people have getting insurance. ”

Political expediency is the name of the game. It does not matter what the facts are or if the plan will be effective. However, if the facts of any problem are ignored, problems can not be solved. Neither the Democrats nor the Republicans have a clue regarding the problems in the healthcare system. Neither has presented any viable solutions.

“Elizabeth Edwards, the wife of former Senator John Edwards, recently pointed out that both she and Mr. McCain could be left uncovered by Mr. McCain’s plan because she has cancer and he has had melanoma. Stung by such criticism, Mr. McCain is trying to develop a way to cover people with health problems while still taking a generally market-based approach to solving the health care crisis.”

John McCain has the advantage of ignoring the pre-existing illness problem. As a Senator, he is entitled to participate in both Medicare Part C and Medicare Part B without premium penalty for his pre-existing illnesses. Both plans mandate that people with pre-existing illness must be covered at the universal rate.

“I’ll work tirelessly to address the problem,” Mr. McCain said in a speech here at the H. Lee Moffitt Cancer Center & Research Institute. “But I won’t create another entitlement program that Washington will let get out of control. I won’t do it. Nor will I saddle states with another unfunded mandate.”

McCain is pandering to conservatives who see red at the word entitlement. He is also pandering to the healthcare insurance industry and its executives’ multimillion dollar salaries. His plan will preserve the healthcare insurance industry’s dominance over its $150 billion dollar waste.

“For people who currently get health insurance through their jobs, Mr. McCain’s plan would give them a tax credit that they could put toward buying a different, and potentially less expensive, health insurance plan tailored to their needs — and allow them to keep that health plan, and their doctors, even if they switch or lose their jobs.’

These words have no meaning. Presently people with insurance do not have adequate and affordable insurance coverage. Out of pocket expenses increase yearly. People without insurance can not afford the restrictions on the policies they could buy if they were eligible.

“ Mr. McCain’s speech here implicitly acknowledged some of the shortcomings of his free-market approach. But rather than force insurers to stop cherry-picking the healthiest — and least expensive — patients, Mr. McCain proposed that the federal government work with states to cover those who cannot find insurance on the open market. With federal financial assistance, his plan would encourage states to create high-risk pools that would contract with insurers to cover consumers who have been rejected on the open market."

Mr. McCain does not seem to know that high risk pools have been created and are failing. He might have a between the lines agenda in opposition to consumers needs

“Mr. McCain was vague Tuesday about just how his safety net would be structured, and did not specify how much it might cost, leaving the details to negotiations with Congress and the states.”

This is an interesting admission. The reality is he does not have a healthcare plan that will solve any of the healthcare system’s problems.

"Some health care experts question whether those tax credits would offer enough money to pay for new health insurance plans. The average cost of an employer-funded insurance plan is $12,106 for a family, according to the Kaiser Family Foundation, a health policy group. Paul B. Ginsburg, the president of the Center for Studying Health System Change."

Enough said about the McCain healthcare plan. It is a non healthcare plan to the advantage of the secondary stakeholders and to the detriment of patients.

It is clear to me that we can not depend on our presidential candidates for help. We are going to have to organize and demand the necessary reform essential to eliminate the dysfunction in the healthcare system.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

Comments

[Scott Dalferes]

Right on. Thanks for the well thought out post.

[Patrick]

Coming up with a good healthcare system is not brain surgery. For starters, we could just copy Singapore's system exactly ( http://econlog.econlib.org/archives/2008/01/singapores_heal.html ) They have a longer life expectancy at 1/3 the per person cost.

The real question is not how to fix healthcare. The real question is to figure out why our political systems gives us systematically poor results, and then fix the political system.

[Emil Sotirov]

Found your blog through Brad's blog. Thank you for writing. Wonder why more of your colleagues are not more vocal.

Here is a blog (http://runningahospital.blogspot.com/) you may want to take a look at... and may be start a conversation with the author (Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston)... through comments on each other's blogs.

[Lyle Paul]

Re The John McCain No Health Plan
I agree with your comment on expediency.
1. Any plan that will be enacted, if in fact one actually does get enacted, must come after many difficult and complicated steps.
2. Any voter who decides on who they should elect as president based on a sound-bite healthcare plan is only deluding themselves.
3. Any plan that is crafted in the backrooms where the public has been excluded from discussions this time as it was in the Hillary Clinton effort fifteen years ago the proposed solution will once again be DOA.
4. All the candidates are guilty of pandering as they put forth proposals. Face it, nothing can or should happen for something of this magnitude until it has been vetted in the Congress and debated in the public forums.
5. Dr Feld correctly states that the healh insurers set the premium rates but he fails to state that the health providers set the healthcare charges which dictate the rates that must be charged.
6. To the above one could add that individuals themselves have the biggest impact on medical care costs by elective lifestyle choices.
7. There is plenty of pain to go around, the healtcare industry, the insurers, and individuals. It will require purpose and sacrfice on all to solve this monster problem, politicians sound bites notwithstanding.

[D Melton]

Excellent article. BTW its Barack Obama