K
Kickin' Ass and Takin' Names
Guest
You gotta love this headline (unless you're a Republican).
McCain camp working out healthcare details
Aides struggle to sort out his promises
Aides struggle to sort out his promises? Oy. See, he's got a problem.
His proposals don't make much sense.
When Senator John McCain unveiled his healthcare proposal last fall, a
journalist asked whether the Arizona senator's battle against skin
cancer would make him sympathetic to the idea of requiring that
insurance companies provide coverage to people with preexisting
conditions.
McCain flatly rejected the idea. "That would be mandating what the
free enterprise system does," McCain said.
McCain's response highlights the challenge he faces as he prepares to
try to sell his healthcare plan in the fall campaign. He says the
country must provide access to healthcare for all our citizens, and
that "we need to help people who need it." But McCain also wants to
shrink government's role in healthcare and doesn't want to impose
regulations on insurance companies.
As a result, McCain's aides have been scrambling to come up with ways
to satisfy those who want more coverage without violating what they
call McCain's conservative principles on the issue.
And therein lies McCain's problem. You can't move toward more coverage
without violating McCain's conservative principles.
McCain, for example, has spoken in general terms about how he might
help people with preexisting conditions. He has said he favors what he
calls a "special provision including additional trust funds for
Medicaid payments." The comment left even some of his aides unsure of
his meaning. Medicaid funds are generally used to help lower-income
Americans.
Lately, some of McCain's aides have said he might try to divert some
Medicaid funds into a program that would help people with preexisting
conditions, but his advisers can't yet say how such a program would
work or how many people would be covered.
"These are real questions, and I think there will be answers, and
there better be, but they are not there yet," said McCain adviser
Thomas P. Miller, a resident fellow at the American Enterprise
Institute. "A lot more remains to be hammered out."
See, McCain doesn't really know a lot about complicated things like
Sunni vs Shi'a or condoms and HIV, and he sure as hell doesn't
understand his own health care proposals. Interestingly, in this case,
neither does his aides.
In a nutshell, the McCain plan focuses much more on cost than access.
Similar to Bush, McCain wants to move the burden of insurance from
employers to individuals, and let the market work it out. This
analysis comes from the Health Care Policy and Marketplace Review,
where Bob Laszewski has asked tough questions of all the candidate
plans:
However, the real question is, will McCain's plan give people enough
to be able to afford health insurance? With the average cost of
employer-provided family health insurance at $12,000 a year, a $5,000
tax credit will often come up way short--especially for higher age
people and those who don't have the benefit of an employer
contribution. High deductibles and HSA plans will help but families
who don't have employer contributions should be prepared to pay at
least a few thousand extra dollars.
And to further expand the part about the McCain tax credit:
If McCain were to be successful in moving the system from the employer
to the individual with his individual tax credit proposals, the
employer arguably would have a smaller incentive to continue providing
these benefits. Many employers might simply say, "Here's the money I
was paying--go find your own coverage." It may just be easier for the
employer to drop the coverage and give the employee the cash value of
the health benefits.
The employer would also have the new advantage of having the
difference in wages go up each year by the wage rate while the
employee saw his health care costs rise at the rate of health care
inflation--which has averaged two to three times more.
McCain does not have a mandate to buy insurance for individuals or
employers. So, people can still opt to go without coverage.
Again, the big question is how does McCain see his individual health
insurance market working. How will he deal with age rating, medical
underwriting, and pre-existing conditions? If McCain does not develop
an individual health insurance market everyone can access, no matter
how old or how sick they are, his plan will fall way short. He needs
to detail his "risk adjustment bonus" scheme for older and higher cost
families.
One of the intriguing things about the McCain proposal is that it gets
more points for cost containment (or, if you prefer, cost-shifting)
than for availability.
McCain camp working out healthcare details
Aides struggle to sort out his promises
Aides struggle to sort out his promises? Oy. See, he's got a problem.
His proposals don't make much sense.
When Senator John McCain unveiled his healthcare proposal last fall, a
journalist asked whether the Arizona senator's battle against skin
cancer would make him sympathetic to the idea of requiring that
insurance companies provide coverage to people with preexisting
conditions.
McCain flatly rejected the idea. "That would be mandating what the
free enterprise system does," McCain said.
McCain's response highlights the challenge he faces as he prepares to
try to sell his healthcare plan in the fall campaign. He says the
country must provide access to healthcare for all our citizens, and
that "we need to help people who need it." But McCain also wants to
shrink government's role in healthcare and doesn't want to impose
regulations on insurance companies.
As a result, McCain's aides have been scrambling to come up with ways
to satisfy those who want more coverage without violating what they
call McCain's conservative principles on the issue.
And therein lies McCain's problem. You can't move toward more coverage
without violating McCain's conservative principles.
McCain, for example, has spoken in general terms about how he might
help people with preexisting conditions. He has said he favors what he
calls a "special provision including additional trust funds for
Medicaid payments." The comment left even some of his aides unsure of
his meaning. Medicaid funds are generally used to help lower-income
Americans.
Lately, some of McCain's aides have said he might try to divert some
Medicaid funds into a program that would help people with preexisting
conditions, but his advisers can't yet say how such a program would
work or how many people would be covered.
"These are real questions, and I think there will be answers, and
there better be, but they are not there yet," said McCain adviser
Thomas P. Miller, a resident fellow at the American Enterprise
Institute. "A lot more remains to be hammered out."
See, McCain doesn't really know a lot about complicated things like
Sunni vs Shi'a or condoms and HIV, and he sure as hell doesn't
understand his own health care proposals. Interestingly, in this case,
neither does his aides.
In a nutshell, the McCain plan focuses much more on cost than access.
Similar to Bush, McCain wants to move the burden of insurance from
employers to individuals, and let the market work it out. This
analysis comes from the Health Care Policy and Marketplace Review,
where Bob Laszewski has asked tough questions of all the candidate
plans:
However, the real question is, will McCain's plan give people enough
to be able to afford health insurance? With the average cost of
employer-provided family health insurance at $12,000 a year, a $5,000
tax credit will often come up way short--especially for higher age
people and those who don't have the benefit of an employer
contribution. High deductibles and HSA plans will help but families
who don't have employer contributions should be prepared to pay at
least a few thousand extra dollars.
And to further expand the part about the McCain tax credit:
If McCain were to be successful in moving the system from the employer
to the individual with his individual tax credit proposals, the
employer arguably would have a smaller incentive to continue providing
these benefits. Many employers might simply say, "Here's the money I
was paying--go find your own coverage." It may just be easier for the
employer to drop the coverage and give the employee the cash value of
the health benefits.
The employer would also have the new advantage of having the
difference in wages go up each year by the wage rate while the
employee saw his health care costs rise at the rate of health care
inflation--which has averaged two to three times more.
McCain does not have a mandate to buy insurance for individuals or
employers. So, people can still opt to go without coverage.
Again, the big question is how does McCain see his individual health
insurance market working. How will he deal with age rating, medical
underwriting, and pre-existing conditions? If McCain does not develop
an individual health insurance market everyone can access, no matter
how old or how sick they are, his plan will fall way short. He needs
to detail his "risk adjustment bonus" scheme for older and higher cost
families.
One of the intriguing things about the McCain proposal is that it gets
more points for cost containment (or, if you prefer, cost-shifting)
than for availability.
