Obama vs McCain on Healthcare: Top 10 Issues
Besides the economy, foreign policy and homeland security, health care is one of the top issues in the upcoming presidential campaign and beyond. From high cost premiums to preventative treatments to preexisting conditions, Americans are struggling to find a plan that will keep them healthy for many years, not just when they need emergency care or when they can afford it. Both John McCain and Barack Obama have pledged to radically change the way health care is organized and accessed, but what are the fundamental differences? Read below for the top 10 health care issues laid out by both candidates.
- Child health care
Obama wants children to be covered as soon as they are born. Parents will be able to sign up their children for health care through their employee health coverage if they want, or they can look into other options like Medicaid, the State Children’s Health Insurance Program (SCHIP), or new plans set up by the Obama administration in the future. Some of these future plans may include a government subsidy awarded to families who do not qualify for Medicaid or SCHIP but still need help paying for their children’s coverage. Parents may be required to submit proof of their child’s insurance coverage before enrolling them in school or daycare in order to ensure that children are receiving health care insurance. Obama argues that because health insurance will be more affordable under his plan, this system would not cause problems for families.
McCain wants families to be able to choose the best option for their lifestyle and their particular health conditions and health risks. He does not favor mandated health coverage for anyone, including children, and believes that the increase in competition among health insurance companies will naturally bring the price of coverage down, making it more affordable and accessible for even low-income families.
- Private Companies vs. Government Intervention:
McCain believes that by encouraging private companies to sell health insurance, rates would fall and the quality of care through individual and family plans would rise due to competition. Individual Americans would have more choice to shop around and find the most affordable and most sensible plan for their families. McCain’s ultimate health care wish is to put control back in the hands of patients and everyday Americans. This plan follows the theory that American families can make the best decisions regarding their own health care coverage.
Obama wants to regulate the way health care companies and drug companies do business while still promoting competition. In order to ensure that low-income families and individuals who have a hard time getting insurance can acquire coverage, the government would have to set up terms that force the insurance companies to cover preexisting conditions. Obama favors competition among health insurance companies, so long as quality care is one of the forces driving competition, as well as lower prices. Consumers who are happy with their current plan and/or employer-sponsored plan will not have to change their health insurance. The only difference they will see is a smaller bill for the same coverage, according to Obama, who estimates that savings could add up to $2,500 for families. Employers would also be given various incentives to offer affordable insurance plans to their employees, fueling competition.
- Tax breaks for businesses and individuals:
McCain would still allow individuals to get health insurance through their employers if they want. All families will receive a $5,000 tax credit and all individuals a $2,500 tax credit that will be sent from the government to whichever health insurance agency the family or individual chooses to use for coverage.
Obama favors a Small Business Health Tax Credit that would help small businesses pay for health insurance for their employees. Businesses would also receive government help for catastrophic health costs, which are purchased in order to secure lower premiums for their employees. For individuals, Obama pledges to give "everyone who needs it" a tax credit to offset the price of purchasing premiums.
- The Elderly:
On this issue, both candidates seem to recognize the crisis facing baby boomer retirement and the burden of paying for long term care for the growing American senior population.
Under Obama’s plan, everyone would have a chance to secure affordable health care, even the elderly. Obama also wants health insurance companies to cover preventative procedures, like cancer screenings, which would help Americans catch and treat diseases earlier, alleviating the heavy burden of more serious, costly conditions that worsen when not treated or diagnosed. Treating conditions earlier saves money and lives in the long run, according to Obama’s theory.
McCain favors the existing Cash and Counseling and The Program of All-Inclusive Care for the Elderly (PACE) programs. PACE offers assistance to seniors who need help paying for Medicaid and Medicare. It also helps seniors find, organize and pay for long-term care services.
- The idea of universal health care:
Obama wants to directly sponsor universal health care while McCain believes that tax credits for individuals would naturally result in more people purchasing health care. Obama’s plan involves more heavily mandated programs and specific regulations on drug companies and health insurance agencies. Even though Obama does support competition and employer-sponsored health insurance, he would use the National Health Insurance Exchange to hold insurance companies accountable for high-cost premiums.
McCain favors a version of universal health care that would naturally develop due to increased freedom for choosing health care plans and a laissez-faire approach to regulation. McCain does, however, want the states to take a more active role in developing the economy of health care. Governors would also help to ensure that their citizens have fair access to affordable health coverage by lowering overhead costs, fund nonprofits to work with insurance agencies on behalf of denied patients, and more.
- John McCain’s Guaranteed Access Plans:
McCain’s Guaranteed Access Plans would involve participation from the states. Governors would design a plan to help the "traditionally uninsurable," including low-income families and individuals and those with preexisting conditions to get health insurance. McCain also plans to make available certain incentives that would encourage states and insurance companies to fund low-cost solution for in-need citizens.
Under Obama’s plan, there would be no such thing as "traditionally uninsurable," as health insurance companies would have to approve patients with preexisting conditions. This system is referred to as "guaranteed eligibility," and even patients with mental health conditions will be taken care of. Small business owners and the self-employed would also be protected under the guaranteed eligibility idea.
- Extent of government help:
McCain would help those below a certain income level, very sick people, and the elderly pay for care. These "higher risk patients" would receive special attention from their states and from federally sponsored programs. Other individuals and families would benefit from the $5,000 and $2,500 tax credits awarded to them by the McCain administration.
Obama plans to make available the same type of health care to all people, regardless of income or health. In addition to Obama’s government mandates regulating health care, his administration would sponsor a National Health Insurance Exchange, a plan benefiting those who prefer to or must purchase plans from private companies, like the self-employed. Individuals will be able to purchase low-cost health insurance plans that are structured similarly to the plans that members of Congress have, and their plan would not expire if they changed jobs. Also, Medicaid and programs like SCHIP would be expanded. Under Obama’s plan, individuals would still be able to choose their own doctors and stay with the same health insurance plans if they wish.
- Budget:
McCain favors measures that would make prescriptions cheaper by fueling competition; make health care for chronic diseases more affordable and efficient by emphasizing prevention, new treatments and research, and the use of health care technology; support more walk-in clinics to encourage early care; encourage coordinated care; reform Medicaid and Medicare; reform medical liability; and publicize health care costs.
Obama’s health care budget will cost between $50 and $65 billion. He intends to pay for the plan by minimizing tax cuts awarded to those who earn more than $250,000 a year and by "retaining the estate tax at its 2009 level," according to his campaign website.
- Portable, accessible health insurance:
McCain favors health insurance plans that people can keep even if they change jobs. Since health insurance could be bought privately, insurance could also be purchased "across state lines," referred to as portable insurance. This action would also alleviate some of the pressure from small businesses who can barely afford to help pay their employees’ premiums.
Obama’s National Health Insurance Exchange allows privately purchased insurance to remain effective even if an individual changes jobs. The difference between this system and McCain’s portable insurance idea is that Obama’s plan is funded by and organized by the national government, while McCain’s is not.
- Education and Efficiency
Obama will disallow health insurance companies to overcharge doctors because of malpractice insurance. Instead, money will be put into programs that improve the efficiency and quality of health care, like health information technology systems, improving education and prevention about diseases–especially chronic illnesses–and helping those who normally can’t get health insurance pay for preventive treatments and regular check-ups to minimize the number of emergency room visits that can’t be paid for by individuals. Spending more in the short term reduces waste, the onset of preventable advanced diseases, and major costs from emergency visits that are needed to treat those advanced diseases that could have been caught early on with a simpler, cheaper (nursing assistant vs. MD servicing you?) trip to a doctor’s office or clinic.
McCain is afraid that a government-run health care system would make health care more inefficient. Private companies, he argues, would be more equipped to deal directly with patients, and patients would be able to pick and choose the plan that suits them best. Health Savings Accounts, according to McCain, serve to educate Americans about making the right choices regarding health care. McCain also wants to fund programs that educate Americans about smoking and other health risks.
