Health plans costly regardless of author
By Herman Wang Washington Bureau
Online: Hear Sen. Bob Corker and Rep. Lincoln Davis talk about health care. Comment on this story. WASHINGTON — Republican presidential nominee John McCain has proposed freemarket reforms to the country’s health care system, while Democratic contenders Hillary Clinton and Barack Obama have offered more centralized, government-backed insurance plans. No matter which candidate takes office, one thing is certain, two health care experts said: The reforms, if they are
actually implemented, will cost plenty of money. “The real bottom line is, you can’t have big reform unless you have enough money to spend,” said Joseph Antos, a health care policy fellow at the conservative-leaning American Enterprise Institute. “The economy is tightening up, and the government is going to be looking for nickels and dimes under the seat cushions.” Added Henry Aaron, a health care expert at the liberal-leaning Brookings Institute: “It’s going to take money. We’ve got federal budget deficits. We’re tax phobic. Where does the money come from?” COMPETITION, NOT GOVERNMENT INTERFERENCE Sen. McCain said his plan, while freeing employers from the expense of providing health insurance for their workers, would force insurance companies to compete for customers shopping the marketplace for affordable coverage that meets their needs. “When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most-expensive and often unnecessary options, and are more satisfied with their choices,” Sen. McCain said last week in a campaign speech unveiling his plan in Florida. Mr. Antos, who is not affiliated with any of the campaigns but said he favors Sen. McCain’s proposal, said the McCain plan makes paying for health care more equitable. The average family policy purchased through an employer plan costs $12,000 in premiums a year, of which the employer pays about 75 percent, or $9,000, Mr. Antos said. “That is not taxed as income, even though it is saving me $9,000,” he said. “What McCain is saying, which is right, is that it’s a tax break that provides the greatest benefit for highincome people with good jobs. The people without jobs don’t get that tax break, so we’ve got things upside down in terms of equity.” But Mr. Aaron, who said he has talked about health care policy with both the Clinton and Obama campaigns, said he doubts Sen. McCain’s plan would drive down health care costs as much as touted. “To make the free market work, you have to regulate the bejeezus out of it to make sure people have access and can still afford it,” Mr. Aaron said. DEMOCRATS: UNIVERSAL ACCESS, GOVERNMENT GUARANTEED Sen. Clinton’s and Sen. Obama’s plans are similar, in that they both call for a nationalized insurance program that would offer the same premiums to everybody, regardless of health status. Under the proposals, individuals could sign up for health insurance through a one-stop shop that would list all of the health-plan choices available and what the premiums are, and insurers would not be allowed to turn down customers for pre-existing medical conditions, thus guaranteeing universal access. “I think we have all learned that America needs to provide health insurance for all Americans,” Sen. Clinton said last year when announcing her plan. Sen. Obama, who unveiled his plan last May, also argued for universal coverage. “If you are one of the 45 million Americans who don’t have health insurance, you will have it after this plan becomes law,” he said. The one difference between the two is that Sen. Clinton would mandate that all Americans have insurance, which she said would guarantee that insurers still cover less-healthy and less-wealthy people. Sen. Obama favors a mandate only for children. Sen. McCain does not favor any mandates. Mr. Aaron said both Democrats have crafted detailed plans for health care that reflect their commitment to reforming the system. But he also challenged the candidates’ assertion that their reforms would save as much money as they say. “The Congressional Budget Office has been very, very stingy in scoring some of these reforms as saving as much money as the Democrats are suggesting,” he said. Mr. Antos, while crediting the Democrats with plans that would make purchasing insurance easier, said they still could result in the end of employerprovided health coverage, the same criticism they have launched at Sen. McCain’s freemarket plan. “If you’re going to have a government fallback insurance plan, many employers will say they can’t keep up with (the benefits offered) and eliminate their plans,” Mr. Antos said. “The Democratic plans could equally be a very quick road to Medicare for all.” DEBATES HIGHLIGHT DESIRE FOR CHANGE Whichever candidate wins the election will find reforming health care a tall order, given the likely costs involved and the political consensus needed on Capitol Hill. Mr. Aaron noted that health care represents 16 percent of the U.S. economy. “There’s a real fear about moving ahead too aggressively,” he said. “The idea that the next president will reform the whole system is fanciful, but he or she could begin a path to meaningful reform with some small steps.” Tennessee and Georgia Republicans in Congress, not surprisingly, are backing Sen. McCain’s plan. “I’m concerned if we go with a government national health insurance plan, we’ll be disappointed, like the Brits and Canadians with long waits and degraded service,” said Rep. Zach Wamp, R-Tenn. Rep. Lincoln Davis, D-Tenn., said any reform should address wellness incentives and preventive care. “When you look at Tennessee and obesity and adultonset diabetes, we’re not being responsible for ourselves, and we can’t expect taxpayers to be,” he said. Sens. Lamar Alexander and Bob Corker, both R-Tenn., are among a bipartisan group of 14 senators that last week touted their health care plan as one that can be embraced by all three presidential candidates. The seven Republicans, six Democrats and one independent have pushed a plan that would guarantee access to private insurance for all Americans and issue tax credits to help them pay for coverage. “Hopefully (the next president) will realize that the way to solve this problem is to deal with a plan that works and has bipartisan support,” Sen. Corker said. E-mail Herman Wang at hwang@timesfreepress.com HILLARY CLINTON Would create a nationalized insurance system that individuals could opt for if they are dissatisfied with their employer’s coverage. Would prohibit insurance providers from denying coverage to anyone with a pre-existing medical condition or illness. Would require all individuals to have coverage. Would cost $110 billion annually, offset by rolling back some of President Bush’s tax cuts. BARACK OBAMA Would create a nationalized insurance system that individuals could opt for if they are dissatisfied with their employers coverage. Would prohibit insurance providers from denying coverage to anyone with a pre-existing medical condition or illness. Would require all individuals under 25 to have coverage, but adults could choose not to purchase insurance. Would cost $50 billion to $60 billion annually, offset by rolling back some of President Bush’s tax cuts. JOHN MCCAIN Would provide annual $2,500 tax credit for individuals and $5,000 for families to purchase health coverage on open market. Would release employers from the costs of providing insurance for employees. Would require states to create “Guaranteed Access Pools” to give coverage to individuals with pre-existing medical conditions who cannot find affordable health insurance in the market. Would cost $10 billion annually, offset by decreased Medicare and Medicaid payments and increasing efficiencies in health care delivery.
