Wednesday, October 29, 2008

Compare Obama, McCain health insurance reform plans


Today (Oct. 29), the Washington Post offers a “comparative government” analysis of the health care proposals by Barack Obama and John McCain on the front page.

The print version of the newspaper calls the analysis “How they would change health care” and both columns are authored by Amy Goldstein,

For Obama (on the left side) the article title is “Obama’s approach emulates Massachusetts except for mandate for covering all adults,” link here.

That is, Obama would cover all children, but leave the employer-based system in place for adults. That’s the rub, because so many adults need coverage.

Obama would provide a “guaranteed issue” concept to handle pre-existing conditions, and would create a national health insurance exchange with a government insurance option.

In Massachusetts, the mandatory insurance plan does not protect workers covered at the workplace who find their premiums are too high. They can wind up paying a fine with no coverage.

For McCain (the right article), the article is “McCain’s proposal for high-risk coverage is similar to a program in Minnesota,” with link here.

The state runs a last-resort catastrophic coverage pool, the MCHA, or Minnesota Comprehensive Health Association. I thought it interesting that Blue Cross and Blue Shield (in Eagan; I drove past I many times when I lived there) turned anyone down; I thought the Blues took everyone. The story gives many cases where catastrophic coverage was inadequate, even in a “blue” state like Minnesota (with a moderate Republican governor).

McCain says he would create a “guaranteed access plan” for those with high risk.

McCain has drawn controversy by saying that he would tax employees for the value of their employer’s contributions, but then turn around and offer tax-free money for individuals to buy insurance on their own. Presumably the tax exclusion would help the employee pay for his or her own contribution to employer coverage, so the net effect would be a wash, maybe.

McCain says his plan is budget neutral. Obama says his would cost $50 billion to $65 billion a year and would be paid for by rescinding Bush tax cuts on the wealthy or increasing taxes on those making over a certain amount ($250000 a year, maybe).

Neither story discussed eldercare.

The Washington Times today offers an op-ed by Robert Moffit, director of the Center for Health Policy Studies at the Heritage Foundation, on p A18, titled "Competing health-care remedies," link here. Moffit starts by admitting that about 47 million Americans lack health insurance coverage, and this is a big problem.

Also, The Lewin Group (I worked for its predecessor from 1988-1990) has offered a webcast of a comparison of Obama's and McCain's health care plans. One must register to listen to and watch the comparison. The report is called "McCain and Obama Health Policies: Costs and Coverage Compared: McCain and Obama Health Policies: An independent comparative analysis of the candidate's potential health care reform policies presented by John Sheils, Senior Vice President The Lewin Group", released Oct. 8, 2008. The link is here.

Peter J. Nelson does have an interesting piece in the Oct. 29, 2008 "MinnPost" (and circulated by the Center for the American Experience) backing up the McCain plan "Why employers won't cut and run when individuals own health insurance," link here.

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