HEALTHCARE - IT COMES DOWN TO PHILOSOPHY

This will be the first in a series in which each issue will be explored using the candidates own words. It is hoped that a careful review and analysis of how Senators McCain and Obama view these national issues and how they plan to address them, will serve to assist in deciding who should be successful on November 4, 2008.





HEALTH CARE





It may come as a surprise to some that there is little or no disagreement between the presidential candidates as to the scope of the problems in the current healthcare system. Both McCain and Obama agree on the following:

• There are 47 million individuals who either have no insurance or inadequate coverage with approximately 9 million of them children.


• Healthcare should be affordable and available to all without regard to their employment status or income level.


• The current system needs to be made more transparent with published prices for regulary performed proceedures and tests.


• The need to lower prescription costs through re-importation and fast tracking generics.

This is the point at which the two diverge along fundamental philosophical lines. John McCain relies on the free market arguing that a nationalized program run by a new federal beauracracy would result in a less efficient, more irrational and costly system.

The McCain plan would feature health savings accounts and tax credits of up to $5000 per family which he says will allow for marketplace competition to assert itself resulting in lowering costs. As for those without employer provided group coverage and the unemployed, he would rely on individual states to establish "risk pools" to limit premiums. He promises to work with governors to create "Guaranteed Access Plans"(GAP) with federal assistance. The cost for the McCain plan, according to the campaign, would not require any additional taxes.

In contrast, Barack Obama's plan would establish a new government department called the National Health Insurance Exchange (NHIE) which would act as a watchdog over private insurers by creating rules and standards while monitoring them to assure that their plans meet basic requirements and would have control over premiums and rates. Further, the plan would require that all employers including those with few employees to contribute a percentage of their payroll towards health insurance coverage. The Obama plan would mandate coverage for all children. Other than the new payroll tax, funding for the plan is not clearly spelled out. Experts seem to agree that if implemented in full, the Obama plan would require 90 Billion dollars per year. Since he has not mentioned cutting any other program, it would appear that the money would have to come from increasing taxes. For the small employer with 2 employees, they could expect to pay an additional $7500 annually.

Americans have accepted for generations that primary and secondary education is a right and but has resisted its nationalization, insisting that control should be local and reflective of the community. The healthcare debate has traditionally been over the similar assertion that healthcare is a basic right and therefore should be guaranteed by the government. The question is the role of the federal government. The choice that the two candidates have put before the voters addresses this fundamental quandary.

The Edge