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Posted: September 03, 2008

McCain vs. Obama on Fixing Health Care: Who Would Do What?

With the presidential campaign in high gear, health care is a front-burner issue for both Democrat Barack Obama and Republican John McCain. Both candidates have offered plans, and a variety of interest groups, such as elderly advocacy group AARP, have aggressively pushed government officials to "fix" health care.


"Fixing" health care is a way of saying that more Americans should be shielded from the costs of their health care. For most, health insurance policies provided through their employers serve as that cost buffer. Those without health insurance, or with minimal coverage, can often face bankruptcy if they get seriously sick or injured.


While Obama and McCain have plans to address the health care issue, they differ in their approach. Political scientist Jonathan Oberlander, of the University of North Carolina, compared the two plans in the latest issue of the New England Journal of Medicine.


Oberlander says Obama's plan would create a federally sponsored health insurance plan, similar to Medicare, which would compete with private plans. McCain's plan 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.


Oberlander says the McCain plan would change the current system more than Obama's would. Under the McCain plan, people who currently get health coverage at work would have to pay taxes on the value of that coverage. That would be offset by a tax credit. Those who don't currently have health coverage could use the tax credit to pay for insurance.


Obama's plan wouldn't change the system for people who currently have health coverage and are satisfied with it. Instead, it focuses on the people who don't have coverage and want it.


Obama's plan would set up a system whereby anyone, regardless of pre-existing conditions, would be able to buy into a new health insurance plan Obama says would be similar to the one that members of Congress have.


Would either of the plans actually "fix" health care? Maybe. But so far, there's little specificity when it comes to details and costs. And costs, some experts argue, is really what needs to be "fixed."


Sam Wein, who entered the health care industry as an outpatient clinic manager and subsequently got involved in the very early stages of the HMO field, says costs to consumers are still too high.


Wein spent time developing the financial and clinical facets of the HMO field and ultimately became the president of a federally-qualified HMO in Northern California. Any changes to the system, he says, should address costs.


Meanwhile, the US Census Bureau reports that 45.7 million US residents had no health insurance last year. While that's fewer than were uninsured in 2006, officials say much of the improvement comes from the fact that more Americans were covered under Medicare and other government health insurance programs.


(Article courtesy of

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