An LA Times piece today contrasts John McCain’s health care plan with the Democratic candidates’ plans by implying McCain is more concerned about health care “costs” while his opponents main concern is “coverage.”
But cost control and universal coverage are not mutually exclusive– they are inextricably connected. By neglecting the 47 million Americans without health insurance, McCain is neglecting one of the best ways to bring costs under control: universal coverage that reduces pricey, last-minute hospital visits by uninsured patients, lowers administrative costs, and encourages cost-effective preventive care.
Furthermore, McCain’s plan would increase the amount America’s families would spend on health care in a few key ways:
Eroding away the value of families’ health care tax benefit: McCain would eliminate the tax break for employee-based coverage, replacing it with a $2,500 tax credit for individuals ($5,000 for families) to help pay for private health insurance. Disturbingly, however, this credit will be pegged to general inflation instead of the price of premiums, the net effect being a “massive tax increase.”
Confusing cheaper coverage with lower costs: McCain wants to shift as many families as possible into an unregulated national insurance market where some people — particularly young, healthy people — may find coverage with enticingly low monthly premiums. But these attractive premiums would disguise, as Ezra Klein points out, “very high deductibles, lots of personal financial risk, and relatively sparse coverage.” After all, when insurance companies “cut costs,” they aim for one thing: denying as much coverage as possible.
Shifting struggling families into flawed, expensive “high-risk” pools: For unlucky families struggling with pre-existing conditions like cancer, heart disease or diabetes, McCain’s plan would offer a chance to buy into “high-risk pools.” Only trouble, these pools have many of the same draconian limitations as the unregulated private market: waiting periods, premiums that are out of reach for many families, substantial deductibles and co-pays, and limits on mental health and maternity care.