Some health care analysts have argued that the current financial crisis undermines the possibility of major health care reform. Indeed, since the crisis erupted, policy makers, save Sarah Palin, have largely divorced the health care crisis from the economic crisis and ignored the contribution of rising health care costs to the growing number of home foreclosures.

In truth, while “lax lending standards, rising interest rates, and irresponsible borrowers” helped cause the current downturn, rising medical costs and loss of work due to injury or illness led to many foreclosures.

According to one recent study, “medical crises contribute to half of all home foreclosure filings.” “If these patterns hold nationwide, medical causes may put as many as 1.5 million Americans in jeopardy of losing their homes each year,” the study concluded:

As middle class incomes remain stagnant, health care costs continue to increase. The employee contribution to health care insurance has more than doubled since 1999 and the total cost for family coverage now averages $12,680 a year, up 5 percent from 2007. “Annual deductibles — the amount employees pay out of their own pockets for medical care before their insurance coverage starts — jumped an average of 29%, to $1,344, for those with family coverage,” a recent Kaiser survey found.

Unless the system is reformed, growing costs will continue to swallow paychecks. As Ezekiel Emanuel observes, “economic, tax and health care policy are inextricably linked“:

Health care may no longer be the acute pain at the forefront of the public’s attention — hence the short shrift so far. But it is a severe disease that will have to be cured to get the economy really going and to ensure we have money for all the other things we need to invest in, like education, alternative energy, infrastructure, defense, national parks and the rest. Let’s hope policy makers can rise above the immediate political agenda to solve the long-term problems.

Digg It!

Today, NPR’s Julie Rovner examined the implications of Sen. John McCain’s (R-AZ) proposal to insure uninsurable Americans — individuals who are unable to obtain coverage in the private market due to their medical history — through state-run high risk pools. As Rovner explains, high-risk pools are plagued by waiting periods, premiums that are out of reach for many families, substantial deductibles and co-pays, and limits on mental health and maternity care.

Listen:

The McCain campaign responds to criticism that high-risk pools provide inadequate coverage and access by suggesting that their Guaranteed Access Plan (GAP) is modeled on the best examples in the states, namely the Minnesota high-risk pool program. But Minnesota, like the other 35 states that run high-risk pool programs, limits eligibility to control costs:

In 2006, the Minnesota high-risk pool cost $8,116 per enrollee (21% of the average income) and provided coverage to just 30,000 people. In short, in most of these states, the programs’ prohibitive premiums, deductibles and waiting periods for pre-existing conditions keep many uninsurable Americans from obtaining coverage.

The McCain campaign, recognizing the program’s limitations, says it “might” subsidize GAP “to those making up to four times the federal poverty level, or $41,600 for a single person” but has not made a decision about “waiting periods for pre-existing conditions.” But “subsidies already cover around 50 percent of high-risk pool costs, and expansion of these programs could cost $100 billion.”

With America in the middle of a financial crisis, the likelihood of subsidizing high-risk pools seems like a distant possibility.

UPDATE: Peter Harbage examines Alaska’s high-risk pool program here.

Today, during an interview with ABC’s George Stephanopoulos, Sen. John McCain (R-AZ), who has previously promised “not [to] raise your taxes nor support a tax increase,” finally admitted that his health care tax credits would not cover the costs of a comprehensive health insurance plan:

MCCAIN: Actually, my position is that it will be, it will give people actually more money to go out and purchase tax – health insurance on their own and only those with the Cadillac gold-plated health insurance policies today are the ones who might suffer from it. The ones -

STEPHANOPOULOS: So they would see their taxes go up potentially.

MCCAIN: It depends on, on, on what plan they have. But that’s usually the wealthiest people. Ordinary working Americans have the kind of – or an overwhelming majority have the health insurance plans that this tax credit, refundable tax credit, will actually put more money in their pockets for the purchase of health care than what they had before.

Watch it:

McCain’s tax increase is worse than he lets on:

- Eliminating Tax Exemption Increases Cost Of Plan For Those Who Need It Most: By equalizing the tax treatment of employer and individual plans and enticing healthy workers to buy cheaper but less substantive insurance in the individual market place, McCain’s tax reform would increase costs for sicker workers and may force some workers to opt out entirely.

- Tax Credits Don’t Keep Up With Health Costs: McCain’s credits will diminish in proportion to growing health care premiums. This is because McCain indexes the growth of his initial $5,000 offering to inflation, not premiums. And, since premiums grow at a higher rate than inflation, McCain’s proposal imposes a large tax increase on the middle class.

- Middle Class Experiences Largest Tax Increase: For a couple earning $40,000 and paying $13,800 for insurance, “McCain’s new tax credit would cut their taxes by $50 in 2009, but because the credit quickly falls behind rising premiums that are the basis of the current tax break, the family would pay $1,169 more in taxes in 2013…[and] would pay $2,809 more in taxes by 2018.”

Ironically, McCain’s health care plan raises taxes for families whose yearly income just barely covers the cost of a Cadillac.

Digg It!

Under Sen. John McCain’s (R-AZ) proposal to tax employee health benefits and encourage more Americans to buy health insurance in the individual market, individuals who actually need and use care will shoulder higher out-of-pocket expenses, prohibitive deductibles and expensive premiums. This is because McCain is more interested in keeping costs down than increasing access to affordable coverage. He believes that if Americans had more ‘skin in the game,’ if the cost and risk of insurance were shifted from the employer to the individual, health care prices would come down.

And while lowering health care cost should be part of any comprehensive health care reform, over-relying on a deregulated individual market fails the 56 million Americans with pre-existing conditions who currently receive insurance through their employer. An unregulated individual insurance market seeks to maximize profit by insuring only the healthiest applicants; individuals who actually use their insurance, drain profits.

For this reason, women — who are more frequent users of health care, “in part because they experience chronic illness more often than men and because they are more likely than men to require prescription drugs, such as oral contraceptives” — “face too many obstacles obtaining comprehensive, affordable health coverage in the individual market — simply because they are women.”

A new report about women in the individual health insurance market, found the following:

- “Under a practice known as gender rating, insurance companies are permitted in most states to charge men and women different premiums.” Among insurers who gender rate, “the majority charge women more than men until they reach around age 55, and then some (though not all) charge men more.”

- The “majority of individual market health insurance policies,” don’t provide maternity coverage. “In the capital cities of Hawaii, New Mexico, North Dakota and South Dakota, the center couldn’t find “an offer of maternity coverage at any price.”

- In nine states and D.C., it is legal “for insurers to reject applicants who are survivors of domestic violence. Insurers can also reject women for coverage simply for having previously had a cesarean section (C-section).

For women, McCain’s plan would only exacerbate the failures of the individual market. In fact, by creating a deregulated national marketplace in which insurers no longer have to comply with rules that require they provide cancer screenings, maternity care, mammograms, and emergency services, or abide by rules that “limit the rates that can be charged to higher-cost consumers and that limit who can be excluded for a health plan,” insurance companies could sell plans across the country that lack even the most basic consumer protections.

Women will be more vulnerable to “cost barriers to care and coverage because they earn less than men on average, work more for small businesses that do not offer coverage, and are more vulnerable to losing health insurance due to job or relationship changes.”

The latest Kaiser Family Foundation survey of employer health benefits concludes that “workers are shouldering higher health care costs as more employers demand bigger out-of-pocket payments from employees before their insurance kicks in.”

According to the survey of 1,927 employers, “annual deductibles — the amount employees pay out of their own pockets for medical care before their insurance coverage starts — jumped an average of 29%, to $1,344, for those with family coverage.” “This is partly, but not entirely, driven by growth in consumer-directed plans such as those that qualify for a tax-preferred Health Savings Account,” the study concludes.

Consumer driven health care plans do increase out-of-pocket expenses. “We may be seeing the tip of the iceberg toward less comprehensive, skimpier coverage,” Kaiser President Drew Altman warned.

But under Sen. John McCain’s (R-AZ) proposed health plan, too many Americans may actually hit the iceberg. As a recent study published in Health Affairs points out, McCain’s plan would push more Americans into the unregulated individual health market place. But, since “it is much more expensive to sell insurance to millions of individuals,” a family that moves from the group to the individual market will experience higher costs:

The typical deductible in nongroup plans is about $2,750, compared to about $1,000 for group policies. Coinsurance rates average 26 percent in nongroup plans, compared to 20 percent in a typical employer-based plan. For plans with copayments, the average copayment in the nongroup market is between $30 and $40 per doctor visit, well above that of group plans. Many services are not covered at all. Thus, much of the apparent savings from shifting to nongroup coverage would be offset by higher out-of-pocket costs for care.

Medical professions are saying “thanks, but no thanks” to the Bush administration’s proposed regulations allowing health care workers to opt-out of providing abortion and contraceptive services.

Health and Human Services Secretary Michael Leavitt has argued that the new rule is necessary to protect the “freedom of expression and action” of medical professionals, but medical professionals disagree. The American Psychiatric Association and the American Academy of Pediatrics say that “doctors and nurses are already not required to perform abortions or sterilizations.”

Indeed, the proposed regulation would be redundant if it weren’t so expansive. By using an “opinion put forth several months ago by the American College of Obstetricians and Gynecologists” as pretext to issue new regulations, Leavitt is potentially expanding the existing conscience exemption. Medical professionals have expressed concern about the consequences of the new rule:

Implementation of this regulation would effectively allow health care providers’ personal beliefs to override patients’ right to full disclosure of accurate information and available health care resources.

Similarly, in a separate letter to the HHS, 13 attorneys general argued that “the rule was too vague about what health care procedures may be withheld”:

The proposed regulation completely obliterates the rights of patients to legal and medically necessary health care services in favor of a single-minded focus on protecting a health care provider’s right to claim a personal moral or religious belief.

For the Bush administration, the new regulation is a bridge to limiting women’s access to reproductive services. They hope to muddy the waters and threaten “both the diversity of beliefs in our pluralistic society and the health and well-being of patients seeking care.”

UPDATE: Time is running out but there’s still a chance to act. You can submit comments on the regulation here or by emailing your comments to consciencecomment@hhs.gov by 11:59 pm EDT Thursday, September 25th.

On Friday, Paul Krugman highlighted an article by Sen. John McCain (R-AZ) in which the senator made the case for deregulating the health insurance industry by extolling the benefits of the last decade of deregulation in the banking sector.

After Sen. Barack Obama (D-IL) ran an ad attacking McCain’s untimely comparison, FactCheck.org falsely argued that the ad improperly conflated banking deregulation with McCain’s plan to allow health insurers to sell plans across state lines:

The ad relies on a single phrase from a journal article under McCain’s byline, in which he said he would reduce regulation of health insurance “as we have done over the last decade in banking.” But the full context reveals that McCain was referring narrowly to his proposal to allow people to purchase health insurance across state lines.

But allowing banks to flout state regulations and permitting insurance companies to sell policies across state lines would have the same negative consequences.

In 2002, “Georgia became the first state to tell players in the secondary mortgage market that they might be on the hook if they purchased loans deemed ‘predatory’ under state law…Before, downstream owners of mortgage-backed securities might see the value of their investments drop, but that was generally the worst that could happen”:

Under the Georgia Fair Lending Act, however, players in the secondary mortgage market could face serious liability if they so much as touched a predatory.

The Office of the Comptroller of the Currency (OCC) over-ruled the states and exempted national banks from the regulations. John D. Hawke Jr., the comptroller, said, ”We have no evidence that national banks are engaged in predatory lending practices.”

Federal deregulation left the states to fill the regulatory void. And the same can be said for health care. Currently, states require companies to cover the most basic of services: cancer medications, cervical cancer/HPV screening, ovarian cancer screening and prostate cancer screening:

– 44 states: mandate emergency services

– 50 states: mandate mammograms

– 29 states: mandate cervical cancer/HPV screening

Under McCain’s plan, health insurance companies, like the banks before them, will be able to ignore consumer protections and sell bare-bones policies with high deductibles and even higher out of pocket expenses. Once sickness strikes, American families will face economic crisis (currently, fifty percent of bankruptcies are related to health care costs) but, unlike with the banks, the American government won’t be there to bail them out.

UPDATE: TNR’s Jonathan Cohn has more.

Our guest blogger is Michael Rugnetta, a Fellows Assistant for the Progressive Bioethics Initiative at the Center for American Progress Action Fund.

The World Stem Cell Summit gets underway today in Madison, Wisconsin. The Summit brings together scientists and research advocates from all over the world to discuss the future of this revolutionary area of medical research. According to the Chicago Tribune, many of those assembled at the summit have misgivings about John McCain’s stance on the issue, which once seemed solid but has since come into question due to his ambiguous policy statements and his selection of the staunchly pro-life Sarah Palin as his running mate.

Indeed, John McCain’s tightrope act on stem cells is getting even more harrowing – and frustrating for anyone that wants a straight answer. McCain’s statement to Science Debate 2008 reveals that he would “support federal funding for embryonic stem cell research.” Although it does not go into explicit detail, that statement suggests that a McCain administration would allow federal funding on stem cells that are derived from embryos left over from IVF clinics.

But McCain’s stem cell policy is more restrictive than it sounds. While supporting stem cell research generally, McCain opposes – and may attempt to criminalize – SCNT, which is a necessary and vital area of regenerative medicine.

During SCNT, a subject’s DNA is placed in an egg that has had its DNA removed, thereby creating a cloned embryo that can divide and produce genetically matched stem cells. McCain’s website, condemns the process: “John McCain opposes the intentional creation of human embryos for research purpose” and the Republican Party platform also calls for a ban on the “creation of or experimentation on human embryos for research purposes.”

But McCain’s policy may criminalize SCNT research. In 2006, McCain voted to ban “fetal farming,” a horrific and universally condemned practice in which a pregnancy is deliberately initiated and terminated solely to obtain fetal tissue for research. Since then, McCain has used an expansive definition of “fetal farming” which, on its face, incorporates and criminalizes SCNT research.

On his website and in the Science Debate 2008 questionnaire, McCain correctly notes that the 2006 law bans research on fetal tissue from human pregnancy that was deliberately initiated for such research and outlaws research on tissue or cells from a human embryo that was gestated in a nonhuman animal. Yet McCain ignores that the regulations allows for the creation of embryos for research purposes (e.g.: SCNT), just as long as the embryos are not put in a human or nonhuman womb.

McCain’s selective interpretation could stifle critical medical research. The McCain campaign must clarify its understanding of fetal farming and articulate a policy toward SCNT or research on stem cells obtained from embryos leftover from IVF clinics. As it stands, McCain’s proposal remains shrouded in what seems like a carefully constructed cloud of ambiguity.

Since the collapse of the U.S. financial system, Sen. John McCain (R-AZ) has struck a “populist tone,” calling for greater government regulation of the financial markets:

Part of the reason we are facing this crisis is an antiquated regulatory system of uncoordinated agencies that haven’t been doing the job. I believe we need a high level oversight board to impose accountability and establish concrete criteria for who gets help and who does not.

McCain credits the financial crisis to “failed regulation, reckless management, and a casino culture on Wall Street” and proposes government regulation, more oversight of the Bush administration’s bail-out plan, and greater accountability.

Unfortunately, “oversight” and “accountability” are both missing from McCain’s health care plan. Whereas the government must eliminate corporate greed and “a casino culture on Wall Street,” it has no responsibility — as far as McCain is concerned — to insure that health insurance companies don’t deny coverage to sick people, jack-up premiums, or conduct another round of medical

As insurance companies deny or price-out of coverage nearly nine out of every ten Americans who apply for individual insurance, 45.7 million Americans live without any coverage, and another 25 million are under-insured, McCain sees no crisis. He continues to propose “a casino culture” for health care: more vigorous nationwide competition, as we have done over the last decade in banking,” deregulation and lax oversight.

In short, the financial crisis demands regulation, but America’s health crisis requires the exact opposite approach. Only the “original maverick” can argue for both.

In the latest edition of American Academy of Actuaries, Sen. John McCain (R-AZ) makes his case for “deregulating the health insurance industry by extolling the benefits of the last decade of deregulation in the banking sector“:

[Individuals] need to be in charge of their health care dollars… I would also allow individuals to choose to purchase health insurance across state lines…Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.

In fact, deregulation of the banking industry “offers a cautionary tale about a little-understood provision at the center of John McCain’s health care plan.”

Following a pair of Supreme Court decisions which deregulated the banking industry, credit card companies relocated to states with no interest rate caps and charged “what they wanted” to borrowers in states with interest rate limits. This deregulated environment allows credit card companies to “use pricing practices, like teaser rates, to attract cash-strapped families and then…double or triple those rates without notice.”

Similarly, in McCain’s national insurance marketplace, insurance companies “would have little incentive to continue doing business” under certain state rules which “require that companies issue coverage to all new customers and not set higher rates for people who are already sick”:

[Under legislation that McCain supports], insurers wouldn’t even need to pick up and move their operations; it would be enough to file some paperwork with a state insurance commissioner and pay that state’s relevant taxes…An insurer operating under Arizona law would be able to offer healthy New Yorkers a cheaper policy than an insurer working under New York law that has to price policies the same for everyone.

Ultimately, “insurance companies could sell plans across the country that deny coverage altogether to high-cost cases. Healthy “individuals, regardless of their state of residence, could move to cheaper (albeit less comprehensive) plans based in states with fewer protections. Plans based in states with more rigorous insurance regulations would be left with sicker, more expensive patients—and higher rates.”

Given the current financial crisis, McCain’s comparison would be unfortunate if it wasn’t so accurate. Indeed, allowing health insurance companies to flaunt consumer protections and sell policies from states which do not require insurers to cover cancer screenings or maternity care could lead Americans into a personal financial crisis (should they actually need medical care, they would have to pay for it out of their own pockets) that mirrors America’s current financial predicament.

Our guest bloggers are James Kvaal and Ben Furnas, senior fellow and research associate at the Center for American Progress Action Fund.

CBS News took a look at whether John McCain’s health care plan would raise taxes on millions of American families the other night. Watch it:

Here’s what we think is important.

First, the McCain plan will eventually result on higher taxes on most households with health insurance through their jobs.  That’s because the McCain tax credit will grow only with inflation. Current tax benefits grow with premiums, which increase three or four times faster than inflation.

Second, the McCain plan will result in higher taxes for some households right away.  Families with higher incomes and more expensive insurance plans are most likely to get hit by higher taxes.

Third, the full impact of the McCain plan is difficult to calculate because the McCain campaign is trying to have it both ways on a critical question at the heart of his health care plan: whether it imposes payroll taxes (as well as income taxes) on health benefits.

As originally announced, McCain seemed to impose both income and payroll taxes on health benefits.  That would mean that typical middle-class families would pay higher taxes within a year or two.

Now the McCain campaign is apparently saying that they will impose only income taxes on health benefits.  If that’s right, then – as CBS reports – most families will see tax cuts in initially.  However, because the credit would still quickly fall behind premiums, the plan would still increase taxes on most families eventually.  Moreover, McCain’s would cost an additional $1.3 trillion — a massive cost which the McCain campaign has not acknowledged.

Making families pay more for their health care is not some accidental quirk due to the details of the McCain plan.  It is a key part of the conservative ideology to shift costs onto families, which they believe will reduce wasteful health care spending.  But it is more likely to leave families struggling with higher and higher health care costs and forced to skip care they need.

On Wednesday, the House Energy and Commerce Committee approved Rep. Joe Barton’s (R-TX) amendment to prevent insurance companies from rescinding coverage for sick Americans. In an attempt to regulate the individual insurance market — which is currently regulated by the states — the amendment protects “insured people seeking treatment for a serious illness from losing coverage because they accidentally fail to reveal a prior unrelated condition.”

Indeed, Barton’s amendment is an important step towards enacting consumer protections that shield individuals from industry abuses.

Just last month, Anthem Blue Cross and Blue Shield agreed “to pay a total of $13 million in fines and to offer new health coverage to more than 2,200 Californians the companies dropped after they became ill.” More recently, Health Net Inc. reached a settlement with the California Department of Insurance, agreeing “to offer new coverage to 926 customers who were dropped from individual or family policies in the years since 2004.”

Across the country, 29 states and the District of Columbia have no state requirements “that insurers complete all medical underwriting and resolve all questions at the time of application” and 13 states do not require “insurers to notify policyholders in advance about what conditions will not be covered.”

Despite much needed consumer protections, however, the American Health Insurance Plans — an insurance industry front group — is trying to maintain the status quo. On Tuesday, President Karen Ignagni wrote to Barton “asking him to delay action on the amendment, adding that AHIP had developed its own proposal that allows insurance companies to rescind coverage only if patients withheld information ‘that should have been included in a complete and accurate response.’”

But delaying action is no solution at all. Ignagni’s suggestion that families strained by denied claims wait longer for relief, in this economy, ignores the growing pains of the middle class and does nothing to reform a system that regularly places Americans into economic turmoil.

Despite analysis and critique to the contrary, the McCain campaign has consistantly argued that exposing workers health benefits to income taxes would have no effect on employer-based coverage:

- Health Policy Adviser Jay Khosla: Employers will continue to deduct health care costs as they do now and hence will have the incentive to provide coverage as a benefit in a competitive workforce market and the employees of course can use their tax credits to maintain their current coverage.

- Senior Adviser Douglas Holtz-Eakin: This is actually not a plan that relies on the individual market, it relies on the traditional source of health insurance, which is employers.

- Senior Adviser Carly Fiorina: John McCain’s plan builds on the current system and allows for greater choices for American families that more uniquely fit their needs, including allowing families to keep their existing coverage.

But employers beg to differ. According to a survey of 187 benefits officers at large U.S. companies, “respondents clearly rejected the assertion that
altering the tax exclusion for employer provided health coverage would not affect employer sponsorship of plans”:

- 74 percent: say that a repeal of the employee tax exclusion for employer-sponsored health coverage (a proposal of Republican Presidential Candidate John McCain) would have a strong negative impact on their workforce.

- 59 percent: responded that their companies would offer a new plan option with less generous benefits.

- 4 percent: said the current tax treatment for workers is of “little or no importance” in continuing employer provided coverage.

UPDATE: The Health Policy and Communication Blog has more on the “value of employer provided health benefits.”

CBS recently ran a “fact-check” on the claim that John McCain would raise taxes on workers’ health insurance. Watch it here:

Though we disagree with the conclusions of the piece (and will be addressing these disagreements in a future post), we first want to point out two factual errors.

–First: Thirty seconds in, the chyron reads “FACT: Employer health benefits for 16 million Americans will be taxed.” This, we believe, is a typo. There are around 160 million Americans who currently receive their health benefits through work, and, under McCain, all of them will pay taxes on their health benefits.

–Second: The announcer, at around forty-five seconds in, says that “McCain does want to tax the health insurance benefits that 60 million Americans now buy through their employer.” Again, the correct number is 160 million.

Check back soon for a more thorough critique of CBS’s conclusion.

Today, in her testimony before the Subcommittee on Health, CAPAF Senior Fellow Elizabeth Edwards strongly criticized so-called consumer-driven health care models for erroneously equating health insurance with other consumer goods.

“We’re not selling toilet paper here, we’re not selling televisions, we are selling an essential part of people’s lives and it needs to be thought of that way,” Edwards noted:

Deciding between the costs and benefits of various cancer treatments like chemotherapy, radiation, and surgery will simply never be the same as choosing between purchasing a Dodge, Pontiac, and Lincoln.

Indeed, individuals who can’t afford a luxury vehicle can downsize to an economy standard, rely on public transportation, or carpool when necessary. But no such crutch exists for health insurance. Americans who don’t have access to insurance can’t piggy-back off of another plan, and, as a result, forego preventive care, allow chronic diseases to go untreated, and postpone needed treatments.

Consequently, “137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006.” Americans who “lack health insurance will spend about $30 billion out of pocket on medical care this year, but others — mainly the government — will end up covering another $56 billion in costs.”

But plans in the individual market do little to lower health care costs for Americans who actually use care. “The individual market is notorious in its poor provision of coverage,” providing insurance “as long as you stay young healthy” and jacking-up premiums or conducting another round of medical underwriting once sickness strikes. For insurance to have any value, “it needs to cover the treatments and services people need and deserve.” Any comprehensive reform, Edwards argued, must strengthen the role of the group market and “address health care for all and cost containment simultaneously”:

The question is not whether we can afford to ensure that all Americans have health coverage. The question is whether or not we can afford to leave people behind.

Edwards recalled the story of an uninsured single mother who whispered to her that she needed a cancer screening but couldn’t cover its costs. “As she whispered in my ear,” Edwards concluded, “she is [now] whispering in yours.”

Our guest blogger is Adam Jentleson, the Communications and Outreach Director for the Hyde Park Project at the Center for American Progress Action Fund.

The centerpiece of John McCain’s health care plan is a tax credit worth $2,500 for individuals. By coincidence, in her speech at the RNC two weeks ago, Gov. Sarah Palin wore a jacket designed by Valentino Garavani that cost $2,500.

Admittedly, McCain’s health care tax credit is worth more than most jackets. The problem is that it’s worth far less than the cost of health care for most Americans.

Individuals paid an average of $4,400 for health care in 2007 – nearly twice the value of McCain’s credit. For families, McCain’s credit is $5,000 – which covers less than half of the $12,000 the average American family paid for health care in 2007.

And unlike Gov. Palin’s jacket, McCain’s credits are not tailored. They are one-size-fits-all. So if you’re healthy, you should be in good shape. But if you are sick, have a pre-existing condition, or endure a medical emergency, once you exceed the value of the credit you are on your own.

Which is why many health care experts agree than McCain’s health care plan boils down to this: don’t get sick.

Yesterday, an independent study published in Health Affairs concluded that Sen. John McCain’s (R-AZ) health care plan would undermine employer-based health coverage, insure just one-million more Americans, and increase costs across the board.

And while some employers would still offer health insurance, McCain’s prescription could allow large firms to discriminate between workers and provide different benefits to high-and low wage employees.

Currently, “to qualify for the tax subsidy” — which shields health benefits from taxes — “employers must abide by IRS nondiscrimination rules, which require firms to provide similar benefits to high-and-low wage employees.”

In short, “all benefits provided for participants who are HCEs [highly compensated employee] are also available to all other participants. All benefits for dependents of HCEs must also be available for the dependents of all other employees.”

But McCain’s health care plan may undermine this protection. By eliminating the current tax exclusion for employer-sponsored coverage, McCain would erode the tax incentive that encourages large employers to provide their workers with identical benefit packages.

With income inequality at an all time high, McCain’s plan could create a new ‘health care gap.’

Yesterday, Oprah Winfrey urged her viewers to contact their senators and ask them to support the Protect Our Children Act (HR 3845/S 1738), which authorizes over $320 million over the next five years for law enforcement to investigate child exploitation:

This is what we want to do. Want to get these guys and put them in jail. So, tell us about the Protect Our Children Act. It’s going before the U.S. Senate this month. We only have a few days.

Watch it:

The bill is being blocked by Sen. Tom Coburn (R-OK), who, in July, successfully derailed the legislation when it was included in the “the so-called Coburn omnibus,” a package of nearly 40 uncontroversial bills that extended funding for cancer research and crime prevention.

Now, Senate Democrats are gearing up for a re-match. According to the Hill, “Senate Majority Leader Harry Reid (D-Nev.), spurred on by activists and TV talk show host Oprah Winfrey…has sent word to Senate Democrats that it would like to bring the so-called Coburn omnibus bill to the floor soon, setting up a rematch with the conservative Oklahoma Republican who has often brought the Senate to gridlock.”

Indeed, in his three short years in the Senate, Coburn has earned the reputation of “a fly in the soup,” abusing the senate’s hold privilege to prevent “the Senate leadership” from bringing matters to a vote. He “initially blocked” S 1738 “because it would have authorized nearly a billion dollars over eight years to fund a law enforcement crackdown on child exploitation,” but now “questions the efficacy of a new program.”

Far from controversial, the bill is co-sponsored by conservative Sens. Orrin Hatch (R-UT) and Ted Stevens (R-AK) and is estimated to cost just $3 per American over the 2009-2013 budgeted period.”

Cross-posted at ThinkProgress.

An independent study of Sen. John McCain’s (R-AZ) health care plan, published today in Health Affairs, concludes that McCain’s proposal “would almost certainly…increase family costs for medical care.” Here are the details:

MCCAIN PROPOSAL: Eliminate the current tax exclusion for employer-sponsored coverage.

CONSEQUENCE: Twenty million people would lose coverage, but “the effect could be much larger.”

- Cost of employers-sponsored coverage would increase. By equalizing the tax status of the individual and group markets, “low-risk employees would have less incentive to remain in employer-sponsored groups,” would leave the employer-risk pool, increasing costs for those left behind.

- Employers could discriminate against workers. Employers would no longer have to abide by rules “which require firms to provide similar benefits to high-and-low wage employees.”

MCCAIN PROPOSAL: Push Americans into the unregulated individual market.

CONSEQUENCE: Americans will have “far less generous policies that those they have today.”

- Nongroup plans are more expensive than group plans. “It is much more expensive to sell insurance to millions of individuals one individual at a time than it is to sell top a much smaller number of employer groups.” For a family that moves from the group to the individual market, “nongroup insurance will raise premiums for an identical policy by more than $2,000 per year.”

- Cheaper but less substantive policies. Insurance providers could have an incentive to develop “bare-bones” insurance policies costing little more than the $5,000 tax credit for families…however, for most uninsured families, the benefits of such policies in terms of protection from financial risk and access to medical care would likely be very small…”

- Less healthy people will not find coverage. According a recent survey, less healthy individuals found it almost impossible to find affordable coverage in the individual market.

- High-Risk Pools will only cover 3 million people. McCain has proposed to fund his Guaranteed Access plan to the tune of $7-10 billion, which could only cover three million people and leave millions without affordable insurance.

MCCAIN PROPOSAL: A national insurance market in which insurance could be purchased across state lines.

CONSEQUENCE: Consumers would lose important protections “designed to establish minimum levels of coverage.”

- Important consumer protections will be lost. Companies will charter in states with scarce regulations, and will no longer have to provide mental health parity, cancer screenings, or abide by regulations that “limit the rates that can be charged to higher-cost consumers and that limit who can be excluded for a health plan.

Under McCain’s plan, “upward of forty million Americans would be uninsured — and that number would likely grow over time.” In fact, since McCain’s health care tax credit would “not automatically adjust as health care costs increase,” Americans will have to stretch their credits to afford the same coverage every year.

As columnist Bob Herbert notes in today’s New York Times, “this entire McCain health insurance transformation is right out of the right-wing Republicans’ ideological playbook: fewer regulations; let the market decide; and send unsophisticated consumers into the crucible alone. You would think that with some of the most venerable houses on Wall Street crumbling like sand castles right before our eyes, we’d be a little wary about spreading this toxic formula even further into the health care system.”

For more on McCain’s health care plan, click here and here.

For pro-choice activists, Gov. Sarah Palin’s (R-AK) short time in public office is characterized by her strong opposition to reproductive rights and sensible sex-education.

As mayor of Wasilla, the Palin administration “cut funds that had previously paid” for rape kits “and began charging victims or their health insurers the $500 to $1200 fee.” Palin expressed support for a constitutional amendment outlawing abortion, opposed abortion in cases of rape or incest, strongly supported failed abstinence-only initiatives, and generally described herself as “pro‐life as any candidate can be.”

In her exclusive interview with ABC’s Charlie Gibson, Palin moderated her rhetoric, saying that she respected the views of the pro-choice community:

I am pro-life. I do respect other people’s opinion on this also, and I think that a culture of life is best for America. What I want to do when elected vice president with John McCain, hopefully be able to reach out and work with those who are on the other side of this issue…I do understand McCain’s position on this, I understand others who are very passionate about this issue who have a differing view.

Watch it:

But Palin’s wasn’t alway so understanding. In fact, according to at least one report, Palin may have physically prevented or intimidated women from exercising their right to have an abortion.

Salon reports that in 1996, as “evangelical churches [in Alaska] mounted a vigorous campaign to take over the local hospital’s community board and ban abortion,” Palin participated in a “boisterous picket line” against an OB-GYN who opposed activists’ efforts to “take over the local hospital’s community board and ban abortion”:

At one point during the hospital battle, passions ran so hot that local antiabortion activists organized a boisterous picket line outside Dr. [Susan] Lemagie’s office, in an unassuming professional building across from Palmer’s Little League field. According to Bess [a priest who often clashed with Palin and the evangelical community] and another community activist, among the protesters trying to disrupt the physician’s practice that day was Sarah Palin.

The protest came two years after President Clinton signed the Freedom of Access to Clinics Entrances Act (FACE), “legislation that makes it a Federal crime to attack or blockade abortion clinics, their operators or their patrons.” Not surprisingly, Sen. John McCain (R-AZ), who has consistantly received a score of zero from NARAL, voted against the bill.

Digg It!

UPDATE: Dr. Susan Lemagtie’s 16-year-old daughter reflected on anti-abortion protests in a 1998 essay:

Picketers began protesting at the hospital across the street from my mom’s clinic. In late ’94, when the national papers carried stories about bombed abortion clinics and murdered doctors, they moved to the sidewalk outside the clinic. My mother no longer talked about managed care and AIDS; she talked about buying a bulletproof vest.