By Catherine Green
An issue that ranks high among most voters’ concerns is healthcare, and its cost and availability. The major-party presidential candidates have different proposals for dealing with the problem, but they agree it is a critical one.
Here are the positions of Democrat Barack Obama and Republican John McCain:
The problem defined
OBAMA: “Too little is spent on prevention and public health. The nation faces epidemics of obesity and chronic diseases as well as new threats of pandemic flu and bioterrorism, yet despite all of this, less than four cents of every health-care dollar is spent on prevention and public health.”
McCAIN: “The problems with healthcare are well known. It is too expensive, and 47 million people living in the United States lack health insurance.”
The plans
OBAMA: His plan would “create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to insure fairness and make coverage more affordable and accessible.”
McCAIN: “While still having the option of employer-based coverage, every family will receive a direct refundable tax credit — effectively cash — of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider, and the money will be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in Health Savings Accounts.”
Medicare
OBAMA: Stop subsidizing Medicare Advantage (a supplemental insurance program) and eliminate the “doughnut hole,” a gap between out-of-pocket payment limits and catastrophic coverage. Provide better management of chronic disease and emphasize prevention.
McCAIN: Reform the payment system to cut the cost of compensating providers for diagnosis and prevention of disease. Medicare should not pay for preventable medical errors or mismanagement.
Prescription drugs
OBAMA: Provide Medicare recipients with a list of the prescription drugs they have taken over the previous year, and their cost. Provide a list of competing health plans and their drug prices on the Internet. Lift the ban on Medicare’s negotiating for the best drug prices. Allow Americans to purchase prescription drugs from Canada and developed countries abroad. Prevent pharmaceutical companies from blocking introduction of safe generic drugs.
McCAIN: Lower drug costs by increasing competition among plans. Allow the importation of safe drugs from Canada and other developed countries. Allow faster introduction of generic drugs. Base coverage of prescription drugs under Medicare Plan D on income.
Long term care
OBAMA: Choice must be consistent with individual needs, not institutional care. Financing of long term care must be reformed to improve the quality of eldercare, including training of nurses and healthcare workers.
McCAIN: Supports state-based experiments, such as Cash and Counseling, that deliver care to people in their homes. Seniors are given a monthly stipend which they can use to hire workers and purchase care-related services and goods. Designated representatives, such as relatives or friends, help them make decisions.
