Reviewing the Candidates’ Health Care Reform Plans
Sunday, July 20th, 2008
With the costs of health care on the rise, and the number of uninsured Americans larger than ever, both major presidential candidates have plans in place to reform the system. Unfortunately, both their plans are seriously flawed, and, as I have said before, until we as a society are willing to reconsider what our expectations are from a comprehensive health coverage plan, we will never be happy.
The candidates’ plans are presented in no particular order. Full disclosure: I am registered as non-partisan, belonging to no political party.
Senator Obama’s plan, in his own words, “begins by covering every American.” However, despite this assertion, details listed further down his web page, make it clear that he is offering availability to everyone, but not necessarily coverage.
In addition, Mr. Obama writes that everyone will have access to the same plan as federal employees and that they would have “affordable premiums.” One has to wonder who can afford such premiums. Reviewing the 2008 premiums for these plans, which vary by state and within states, the plans are hardly cheap. Lower cost individual plan premiums run $3,939/year, and family plans are $9,060/year. More expensive plans run $6,522/year for premiums, and families pay $15,081/year. Hard to call that affordable.
Of course, we forget that when employers pay for plans, that money is really coming out of the employee’s pocket, because it is the total compensation package that the employer pays for, and truth be told, if health coverage were not offered, that additional money would be available in the form of salary. But most people don’t think that way.
Senator McCain, on the other hand, clearly offers a plan with universal access, not universal coverage, saying “access to health care for every American.” His program relies on private enterprise to provide coverage to all Americans instead of implementing a government controlled plan. This, however, is simply not realistic. Health plans, despite what they want the world to think, are in the business of making money, and have no interest in covering the sickest (read: most expensive) patients. The Senator writes about his GAP program – Guaranteed Access Plans – but details are conspicuously absent.
To make matters worse, Senator McCain’s program offers tax rebates to employees who opt out of employer-offered health plans, with the intention that those people would use the rebate money to purchase their own health plan. Alas, he appear to have ignored the rule of unintended consequences: as young, healthy people, who can purchase cheap health coverage, opt out of employer-offered plans, and the sicker people remain with the ‘more affordable’ plan, the employer plans will become more expensive with each iteration as the plans find their members costing more each year, and ultimately the gap between those who do and do not need comprehensive care will grow wider yet. (The irony of gap v. GAP is not missed.)
Lastly, it is worth bearing in mind that foreign governmental plans that provide comprehensive coverage for all citizens (i) have special, usually high, taxes that pay for those plans, and (ii) have many coverage limitations that would shock most Americans. It is hard to imagine a universally accepted national health program in this land of opportunity that would have coverage limitations such as no dialysis over the age of 65, or no pacemakers over the age of 70. On the other hand, if such limitations, which are not unheard of overseas, would be absent in a national American program, the costs of our national health care would certainly exceed today’s 16% of GDP by a large margin, and that money would have to come from somewhere.