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Ellie and I have both been interested in health care policy lately, especially with the elections coming up. It is not so much that we ourselves need health care. Our own benefits with
OSU are excellent. It is just that we've seen people we love struggling with health care cost, and we think that it is a moral imperative that something be done. We've looked into both health care plans. No surprise: While neither plan is perfect, we like
Obama's plan much better than McCain's.
Here is the core of McCain's plan, as I understand it: He will give each family a $5,000 tax credit ($2,500 to individuals), while at the same time phasing out the employer tax exemption for health insurance. Whatever money people don't use out of their credit, they can put into an individual health savings account. McCain seems to think that the problem with health care costs is that people use too much health care. If we arrange the financial incentives so that people pay for their own health care, he thinks, people will be more careful about going to the doctor. Less demand for health care = greater competition = lower health care costs for everybody.
The goal of the policy is that employers stop supplying health insurance and that people purchase their own policies. Getting rid of employer-based health care may actually be a very good thing if, of course, there is something to take its place. But there isn't. The average family policy costs over $12,000 a year, so the $5,000 tax credit McCain offers would not even come close to covering this. More importantly, perhaps, it does nothing for people who have
pre-existing conditions who cannot purchase insurance in the marketplace. McCain merely does a little hand waving about a "
Guaranteed Access Plan" and promises that something will be done.
Here is what this all means in personal terms: If Andrew has a high fever at 3:00 AM, I personally don't want to calculate the
costs of taking him to the emergency room.
Health care isn't like buying new cars or plasma TVs. If a child is sick, he should get treatment. The same moral claim does not exist for people who merely desire cars or TVs. Plus, I don't know enough about medicine to make a fully informed decision about health care purchases -- that is why we send people to four years of medical school. Thus, market forces cannot rule health care like they can (and should) rule in many other areas. The moral structure is different in health care, and the expertise necessary for informed consumers is nonexistent.
Compared with the detail and comprehensiveness of the
Obama plan, McCain's plan is almost childlike.
Obama's plan is more expensive, to be sure, but he has serious ways of paying for it (repealing Bush tax cuts, employer "pay or play" provisions, etc.) Once again, McCain treats us like children,
Obama like grown-ups.
Here are the most detailed version of the plans I could find on the respective websites. See for yourself:
McCain's planObama's plan (
pdf)