The McCain Healthcare Plan

As I noted in a previous post on the future of healthcare in America, both candidates have dynamic proposals for reforming our healthcare system. Previously, I have discussed the Obama healthcare plan and what I found interesting about it. Today, I will address John McCain's healthcare plan. The entire plan can be found here: Straight Talk on Healthcare Reform

Here are the key points that I found interesting:

• John McCain Will Reform Health Care Making It Easier For Individuals And Families To Obtain Insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.
  
  An interesting proposal, but seeing as most families receive their health insurance through their employer, I am not sure how this would be implemented. I assume he means that employers will be able to do this on behalf of their employees. Furthermore, while competition may indeed prove beneficial, health insurance differs from other goods due to the complex nature of what is covered. If policies end up competing primarily on price without regard to benefits, it is not clear how families would be better served.
  
  
  
• John McCain Will Reform The Tax Code To Offer More Choices Beyond Employer-Based Health Insurance Coverage. While still having the option of employer-based coverage, every family will receive a direct refundable tax credit - effectively cash - of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider
  
  Seems like a good idea, except from what I have heard, most plans start around $12,000 per year for a family of four, so I think the credit would have to be expanded.
  
  
  
• John McCain Proposes Making Insurance More Portable. Americans need insurance that follows them from job to job. They want insurance that is still there if they retire early and does not change if they take a few years off to raise the kids.
  
  Makes sense, but how will this be enforced? What if the company fired the employee for poor performance or illicit behavior? This gets to the heart of the problem of tying insurance to employment. Sure, employee pools make for good pseudo-random groups to insure, but it doesn't make sense in the grand scheme of things, especially when one considers that sick people generally are not good workers.
  
  
  
• John McCain Will Work With States To Establish A Guaranteed Access Plan. As President, John McCain will work with governors to develop a best practice model that states can follow - a Guaranteed Access Plan or GAP - that would reflect the best experience of the states to ensure these patients have access to health coverage. One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.
  
  I don't understand how the government forming a "nonprofit corporation" (NPC) that covers apparently everyone that the insurance companies don't want to cover (ie, the costliest patients) is any different from a bastardized single payer system. If anything, this is worse than single payer, since this NPC would effectively take on the 'worst' patients leaving the insurance companies to cherry pick the lowest risks for themselves.
  
  
  
• CHEAPER DRUGS: Lowering Drug Prices. John McCain will look to bring greater competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs.
  
  I have the same issues here as I did with Obama's version, namely who is going to regulate this? The FDA? Also, McCain does not address the 2003 Medicare bill.
  
  
  
• TORT REFORM: Passing Medical Liability Reform. We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an invitation to endless, frivolous lawsuits.
  
  Again, makes sense. However, without any specifics, it seems like empty rhetoric, especially under the current system, this is more a state-by-state issue, rather than a federal one.
  
  
  
• John McCain is very concerned about the rising incidence of autism among America's children and has continually supported research into its causes and treatment
  
  A nice sentiment, but is this really a national issue? Somehow, I feel like McCain has only come to care about this in the last 8 weeks or so...
  
  

Overall, I think McCain's plan has some intriguinig ideas but without more specific details, it is hard to evaluate them. Both plans seem to suffer from a lack of detail in terms of how they will pay for these proposals, implement them, or enforce them. Still, it bothers me that McCain seems to think that the solution lies in putting more power in the hands of patients without many safeguards to ensure that they actually receive adequate care. Having a $5000 tax credit isn't much solace to someone with a new diagnosis of cancer, especially if they are uninsured, since the cancer is now a 'pre-existing condition,' meaning they will not be insured in the future. Perhaps the non-profit corportation would pick up the slack here, but without much detail, who knows how that would work?

In the final judgment, I think both plans have significant deficiencies, but I believe the Obama plan to be the stronger of the two. Still, much change is needed before the U.S. healthcare system truly lives up to its potential. Your thoughts?