Presumptive Republican Presidential Nominee McCain Promotes Health Care Proposal at Cleveland Clinic

Presumptive Republican presidential nominee Sen. John McCain (Ariz.) on Thursday during a visit to the Cleveland Clinic discussed his health care proposal, the Akron Beacon Journal reports (Wheeler, Akron Beacon Journal, 5/2). The proposal would replace a tax exemption for employees who receive health insurance from employers with a refundable tax credit of $2,500 for individuals and $5,000 for families for the purchase of private coverage, which McCain maintains would promote competition among health insurers, reduce costs and improve quality (Vanac, Cleveland Plain Dealer, 5/2).

"The key to real reform is to restore control over our health care system to the patients themselves," McCain said, adding, "The health plan you choose would be as good as any that an employer could choose for you. It would be yours and your family's health care plan, and yours to keep" (Akron Beacon Journal, 5/2). McCain said, "It is not the quality of health care in America that's the problem, it is the cost of health care in America that's the problem." He added, "When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options and are more satisfied with their choices."

In addition, McCain cited the need to focus on preventive care to help reduce health care costs. He said, "We need to encourage simple things, like membership in a health club." McCain also praised the Cleveland Clinic for the adoption of electronic health records, which he maintained can reduce medical errors, improve quality of care and lead to a reduction in medical malpractice insurance premiums (Cleveland Plain Dealer, 5/2).

Kaisernetwork.org webcasts of McCain's speeches about health care this week in Pennsylvania and Florida are available online.

Criticism
J.B. Silvers, director of research for the Health Systems Management Center at Case Western Reserve University, said that McCain's proposal "may not kill -- but it certainly is going to hurt -- group health plans."

He added, "If they backed it up with real heavy-duty regulation to make sure there was no discrimination and open enrollment, no matter what, then you could say 'OK, why not?'" However, "unless you're willing to do that, you're going to have people who don't get insurance," Silvers said, adding, "It won't deal with the insurance problem" (Akron Beacon Journal, 5/2).

CNN chief medical correspondent Sanjay Gupta on Wednesday discussed the health care proposals of the presidential candidates (Gupta, CNN, 4/30).

Opinion Piece
Republicans "have become the party of denial," and Democrats should focus on health care to "pin the denialist label on John McCain," New York Times columnist Paul Krugman writes. According to Krugman, the health care system is "going from bad to worse," and, although the health care proposals of Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) are "not perfect," they would make a "serious" effort to expand health insurance to more U.S. residents.

McCain "hasn't even tried to address concerns about coverage," Krugman writes. He writes that the McCain proposal is "all ... about costs, which Republicans insist (wrongly) can be dramatically reduced by a policy of ... deregulation and tax cuts," adding that "McCain has admitted that maybe a government program is needed for those who can't get private insurance."

Health care "could be Exhibit A for a Democratic campaign based on the argument that they are the party of pragmatic solutions, while modern Republicans won't even acknowledge problems that don't fit into their rigid ideological framework," according to Krugman. However, he writes, "Obama is doing much more harm to the Democratic cause by echoing Republican attack lines on ... insurance mandates" (Krugman, New York Times, 5/2).

Letter to the Editor
The statement from Obama that the Clinton health care proposal "'would force people to buy health insurance they can't afford' shouldn't be dismissed as fear-mongering," or at least no more than "Clinton's statement that the Obama plan doesn't aim to cover everyone," Jennifer Baron, a research associate at the Harvard Business School Institute for Strategy and Competitiveness, writes in a Times letter to the editor in response to an April 25 Krugman column.

She adds, "Both senators have a point. Universal coverage is important for both equity and efficiency," but "requiring people to buy insurance at current rates is debatable." In addition, she writes, "Subsidies are crucial but can only cover so many," and "universal coverage, regardless of when a mandate is introduced, cannot succeed until health care becomes affordable."

According to Baron, to reduce health care costs, "we must recognize that costs are only a symptom ... of a far deeper problem overshadowed by the wrangling over universal coverage: the dysfunctional structure of our health care system." She concludes, "Only after reshaping the way health care is paid for and delivered will costs sustain and decrease," and "only then can universal coverage become a reality" (Baron, New York Times, 5/1).