Democratic and Republican health plan: much ado over not much

5 comments

August 6, 7:49 PM

by Doctor Lissa, Health Care Examiner

 

 

        John McCain

So, as promised, what's the difference between the Republican and Democratic health care proposals?  What I think you'll see is, not that much really.  First, let's focus on the similarities since there are more of those.

Neither of the candidates wants to mandate that all Americans have health insurance.  (As you know from my last post, I think that's a mistake)

Both candidates would have the government set up a market place where people could buy coverage from private companies or the government, with subsidies for lower income earners. 

And both candidates would bar insurance companies from rejecting people with pre-existing conditions or charging them more.

Both candidates want to include more people by making sure insurance is affordable, therefore, the reasoning goes, everyone who can afford it will buy it (which is not necessarily true).

Here's where it gets fun: (Differences)

         Barack Obama

McCain would sever the ties between health insurance and the employer. Under existing law, citizens get a tax break on the cost of their health insurance if it is provided by the employer.  (Currently 170 million Americans have this benefit). Under McCain's plan, a refundable tax credit would go to all citizens with insurance no matter how they got it.  (At last count the proposed tax credit was $2,500 for an individual and $5,000 for a family. ) This would in effect diminish employer provided insurance and increase plans brought to the open market.  According to McCain's camp, this would make insurance portable, since it is no longer tied to employment.  Businesses would love this idea as they hate to offer health insurance anyway. ( I'm intrigued by this idea even though I don't think the public will go for it)

Gratuitous picture of Paris

Democrats hate this idea since they feel it discriminates against older workers who will pay higher rates on the open market since they typically have health concerns.  That's because they will not be pooled with younger workers who typically use fewer resources.  Without that pool, the older worker with health issues will pay more or perhaps be uninsurable. ( This is a legitimate concern.)

McCain would also allow health insurers to sell across state lines.  This is to stimulate competitiveness.  Democrats hate this idea as well because they fear that health insurance companies will flock to states with few rules, effectively avoiding regulations that have been built over the decades.  (Based on our experience with credit card issuers, I agree that we have more to fear than not.)

Does Obama favor anything that the McCain camp can't abide?  It is harder for McCain than it would have been if Hillary Clinton were the candidate, but  there are differences here as well.  McCain doesn't think that the government should be responsibile to insure it's citizens (the issue is responsibility, not mandates), the market place should.  He also doesn't agree with Obama on the issue of children.  Obama wants all children to have access to basic coverage regardless of whether their parents do.  Again, McCain believes the market place should provide coverage, not the government.  (In my view, children are a vulnerable population, just like Seniors.  And as I said before, sick, uninsured children go to school and play with everyone else's kids, regardless of coverage.  I agree with this one.)

I'm still waiting for Paris' plan, but unless she's insulted don't look for anything to happen soon. 

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