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McCain's health "plan"
Old 04-08-2008, 09:04 AM   #1
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McCain's health "plan"

There is a fair chance McCain might be our next president. Before you vote for the guy because you are so upset at the democrat's shenanigans, be sure to read about his plan for reforming the health care sector and health insurance.

He has no plan for covering people with pre-existing conditions beyond letting the market take care of the problem. Not likely, as the market has not taken care of the problem in the past and insurance companies make money by choosing to cover healthy people, not sick people. Why would they voluntarily cover people who are not well?

John McCain 2008 - John McCain for President

Here is McCain on health care reform: I put a few of my comments in blue.

John McCain is willing to address the fundamental problem: the rapidly rising cost of U.S. health care.
  • Bringing costs under control is the only way to stop the erosion of affordable health insurance, save Medicare and Medicaid, protect private health benefits for retirees, and allow our companies to effectively compete around the world.
  • Families should be in charge of their health care dollars and have more control over their care. We can improve health and spend less, while promoting competition on the cost and quality of care, taking better care of our citizens with chronic illness, and promoting prevention that will keep millions of others from ever developing deadly and debilitating disease.
  • While we reform the system and maintain quality, we can and must provide access to health care for all our citizens - whether temporarily or chronically uninsured, whether living in rural areas with limited services, or whether residing in inner cities where access to physicians is often limited. Nothing proposed here and will not occur if the only reforms are those he proposes below.
  • America's veterans have fought for our freedom. We should give them freedom to choose to carry their VA dollars to a provider that gives them the timely care at high quality and in the best location. The VA is a major success story, delivering health care at a reasonable cost and doing a great job of followup and monitoring. This plan would dismantle the VA.
  • Controlling health care costs will take fundamental change - nothing short of a complete reform of the culture of our health system and the way we pay for it will suffice. Reforms to federal policy and programs should focus on enhancing quality while controlling costs:
  • Promote competition throughout the health care system - between providers and among alternative treatments.
  • Make patients the center of care and give them a larger role in both prevention and care, putting more decisions and responsibility in their hands.
  • Make public more information on treatment options and require transparency by providers regarding medical outcomes, quality of care, costs, and prices.
  • Facilitate the development of national standards for measuring and recording treatments and outcomes.
  • Reform the payment systems in Medicare to compensate providers for diagnosis, prevention, and care coordination. Medicare should not pay for preventable medical errors or mismanagement. Sounds nice, but what if someone has to go to another provider because of an error? Certainly the cost needs to be paid.
  • dedicate federal research on the basis of sound science resulting in greater focus on care and cure of chronic disease.
  • Give states the flexibility to, and encourage them to experiment with: alternative forms of access; risk-adjusted payments per episode covered under Medicaid; use of private insurance in Medicaid; alternative insurance policies and insurance providers; and, different licensing schemes for medical providers.
  • Build genuine national markets by permitting providers to practice nationwide. Not sure what he means here by providers. Currently states have some control over quality through licensing. How would this effect that control?
  • Promote rapid deployment of 21st century information systems.
  • Support innovative delivery systems, such as clinics in retail outlets and other ways that provide greater market flexibility in permitting appropriate roles for nurse practitioners, nurses, and doctors.
  • Where cost-effective, employ telemedicine, and community and mental health clinics in areas where services and providers are limited.
  • Foster the development of routes for safe, cheaper generic versions of drugs and biologic pharmaceuticals. Develop safety protocols that permit re-importation to keep competition vigorous.
  • Pass tort reform to eliminate frivolous lawsuits and excessive damage awards. Provide a safe harbor for doctors that follow clinical guidelines and adhere to patient safety protocols.
  • Protect the health care consumer through vigorous enforcement of federal protections against collusion, unfair business actions, and deceptive consumer practices.
John McCain believes that insurance reforms should increase the variety and affordability of insurance coverage available to American families by fostering competition and innovation.
  • Reform the tax code to eliminate the bias toward employer-sponsored health insurance, and provide all individuals with a $2,500 tax credit ($5,000 for families) to increase incentives for insurance coverage. Individuals owning innovative multi-year policies that cost less than the full credit can deposit remainder in expanded health savings accounts. I understand and appreciate the theory behind this but this will not help if you are uninsurable or if the insurance companies want to price commensurate with your risk. This could be great for the young, healthy middle class but won't do anything for poorer people who already don't pay taxes or for chronically ill people. Also, small employers find health insurance much more expensive than large employers, but the tax credit remains the same. My former employer pays roughly $12,000 a year for family coverage. I had small employer clients who paid even more.
  • Families should be able to purchase health insurance nationwide, across state lines, to maximize their choices, and heighten competition for their business that will eliminate excess overhead, administrative, and excessive compensation costs from the system. This is a big big problem. Currently, states are the only ones who regulate in any significant extent the insurance market. State governors and insurance commissioners have been uniformly against similar proposals in the past. If we allow people to buy from anywhere, state regulation will be meaningless and all will fall to the lowest common denominator. This will dramatically increase the problem of adverse selection.
  • Insurance should be innovative, moving from job to home, job to job, and providing multi-year coverage. Sure. Are you going to pass a law that requires it?
  • Require any state receiving Medicaid to develop a financial "risk adjustment" bonus to high-cost and low-income families to supplement tax credits and Medicaid funds.
  • Allow individuals to get insurance through any organization or association that they choose: employers, individual purchases, churches, professional association, and so forth. These policies will be available to small businesses and the self-employed, will be portable across all jobs, and will automatically bridge the time between retirement and Medicare eligibility. These plans would have to meet rigorous standards and certification. Without underwriting? Not likely. What standards? What if a plan limited coverage to $10,000 per illness? Or $50,000 a year?
John McCain Believes in Personal Responsibility
  • We must do more to take care of ourselves to prevent chronic diseases when possible, and do more to adhere to treatment after we are diagnosed with an illness.
  • Childhood obesity, diabetes and high blood pressure are all on the rise. We must again teach our children about health, nutrition and exercise - vital life information.
  • Public health initiatives must be undertaken with all our citizens to stem the growing epidemic of obesity and diabetes, and to deter smoking. Absolutely agree.
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Old 04-08-2008, 09:11 AM   #2
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Its a start. No plan will pass without it being bi-partisan anyways.
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Old 04-08-2008, 09:40 AM   #3
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Originally Posted by Notmuchlonger View Post
Its a start. No plan will pass without it being bi-partisan anyways.
Agree that bipartisan support (probably driven by political realities) will be necessary, ideally a McCain-Feingold style alliance if McCain wins the general election - not necessarily Feingold, but some other torch-carrier for the Democrats). For that matter, Hillary or Barack will need influential republicans behind them as well for either one's plan.

So far, McCain's proposals are a non-starter for me in this area, effectively just a tweak here and a tweak there for the current "system." I think his ideas may firm up into more of a plan as his campaign matures after the primaries, but so far he is not out in front of this issue at all.

I'd favor a more substantive reform which means leadership that looks beyond the politics, starting with universal access to health insurance at uniform premiums, without exclusions based on health or employment status.
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Old 04-08-2008, 09:48 AM   #4
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Well the one thing I do not like or maybe I do not get it. Is a system that would exclude the sick or high risk persons. Does not make much sense to me.
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Old 04-08-2008, 09:59 AM   #5
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Sounds like "I got mine, eff the rest of you."

I really do not want an octogenarian cold warrior in the White House.
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Old 04-08-2008, 10:20 AM   #6
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Sounds like "I got mine, eff the rest of you."

I really do not want an octogenarian cold warrior in the White House.
McCain was born in 1936.........
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Old 04-08-2008, 10:21 AM   #7
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McCain was born in 1936.........
Close enough. Add a few years for the torture experience and add a few more due to the general cluelessness about real life that develops from spending so many years in Congress.
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Old 04-08-2008, 10:46 AM   #8
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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.
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Old 04-08-2008, 10:49 AM   #9
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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.
Well, instead your colleague gets to do his "patriotic, unselfish duty."

Idiotic system.
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Old 04-08-2008, 11:32 AM   #10
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Martha, I agree with much of what you said. We have some serious health care problems and McCain's program doesn't seem likely to fix our health care system.

But the VA? I don't know. I think that if I were a military veteran, I'd want to have the option of going somewhere else for my medical care. I have always thought the VA provided inferior care though I recognize I could be wrong about that! But if veterans had the choice, I'm sure they would gravitate towards what they felt was the best care. If they think the VA is the best, then they will go there. The specter of competition might spur the VA to improve in many ways, too.

Don't mean to pounce on one little detail (sorry!). Good post.
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Old 04-08-2008, 12:50 PM   #11
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That's fine, W2R. I brought up the VA because the reforms in the Clinton years were such a success. The problem with allowing shopping is that the VA may no longer be able to keep its clinics and hospitals. If that is the choice that people want to make, fine. But I sure would dislike seeing a program that is working well get tossed for "choice." Having a lot of choices isn't necessarily a good thing. It is like going to the mall shoe stores, having thousands of choices, none of which are what you need.
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Old 04-08-2008, 12:59 PM   #12
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Perhaps health care is an area were absolute equity should prevail. Perhaps expanding the VA to a size where all can be accomocated would be the answer. Everyone gets the same. Have no coverage today? No problem, you'll get whatever the future common denominator is tomorrow. Have superb coverage today? Small problem, you'll get whatever everybody else is getting tomorrow. Have money to pay for coverage outside the system? Fine, but shop for it offshore as all domestic care will be in clinics and hospitals similar in structure to what the VA offers today.

I could live with that. I'm tired of worrying about those without coverage and of envying those with superior coverage to what I can afford and have access to.

But everyone must have the same care available. No exceptions for the wealthly. No exceptions for folks with excellent coverage today, such as many public sector employees/retirees. Etc.
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Old 04-08-2008, 01:09 PM   #13
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I agree. Though I tend to vote conservative, I think the health care system in this country is broken, inefficient, and unethical. Like others, I'm on the verge of being chained to a job where I arguably don't belong, simply due to health insurance. I'd like to see a universal system where everybody pays according to ability and everybody is eligible for the same (probably modest) benefits. Nobody would have to worry about going without routine or conventional care, or being in pain, just because of finances. Those who could afford more exotic care outside the system could pay for it.
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Old 04-08-2008, 01:34 PM   #14
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But everyone must have the same care available. No exceptions for the wealthly. No exceptions for folks with excellent coverage today, such as many public sector employees/retirees. Etc.
I think that 's a very nice sentiment but unrealistic . There will always be options such as moving up the transplant list quicker to very wealthy or notable people. Mickey Mantle for example .
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Old 04-08-2008, 02:14 PM   #15
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I think that 's a very nice sentiment but unrealistic . There will always be options such as moving up the transplant list quicker to very wealthy or notable people. Mickey Mantle for example .
Let's be pragmatic. A few of the very rich or very famous will always be exceptions to laws and social mores. But we can at least define the new "for all" universal medical plan to really be "for all." No exceptions for public sector employees/retirees whose current coverage might be better than what the new universal plan will provide. If onesey - twosey rich and/or famous folks slip by, so be it. As long as, for example, the millions of public sector folks, including (and especially!) high level politicians have the same coverage as "joe citizen" we will have done well!

My prediction is that resistance by folks whose current health care entitlements are superior to whatever the new universal plan proposes will be a major stubling block and delay to getting the new plan passed. We must all be ready and willing to go with the new plan regardless of what our current plan is!
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Old 04-08-2008, 02:18 PM   #16
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Let's be pragmatic. A few of the very rich or very famous will always be exceptions to laws and social mores. But we can at least define the new "for all" universal medical plan to really be "for all." No exceptions for public sector employees/retirees whose current coverage might be better than what the new universal plan will provide. If onesey - twosey rich and/or famous folks slip by, so be it. As long as, for example, the millions of public sector folks, including (and especially!) high level politicians have the same coverage as "joe citizen" we will have done well!

My prediction is that resistance by folks whose current health care entitlements are superior to whatever the new universal plan proposes will be a major stubling block and delay to getting the new plan passed. We must all be ready and willing to go with the new plan regardless of what our current plan is!
Ive already heard people with government health care grumble about it.
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Old 04-08-2008, 02:21 PM   #17
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Ive already heard people with government health care grumble about it.
Then I hope that whatever the new universal plan is, it's better than what they're grumbling about! I just think it's imperative that, in all fairness, it's the same for everyone. If public sector folks are grumbling now, perhaps they won't mind giving it up and going with the rest of us.....
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Old 04-08-2008, 02:26 PM   #18
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Then I hope that whatever the new universal plan is, it's better than what they're grumbling about! I just think it's imperative that, in all fairness, it's the same for everyone. If public sector folks are grumbling now, perhaps they won't mind giving it up and going with the rest of us.....
Well their argument is that they gave up lesser pay for these retirement benefits.
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Old 04-08-2008, 06:29 PM   #19
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Seems to me that, although it's sometimes a little pricey & inefficient, most folks in this country do, in fact, get a fairly good level of health care.
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Old 04-08-2008, 06:32 PM   #20
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Martha,

With all due respect (sincerely), have you scrutinized the "plans" of Obama and Hillary and found either significantly better/more convincing? Seems the choice among candidates is SOP politics once again, the 'lesser of all evils' offered. I can't remember anyone I've voted for that I thought had every single issue answered with what I wanted to hear (and never expect to).

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

And if we did suddenly get universal healthcare, can you imagine the FIRE stampede?
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