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Second opinions

"Second opinions" Continued...

Issue: "The audacity of real change," Aug. 23, 2008

McCain's plan could represent a radical shift in the health-care system: It encourages a gradual move away from employer-based plans. McCain would eliminate the tax deduction on employer-provided insurance and instead provide tax credits for individuals to purchase their own coverage. The plan calls for a $2,500 credit for individuals and a $5,000 credit for families.

Though workers could keep their employer-provided insurance, McCain says the tax credit would encourage individuals to shop around for a better deal. That would create more competition in the private market, he says, and drive down costs.

Cato's Tanner says moving away from employer-based coverage is an idea many economists embrace: "There's no logical reason your boss should choose your health insurance." It's also an idea some Democrats have embraced: Portable health-care coverage is a key piece of a bipartisan health-care proposal in the House.

Critics say McCain's plan could lead some employers to stop providing coverage. McCain adviser Gail Wilensky says workers shouldn't worry. "I can't imagine most large employers not continuing to offer health-insurance plans for the foreseeable future," she said. "Ten or 20 years down the road-who knows?"

Critics also say the McCain tax credits wouldn't be enough to offset the cost of purchasing private insurance for many individuals and families. Health insurance for a family of four averages $12,000 a year, according to a recent Kaiser Family Foundation study. McCain says his plan would drive down costs, but analysts say those changes would come slowly.

Tanner likes McCain's market-based approach to health care, but he points out problems. For instance, McCain's plan to use tax credits could turn into a bidding war in Congress to see who could "be most compassionate by offering the biggest tax credit." That could drive up costs, he says.

But he points out a larger problem: Tanner says McCain hasn't yet streamlined his proposals into a cohesive plan. "It risks being seen as individual pieces . . . rather than a comprehensive whole," he says. "And if you try these reforms piecemeal, you're apt to create more problems than you solve."

Back at the gathering in Chicago earlier this month, Rep. Rush thanked his doctors for his treatment and told the crowd that he favors universal health care. But he also acknowledged something more important in his recovery: With clasped hands, the former Black Panther lifted his head and publicly thanked God.

On the record

By The Editors

Obama

  • Proposes a national health-care system administered by the federal government
  • Would mandate health-care coverage for children
  • Would require employers that don't provide insurance to contribute a portion of their payroll to the national program
  • Supports federal subsidies for families and individuals unable to afford insurance
  • Wants to allow the re-importation of prescription drugs from abroad

McCain

  • Opposes a national health-care system and mandating coverage, favors market-based approach
  • Would eliminate the tax deduction on employer-provided coverage and give tax subsides to individuals and families to purchase private plans
  • Proposes federal assistance to states to help insurers cover individuals who have been rejected on the open market
  • Would expand the benefits of health savings accounts
  • Supports the re-importation of prescription drugs
Jamie Dean
Jamie Dean

Jamie lives and works in North Carolina, where she covers the national political beat and other topics as news editor for WORLD. Follow Jamie on Twitter @deanworldmag.

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