McCain's health "plan"

[Rich_in_Tampa]

Originally Posted by Midpack

And on healthcare specifically, I think it's inevitable that we will have socialized healthcare eventually. But I don't think it's going to happen suddenly no matter what any candidate promises while campaigning.

Mid,

Are you sure you mean "socialized medicine?" I think we are talking about universal health care, a very different set of rights and privileges.

I don't ever see socialized medicine as realistic in America, but universal health care does indeed seem inevitable (I hope). There are millions of people from both conservative and liberal political persuasions who are supporting this.

Just the basics to start: the ability to buy health insurance for all americans, spread equitably amongst the healthy, sick, old, young, working, unemployed, retired; add a safety net of basic care for the disabled, mentally ill, etc.

My conservative friends seem to agree right about the time they want to early retire .

[Khan]

Originally Posted by Rich_in_Tampa

Mid,

Are you sure you mean "socialized medicine?" I think we are talking about universal health care, a very different set of rights and privileges.

I don't ever see socialized medicine as realistic in America, but universal health care does indeed seem inevitable (I hope). There are millions of people from both conservative and liberal political persuasions who are supporting this.

Just the basics to start: the ability to buy health insurance for all americans, spread equitably amongst the healthy, sick, old, young, working, unemployed, retired; add a safety net of basic care for the disabled, mentally ill, etc.

My conservative friends seem to agree right about the time they want to early retire .

"socialized medicine" is part of the scare tactics. Socialized medicine->socialism->communism->atheism...

[Midpack]

Originally Posted by Rich_in_Tampa

Mid,

Are you sure you mean "socialized medicine?" I think we are talking about universal health care, a very different set of rights and privileges.

You're right, I didn't choose my terms very well and I've modified my original post to universal healthcare...

[samclem]

Aside from the specifics of the various plans/proposals, there is the factor of the track record of the three individuals. Reforming the way health care is delivered is not going to happen without consensus across the political spectrum. Only one candidate, McCain, has a proven record of reaching across the aisle to get things done (it's why many Republicans hate him). Hillary took a swing at this very problem--it's the only significant policy initiative she was ever entrusted with, and she failed miserably (due primarily to her poor ability to gain consensus and build trust--personal skills that she does not appear to have enhanced).

I understand why some people like the VA health care system, and especially what it represents. It is perfectly egalitarian, and it is cheap. If this system is the example that universal health care proponents are going to hold out to the public as a success, they can save themselves a lot of time by just folding up their tent right now.

We can fix what is wrong without making everyone buy a Mao jacket.

- De-link health insurance from employment. If we just eliminated the tax break employers get in this area, we'd be 90% of the way there (since employers would stop offering coverage and would instead compete for workers by offering enhanced pay-which employes could use to buy their own insurance).

- Standardize coverage types (ala Medicare supplemental policies). This creates a more efficient market by standardizing the coverage packages. it has been successful in significantly reducing costs. Providers compete on price and service. You buy the policy you want.

- Underwriting/physical exams: Nope. If a company offers a particular coverage package (see above) to one person, it must offer it to everyone. This eliminates the problem of adverse selection.

- Cross-state portability: I confess that I'm torn here. I'm a "local control" fan, but if every state can make their own rules then the market won't be as efficient and people might end up shackled to their state of residence just as they are now shackled to an employer.

- The poor: We could go two ways:
-- The government gives them a voucher for the "basic" standardized coverage type (see above). Expect to have basic medical care, to share a room with a few other people in the hospital, and to have to wait for diagnostic tests. You might need to take a bus to a nearby city for that MRI rather than go to the nearer posh "designer" hospital.
-- Expanded VA-type care. Government (or government-contracted) doctors, no right to sue in cases of adverse outcomes, and a lot more PAs than MDs.
Either of these options would provide the same standard of care offered by the Western nations which have socialized medicine. In the US, this care would be paid for with taxes--money forcibly taken from other Americans. In fairness, it should not be better coverage than these Americans (who earned that money) can afford to provide for themselves.

Yes, people should still be free to buy their own health care out of pocket--this is still America. Look at the Canadian experience for examples of what happens when this option is closed.

[MileKing]

Originally Posted by samclem

Hillary took a swing at this very problem--it's the only significant policy initiative she was ever entrusted with, and she failed miserably (due primarily to her poor ability to gain consensus and build trust--personal skills that she does not appear to have enhanced).

Amen! Hillary failed completely with reforming healthcare. She had a chance and delivered nothing, absolutely nothing. Her track record in this area is a big fat zero. McCain's proposal isn't perfect, but at least it is a start.

[Rich_in_Tampa]

Might be worth re-posting this side-by-side comparison of the candidates' proposed health plans. From the very prestigious Kaiser Foundation (not the HMO) which is generally acknowledged as being accurate, objective and nonpartisan.

[Notmuchlonger]

Seems to me McCain's plan would benefit my wife and I more than the other two candidates.

Whatever the case something needs to be changed thats for sure.

[prgsdw]

Line "A" is the clincher for me in comparing the three plans...

I strongly feel that everyone must be in for it work. Also, it's not time to give a freebie to corporate America to offload their responsibilities for employee health care to the tax payer. I don't think Obama goes far enough in this regard and McCains' position on this - can it scream any louder "status quo"?

So this comparison reaffirms my belief that the Clinton plan lines up best with my thinking on this subject...(even if in the end it might cost me the most).

[samclem]

Rich,
Thanks for the link, that's a useful resource. Maybe I'll build a chart for my (super-duper perfect) plan.

One thing jumps out at me--the seams/artificial distinctions. Every one of them is a flag for inefficiency and another arbitrary complication. If "large" businesses are treated differently from "small" businesses, then somebody gets an unfair advantage, or a worker's costs change when he changes jobs. Or companies merge or strip off divisions to get ion the other side of the line. "Medicaid and SCHIP safety net strengthened “for the most vulnerable populations”" : another seam-- how do I get into the "most vulnerable" group? Who decides?

"In market areas where there is not enough competition, require insurers to pay out a “reasonable share” of premiums on patient care benefits" Oh, good! Government gets to make more arbitrary distinctions.

My employer doesn't buy my food, doesn't give me a house, doesn't help pay my electric bill. Aside from a legacy from a dumb WW-II government policy, can someone please tell me . . . .By what rational argument should the nation's employers be in the health care delivery business??

[Texarkandy]

Originally Posted by samclem

Aside from the specifics of the various plans/proposals, there is the factor of the track record of the three individuals. Reforming the way health care is delivered is not going to happen without consensus across the political spectrum. Only one candidate, McCain, has a proven record of reaching across the aisle to get things done (it's why many Republicans hate him). Hillary took a swing at this very problem--it's the only significant policy initiative she was ever entrusted with, and she failed miserably (due primarily to her poor ability to gain consensus and build trust--personal skills that she does not appear to have enhanced).

I understand why some people like the VA health care system, and especially what it represents. It is perfectly egalitarian, and it is cheap. If this system is the example that universal health care proponents are going to hold out to the public as a success, they can save themselves a lot of time by just folding up their tent right now.

We can fix what is wrong without making everyone buy a Mao jacket.

- De-link health insurance from employment. If we just eliminated the tax break employers get in this area, we'd be 90% of the way there (since employers would stop offering coverage and would instead compete for workers by offering enhanced pay-which employes could use to buy their own insurance).

- Standardize coverage types (ala Medicare supplemental policies). This creates a more efficient market by standardizing the coverage packages. it has been successful in significantly reducing costs. Providers compete on price and service. You buy the policy you want.

- Underwriting/physical exams: Nope. If a company offers a particular coverage package (see above) to one person, it must offer it to everyone. This eliminates the problem of adverse selection.

- Cross-state portability: I confess that I'm torn here. I'm a "local control" fan, but if every state can make their own rules then the market won't be as efficient and people might end up shackled to their state of residence just as they are now shackled to an employer.

- The poor: We could go two ways:
-- The government gives them a voucher for the "basic" standardized coverage type (see above). Expect to have basic medical care, to share a room with a few other people in the hospital, and to have to wait for diagnostic tests. You might need to take a bus to a nearby city for that MRI rather than go to the nearer posh "designer" hospital.
-- Expanded VA-type care. Government (or government-contracted) doctors, no right to sue in cases of adverse outcomes, and a lot more PAs than MDs.
Either of these options would provide the same standard of care offered by the Western nations which have socialized medicine. In the US, this care would be paid for with taxes--money forcibly taken from other Americans. In fairness, it should not be better coverage than these Americans (who earned that money) can afford to provide for themselves.

Yes, people should still be free to buy their own health care out of pocket--this is still America. Look at the Canadian experience for examples of what happens when this option is closed.

I quite agree with ideas like these - maybe not exactly everything you cite, but I think we should be looking along these kinds of lines for solutions -

govt should tweak regulation of the industry to prevent abuses & promote fair competition & wider availability of more standardized insurance products that are more understandable to the consumer in terms of what coverage they will have for how many premium dollars they will pay.

govt can at the same time subsidize individual's procurement of health care in certain circumstances (the poor, the uninsurables, the elderly, etc) & in a manner that still promotes a free and fair market.

A bare-bones "basket case" govt program for those who absolutley can't (or won't) pay their own way.

I can't say I entirely agree with separating health care from employers without replacing it with something that gives consumers the "group" purchasing power and risk sharing that employer sponsored group insurance deals give them. Perhaps unions, churches, fraternal organizations or other institutions could sponsor group plans if individuals had more of the health insurance premium dollars (power) in their own hands. (we need more Unions in this country again IMHO)

There are problems with our health care systems, but the sky is not falling either - govt sponsored/initiated tweaks to the system of these kinds are apppropriate and the American way to go (free market solutions with appropriate regulation)

- it cannot happen overnight of course - but neither can "universal" or "socialized" medicine and any "pol" who wants us to believe "universal"/"socialized" medicine is do-able in just a few years is just lying.

[youbet]

Originally Posted by Rich_in_Tampa

Just had a visit from a colleague age 61, ready, eager, and rich to retire. His wife is diabetic. He will be working another 4 years against his will and needs for lack of health care insurance options. That's the kind of thing that needs to be fixed for both the rich and the poor. Don't see it in the McCain proposalette.

Are you saying your rich friend can't buy insurance for his diabetic wife at any price? Or that he isn't willing to part with the bucks that a policy would cost due to her condition?

[Rich_in_Tampa]

Originally Posted by Texarkandy

There are problems with our health care systems, but the sky is not falling either

If the sky's not falling, it's certainly sagging badly, and scraping the floor in some quarters. More than many issues, it can be quite invisible to many; It does work well for generally healthy people with means, insurance, and accessible care.

You are not alone in feeling that the problem is not as severe as I see it to be. What is bringing it home to many is that the happy consumer I mention above is inches from being victimized: loss of a job especially if health related, a severe illness that really presses up against the limits of coverage (think 12 months of rehab from a bad accident where coverage ends at 90 days), a chronic but costly outpatient disease like diabetes, the means and desire to retire but deferring due to unavailability of coverage; a life-sustaining drug regimen that costs $3000 a month uncovered; those who wish or need to move for family reasons but unable to abandon their current health policy which doesn't cover them out of state.

Really doesn't matter which side of the political spectrum you hale from: a bad system is a bad system, whether it's Enron, Countrywide, or the current US health insurance mess. Being the optimistic type, I think we can fix it within a few years if we de-politicize it.

[youbet]

Originally Posted by Notmuchlonger

Seems to me McCain's plan would benefit my wife and I more than the other two candidates.

I don't think the other two candidates need any benefits from McCain's plan. They're both rich and have generous gov't benefits beyond that. So, sure, you and your wife should help yourself to them. The heck with the BG and his competitor.

[Notmuchlonger]

Sorry Im slow on the uptake.


"The heck with the BG and his competitor. "

What does that mean?

[Texarkandy]

BG = The Black Guy
WW = The White Woman (you could also substitute WL for "The White Lady")
OWG = The Old White Guy

[youbet]

Originally Posted by Notmuchlonger

Sorry Im slow on the uptake.


"The heck with the BG and his competitor. "

What does that mean?

You said "Seems to me McCain's plan would benefit my wife and I more than the other two candidates."

And I say that if that's the case, the heck with the other two candidates, you and DW take the benefits from McCain's plan.......

Oh, never mind, bad attempt at humor on my part!

[Texarkandy]

Originally Posted by Rich_in_Tampa

If the sky's not falling, it's certainly sagging badly, and scraping the floor in some quarters. More than many issues, it can be quite invisible to many; It does work well for generally healthy people with means, insurance, and accessible care.

Oh, it's quite visible to me thank you (having just seen a 26K radiation bill come in the mail this very evening) - & yes between "means" & "insurance" (brought on by years of work, LBYM, & planning with my eyes wide open) we are managing quite fine.