Candidates' Health Care Plans: Private Vs. Public

**min0 lee** · 08-11-2008, 03:28 PM

Election 2008
Candidates' Health Care Plans: Private Vs. Public

by Julie Rovner

Gabriel Bouys/Emmanuel Dunand
AFP/Getty Images

Comparing The Plans

McCain: He would replace the current tax-free status of health insurance coverage provided by employers with refundable tax credits worth $2,500 for individuals and $5,000 for families to help purchase insurance. McCain would allow the sale of insurance policies across state lines, rather than state by state, as is currently the case.

Obama: He would create a new plan for those who lack other access to coverage, as well as a National Health Insurance Exchange to help pool the purchasing power of small businesses and individuals. Obama would also offer a combination of subsidies and tax credits to help make coverage more affordable. He would mandate health insurance coverage for children, but not adults. Obama would create a federally sponsored health insurance plan, similar to Medicare, that would compete with private plans for those under age 65.

NPR.org, August 20, 2008 Â· Health care has fallen from its status as the top domestic issue in this year's presidential campaign, but that doesn't mean voters no longer care.
A poll released last week found more than 80 percent of those surveyed think the nation's health care system needs fundamental change. Both Arizona Sen. John McCain and Illinois Sen. Barack Obama are promising that, but change is really the only feature their plans have in common.
McCain and Obama have very different prescriptions for solving the problem of ballooning health care costs, says Jonathan Oberlander, a professor of health politics and policy at the University of North Carolina at Chapel Hill.
"There are many issues where Obama and McCain differ," he said. "I'm not sure there's any issue where they differ as much as this. Sometimes we complain in politics that Democrats and Republicans run to the center, and they copy each other with their proposals. At least in health care, we don't have to worry about that."
McCain's Plan
Of the two candidates, McCain is arguably the one whose plan would change the health system the most. Right now, if you get insurance from your employer, you don't pay taxes on the value of that benefit.
But if you have to buy your own insurance and you're not self-employed, you don't get any tax help. McCain would change that: He'd make employer-provided insurance taxable, but then give everyone a tax credit.
"Our proposal is to give every family in America a $5,000 refundable tax credit, and they take that tax credit and that money â€” a refundable tax credit â€” to go across state lines, to go any place in America, and go online, and pick out the insurance policy they want," McCain said.
There are lots of questions about McCain's plan. How hard will it be for people who are already sick to buy insurance? Will people really be able to find policies they can afford when the average family policy now costs more than $13,000? And does the public really want to move away from a system in which employers provide most people's health insurance to one where most people buy their own?
But McCain says in the end, there's one main reason he wants to move in the direction he has chosen.
"I want the families to make the choices," he said. "[Democrats] want the government to make the choices. That's a fundamental difference."
Obama's Plan
What Obama is proposing isn't really government-run health care. It doesn't even have a requirement for individuals to have coverage, like the plans offered by his main Democratic primary opponents, former North Carolina Sen. John Edwards and New York Sen. Hillary Clinton.
Obama says that under his plan, if you already have insurance you like, you can keep it.
"But if you're one of the 45 million Americans who don't have health insurance, then you will have it available to you. No one will be turned away because of a pre-existing condition or illness," Obama said. "Everyone will be able to buy into a new health insurance plan that's similar to the one that every federal employee from a postal worker in Iowa to a congressman in Washington currently has for themselves."
If you can't afford coverage, you'll get a subsidy. Employers would have to offer coverage to their workers, but they'd get government help, too.
Comparing The Candidates' Plans
Oberlander says the McCain and Obama plans would essentially move the system in exactly opposite directions.
"While Sen. Obama wants to build on top of the employer-sponsored insurance system, Sen. McCain wants to build away from it and move more people to the individual insurance market," he said.
In fact, says Oberlander, in many ways the current debate reminds him of the movie Groundhog Day â€” except he keeps waking up and thinking it's 1992.
"The stock Democratic health reform solution, before Bill Clinton changed it, was a play-or-pay employer mandate, and that's exactly what Barack Obama has," Oberlander says. "And in 1992, the favorite GOP solution was tax credits to buy private health insurance. So, a lot of things have happened in 16 years; the health care system is much worse than it was, but we pretty much have the same solutions that we've always had."

**maniclion** · 08-11-2008, 07:34 PM

It's a buy-me-drinkie bar system fools paying to have sweet nothings whispered in their ear by the candidate they find the most attractive to their mentalities, pay to hear what you want while telling your buddy his drinkie girlie looks like a pigeon-toed wombat, but I always saw their skulls.....and still do.

**bio-chem** · 08-11-2008, 10:03 PM

Originally Posted by maniclion

It's a buy-me-drinkie bar system fools paying to have sweet nothings whispered in their ear by the candidate they find the most attractive to their mentalities, pay to hear what you want while telling your buddy his drinkie girlie looks like a pigeon-toed wombat, but I always saw their skulls.....and still do.

lay off the crack pipe

**bio-chem** · 08-11-2008, 10:07 PM

government sponsored healthcare is a failure. ask canada. look at how many canadians jump the border to get healthcare in america. private canadian healthcare systems are also popping up to compete with government hospitals. healthcare is so bad in canada that people are willing to pay extra on top of the taxes they normally pay for access to private hospitals. McCain FTW. we need competition to keep the american healthcare system strong. if you look at it, because of competition here in america we come up with more new procedures than any other country. cutting edge healthcare is found in america for a reason. it aint medicare.

**ST240** · 08-11-2008, 10:26 PM

Originally Posted by bio-chem

government sponsored healthcare is a failure. ask canada. look at how many canadians jump the border to get healthcare in america. private canadian healthcare systems are also popping up to compete with government hospitals. healthcare is so bad in canada that people are willing to pay extra on top of the taxes they normally pay for access to private hospitals. McCain FTW. we need competition to keep the american healthcare system strong. if you look at it, because of competition here in america we come up with more new procedures than any other country. cutting edge healthcare is found in america for a reason. it aint medicare.

Eh? I savagely broke my ankle 5 months ago. I was admitted to the ER and was in surgery 5 hours later. A few hours of surgery, one plate and two large screws later I was out and on the road to recovery. I left the hospital less than 48 hours after arriving. If that isnt good healthcare then please tell me what is.

**bio-chem** · 08-11-2008, 11:09 PM

Originally Posted by ST240

Eh? I savagely broke my ankle 5 months ago. I was admitted to the ER and was in surgery 5 hours later. A few hours of surgery, one plate and two large screws later I was out and on the road to recovery. I left the hospital less than 48 hours after arriving. If that isnt good healthcare then please tell me what is.

i spend every day at work speaking with healthcare professionals throughout north america and all of them in canada say the same thing. they wish it was like the US.

and to my other point. how often do you hear of people flying to canada for healthcare? now, how often do you hear of people having to fly to america for a surgery because it has only been done here?

**brogers** · 08-11-2008, 11:53 PM

IBDeditorials.com: Editorials, Political Cartoons, and Polls from Investor's Business Daily -- A Canadian Doctor Describes How Socialized Medicine Doesn't Work

Congress's approval was 9% last I heard (couple weeks ago). People whine and moan about Bush wasting money and creating big deficits and how inept the government is (which I agree, it is), yet these same people want to turn over their health care to the government.

I for one would like to avoid my doctor's office turning into the DMV, service-wise. Would you?

**busyLivin** · 08-12-2008, 05:51 AM

People have no concept of what government-run health care will do, especially our inept & incompetent government. Absolutely no concept. This country deserves an Obama for their ignorance.

In four years, maybe they'll pay a little more attention.

**tucker01** · 08-12-2008, 11:13 AM

Originally Posted by bio-chem

government sponsored healthcare is a failure. ask canada. look at how many canadians jump the border to get healthcare in america. private canadian healthcare systems are also popping up to compete with government hospitals. healthcare is so bad in canada that people are willing to pay extra on top of the taxes they normally pay for access to private hospitals. McCain FTW. we need competition to keep the american healthcare system strong. if you look at it, because of competition here in america we come up with more new procedures than any other country. cutting edge healthcare is found in america for a reason. it aint medicare.

Hardly a failure. Does it need a drastic overhaul yes. I like that private facilities are available as well (two-tiered)

**bio-chem** · 08-12-2008, 11:15 AM

Originally Posted by IainDaniel

Hardly a failure. Does it need a drastic overhaul yes. I like that private facilities are available as well (two-tiered)

knowing it needs a drastic overhaul why oh why would americans want to move more in that direction?

**tucker01** · 08-12-2008, 11:16 AM

Originally Posted by bio-chem

i spend every day at work speaking with healthcare professionals throughout north america and all of them in canada say the same thing. they wish it was like the US.

and to my other point. how often do you hear of people flying to canada for healthcare? now, how often do you hear of people having to fly to america for a surgery because it has only been done here?

They say that cause of pay structure. Any good surgeon would go to the states obviously cause they can demand a higher price. There has been talk about Brain-Drain in the medical community in Canada for years. Cause of the powerful dollar.

**tucker01** · 08-12-2008, 11:17 AM

Originally Posted by bio-chem

knowing it needs a drastic overhaul why oh why would americans want to move more in that direction?

I am not saying our system is the right direction. I don't believe it is either.

**bio-chem** · 08-12-2008, 11:18 AM

Originally Posted by IainDaniel

I am not saying our system is the right direction. I don't believe it is either.

and that is the decision some of our leaders here in the US want to take us

**tucker01** · 08-12-2008, 11:19 AM

Originally Posted by busyLivin

People have no concept of what government-run health care will do, especially our inept & incompetent government. Absolutely no concept. This country deserves an Obama for their ignorance.

In four years, maybe they'll pay a little more attention.

Agreed it is a huge task to take on, and considering the financial situation already in the states, this doesn't make sense.

**BulkMeUp** · 08-12-2008, 11:22 AM

Originally Posted by IainDaniel

Hardly a failure. Does it need a drastic overhaul yes. I like that private facilities are available as well (two-tiered)

**BulkMeUp** · 08-12-2008, 11:23 AM

Originally Posted by bio-chem

knowing it needs a drastic overhaul why oh why would americans want to move more in that direction?

Why dont you look it as an opportunity to learn for its mistakes and come up with a better system? or are you saying americans are not able to do that?

**tucker01** · 08-12-2008, 11:26 AM

I honestly don't think a country as large as the states 300+ million people could support social health care. It is too late, a disgustingly expensive.

**BulkMeUp** · 08-12-2008, 11:31 AM

Originally Posted by IainDaniel

I honestly don't think a country as large as the states 300+ million people could support social health care. It is too late, a disgustingly expensive.

They could start with a state-by-state kinda setup just as we have our provincial healthcare setup. Smaller setupto start with before going universal. I'm just thinking out aloud. But i agree with you, it will cost mucho dollar and be a massive program to be implemented.

**min0 lee** · 08-12-2008, 11:38 AM

Is it me but are doctors becoming more crooks by the day, I swear when I had co-pay they always tried to make me come more than necessary in order to get the co-payment money. Hey it adds up.

**tucker01** · 08-12-2008, 11:39 AM

Originally Posted by min0 lee

Is it me but are doctors becoming more crooks by the day, I swear when I had co-pay they always tried to make me come more than necessary in order to get the co-payment money. Hey it adds up.

Yep they do that all the time up here. They only get paid for office visits.

**bio-chem** · 08-12-2008, 01:14 PM

Originally Posted by BulkMeUp

Why dont you look it as an opportunity to learn for its mistakes and come up with a better system? or are you saying americans are not able to do that?

I hope we are. I'm saying that we have two plans set before us right now. one will take us towards that system the other will take us away from it. people's votes will largely determine the next few years direction of the american healthcare system. i'll tell you this, if obama's plan is put into effect american hospitals will start spending less money on new systems and equipment and will largely try and make due with what they have. if the reimbursement is not there for them from private insurers spending is greatly curtailed in a hospital.

**bio-chem** · 08-12-2008, 01:17 PM

Originally Posted by min0 lee

Is it me but are doctors becoming more crooks by the day, I swear when I had co-pay they always tried to make me come more than necessary in order to get the co-payment money. Hey it adds up.

if the american people understood how the financial system of america's healthcare works we would be happy to pay our co-pay. american hospitals have programs built into the billing system for circumstances they know they will not be payed for. the fact these guys survive to provide us the level of care we get is amazing.

**min0 lee** · 08-12-2008, 01:39 PM

Originally Posted by bio-chem

if the american people understood how the financial system of america's healthcare works we would be happy to pay our co-pay. american hospitals have programs built into the billing system for circumstances they know they will not be payed for. the fact these guys survive to provide us the level of care we get is amazing.

I was already paying a lot of for my health insurance.
To make matters worse we still had to pay a lot for what's not covered.

A ride in a ambulance is something like $900.00....next time I'll ride the subway...all bloody and all.

Crooks, all of them.

**NeilPearson** · 08-12-2008, 02:23 PM

Originally Posted by bio-chem

i spend every day at work speaking with healthcare professionals throughout north america and all of them in canada say the same thing. they wish it was like the US.

and to my other point. how often do you hear of people flying to canada for healthcare? now, how often do you hear of people having to fly to america for a surgery because it has only been done here?

As a Canadian, I have never known of anyone that flew to the US for a surgery.

I keep hearing how Canada's system is a failure but it's not really the Canadians that are talking.

**min0 lee** · 08-12-2008, 02:26 PM

I know of a few people in Rochester going over to get medication in Canada.

**BulkMeUp** · 08-12-2008, 02:27 PM

Originally Posted by NeilPearson

As a Canadian, I have never known of anyone that flew to the US for a surgery.

I dont know about surgery but there have been news items in the past on those that went across for tests like mammograms. Usually it is those that dont want to want for their turn to do the test here and opt to go over and pay for the test done to get the results. At one point i think there was a backlog but i think that has been fixed now.

**BulkMeUp** · 08-12-2008, 02:34 PM

Originally Posted by min0 lee

I know of a few people in Rochester going over to get medication in Canada.

Thats been going on for quite a while. I dont know how prevalent is it currently now that the ca$=us$. The big US drug companies have been doing their best to stop it so that they can continue to gouge their fellow Americans with higher prices.

**min0 lee** · 08-12-2008, 03:04 PM

From what I understand you can save a whole lot of money, and I do mean a lot.

**bio-chem** · 08-12-2008, 03:19 PM

Originally Posted by NeilPearson

As a Canadian, I have never known of anyone that flew to the US for a surgery.

I keep hearing how Canada's system is a failure but it's not really the Canadians that are talking.

speak to the canadians who work in healthcare. and i really meant people flying to america from asia or europe. inovation in healthcare predominately comes from america.

**BulkMeUp** · 08-12-2008, 03:28 PM

Originally Posted by bio-chem

speak to the canadians who work in healthcare. and i really meant people flying to america from asia or europe. inovation in healthcare predominately comes from america.

I'm confused from your posts. Are you talking about health care as a system or the quality of health care? I do agree that the US, among other countries, is a leader in the kind of medical care it can offer. But I thought we were talking about health care as a system and its level of accessibility to the population.

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