• The Heritage Network
    • Resize:
    • A
    • A
    • A
  • Donate
  • Health Care at a Crossroads: McCain and Obama's Proposals

    Presidential candidates John McCain and Barack Obama are offering ambitious, comprehensive and expensive health care reform plans. Both would greatly expand health insurance coverage for millions of Americans.

    Examining the key elements of these two competing plans, one can discern clearly two very different visions of America’s health care future. They are polar opposites. The Obama health plan would centralize power over health care financing and delivery in Washington. The McCain health plan would decentralize control over health care financing and decision-making among individuals and families, while retaining authority in the states. This is not a judgment; it is a fact.

    The Obama plan is comprehensive in scope, but sparse in detail. He proposes four major steps to expand coverage:

    1. The creation of a new national health plan (a government health plan) that would enroll those who do not have employer based coverage or who are ineligible for existing government health programs, such as Medicaid and SCHIP
    2. The creation of a national health insurance exchange, which would serve as a regulatory “watchdog” to enforce federal rules and standards on both the new federal health plan and those private health plans permitted to compete with the new government health plan.
    3. An employer mandate, whereby employers either offer a government-approved health benefits package of unspecified value or pay a new federal tax of an unspecified amount, which would finance coverage in the new government plan.
    4. An expansion, again unspecified, of existing government health programs, particularly Medicaid and SCHIP, along with new regulatory initiatives governing the delivery of medical care by physicians and other medical professionals.

    Independent analysts expect that Obama’s creation of a new national health plan within a federally run “health insurance exchange” would lead to a rapid erosion of private coverage in general and employer-based coverage in particular. The Lewin Group, a prominent econometrics firm based in Virginia, estimates that the Obama plan would result in a net reduction of the uninsured by 26.6 million. But the composition of American insurance coverage would change. 22.5 million Americans would lose their employer based coverage, according to the Lewin analysis, and an estimated 48.3 million more Americans, including those who lost employer-based coverage, would be enrolled in government health care programs.

    The McCain plan is also comprehensive in scope, and likewise lacks some critical details. He proposes three major steps to expand coverage:

    1. The replacement of existing federal tax breaks for employment-based health insurance (specifically, the employees’ tax exclusion, not the employer’s deduction) with a universal health care tax credit worth $5,000 for a family and $2,500 for an individual, annually indexed for inflation.
    2. The creation of a national market for health insurance (quite unlike Obama’s national health insurance exchange), where individuals and families could buy state-regulated health insurance plans anywhere in the country, not just in the state where they happen to live.
    3. A “guaranteed assistance program,” whereby federal authorities would financially assist state officials in providing affordable insurance coverage for the estimated 2 million to 5 million Americans who are “uninsurable” or hard to insure because of medical conditions. This would be accomplished through state-based high risk pools or similar mechanisms. Like Obama, McCain would also promote changes in the delivery of medical care to secure greater value for health care dollars.

    Independent analysts generally see McCain’s proposal as a bold and innovative change in health care financing. Powered by a universal health care tax credit, the tax policy change would result in a rapid expansion in private health insurance coverage and a decrease in dependency on government programs. While some critics imply that McCain’s proposal to tax health benefits to finance the tax credit amounts to a tax increase, the indisputable truth is that it is a major tax cut, particularly for the middle class. Urban Institute analysts, for example, estimate that the typical family would come out roughly $1,200 ahead annually. The Lewin Group estimates that the McCain plan would result in a net reduction of the uninsured by 21.1 million. Likewise, the composition of American insurance coverage would change. An estimated 26.5 million persons would gain private insurance coverage, according to the Lewin Group, and 5.4 million Americans currently on Medicaid would secure private health insurance coverage.

    Posted in Obamacare [slideshow_deploy]

    9 Responses to Health Care at a Crossroads: McCain and Obama's Proposals

    1. Pingback: Learn Health Today » HealthCare at a Cross Roads

    2. Pingback: Health Made Easy » HealthCare at a Cross Roads

    3. Pingback: Health Babe » MRSA Infections Come to the Doctor s Office

    4. Pingback: Health Care at a Crossroads: McCain and Obama’s Proposals - Jason’s Blog

    5. Teri, Medford OR says:

      About four years ago I check into getting health insurance for myself. I don't have any. I'm 58 years old now and I'm healthy – with exception of a few aches and pains. I don't smoke or drink.

      The cost for insurance with a $10,000 deductible (yes, ten-thousand dollar deductible) would have cost me $350 per month. I couldn't afford it.

      Even though I'm voting for McCain (I'm even a McCain volunteer) I can see that his health care plan wouldn't even begin to help me.

    6. B. Jacoby says:

      I am going to vote for McCain. BUT, I do not understand how a $5000. tax credit is going to help my grandchildren and their families.

      They don't have the money to purchase insurance in the first place. So, unless they get a check from McCain for $5000 first, they won't be able to take advantage of a tax credit.

      This plan really doesn't seem to help those that cannot afford insurance. Insurance companies have such high deductibles now, most people just go to a doctor or hospital, and have to let the taxpayers pay their bills.

      If people aren't covered by their employer's plan, and can barely pay a portion with their paychecks, then how in the world will they pay the full price for insurance of their choice?

    7. Jerry Johnson, Lees says:

      Health care premiums are only part of the problem. My wife and I pay $1201 for a retiree plan from my former employeer. Other problems include the physician's cost for liability insurance, the CYA tests that result and our ability to maintain life beyond what is often reasonable. All of us have to make individual decisions about when enough is enough for a terminal parent or God forbid, child. The truth of the matter is we are all going to die. I am 64 and have a medical directive to prevent the costly extra mile(s) of treatment that will keep me going just for the sake of keeping me going. It's not the length of life that counts but the quality and fruitfulness of the life we have lived. These issues need to be discussed openly if we are to get a handle on these costly areas of modern health care.

    8. Phyllis Talmadge, Ge says:

      I would like to be able to pay for my own health care. I would like for the Washington bureaucrats to stop getting into private sector issues and let the free market decide. I think a lot of health issues are caused by personal irresponsibity. Sometimes there is a birth defect or something too big for persons to handle by themselves. At that time some outside help would be called for. But for the most part we must be responsible and watch what we put into and do or don't do to our own bodies. The Government bureaucrats are so well paid and well cared for that they think that all of America is unable or unaware of the wonders of what Federal money can do for and to American, forgetting the Can-Do spirit and self-suffiency. Bureaucrats fix for solving every problem is to throw money at it: that taxpayers must pay. (Money-Which is only paper that the Mint is printing limitlessly)

    9. Lary, Asheville,NC says:

      This is a very touchy and confusing issue for most Americans, we have not been given enough information by either candidate on their plans. Most people see the word "free" and they think that everyone is going to get Health Insurance at no cost. Just remember Hillary worked on it for 8 years and nothing changed. The AMA and Health Care industries have lobbyists also.

    Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone's intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.

    Big Government Is NOT the Answer

    Your tax dollars are being spent on programs that we really don't need.

    I Agree I Disagree ×

    Get Heritage In Your Inbox — FREE!

    Heritage Foundation e-mails keep you updated on the ongoing policy battles in Washington and around the country.