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McCain starting to talk about health care

This morning John McCain’s team will be talking about health care. There are some interesting ideas in McCain’s plan, which is the Bush tax deduction idea morphed into a tax credit, plus changes in Medicare payments. The best quick explanation is from our friends at ICYou.

Matthew Holt

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  1. McCain’s ideas to lower costs from his web site:
    “CHEAPER DRUGS: Lowering Drug Prices. John McCain will look to bring greater competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs.”
    Those cheaper drugs from Canada were because of Canadian price controls – not more competition. Safe re-importation? We can’t control the safety of drug ingredients from other countries now. Anyone trust the FDA and China to inspect drugs and drug ingredients? How about the Heparin deaths – does that give you comfort?
    “CHRONIC DISEASE: Providing Quality, Cheaper Care For Chronic Disease. Chronic conditions account for three-quarters of the nation’s annual health care bill. By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can reduce health care costs. We should dedicate more federal research to caring and curing chronic disease.”
    How is he going to “Providing Quality, Cheaper Care For Chronic Disease”? He hasn’t said anything. Are providers going to charge less? Are hospitals going to charge less? Who’s going to co-ordinate this?
    “COORDINATED CARE: Promoting Coordinated Care. Coordinated care – with providers collaborating to produce the best health care – offers better outcomes at lower cost. We should pay a single bill for high-quality disease care which will make every single provider accountable and responsive to the patients’ needs.”
    Promoting? What’s that? Paying a single bill for high-quality disease care? To who? For what? Providers collaborating – how are you going to get them to do that? I thought competition was going to bring costs down, not “collaborating”.
    “GREATER ACCESS AND CONVENIENCE: Expanding Access To Health Care. Families place a high value on quickly getting simple care. Government should promote greater access through walk-in clinics in retail outlets.”
    Again the word “promote”. How? If it’s free market forces he wants what promoting should the government have to do? Walmart’s doing a better job at this than the government is right now. Is he going to offer Walmart tax incentives?
    “INFORMATION TECHNOLOGY: Greater Use Of Information Technology To Reduce Costs. We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines.”
    Who’s going to pay for what system? And who’s going to force providers to use any system. This is a problem even for single-pay countries. Doctors practising across state lines? Boy that’ll get the doctors guild upset. Does that mean I can phone a doctor in another state to get a diagnosis?
    “MEDICAID AND MEDICARE: Reforming The Payment System To Cut Costs. We must reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement.”
    Reforming the payment system? To providers that means paying more, not less. Preventable? Define that one please. If Medicare and Medicaid should not pay for errors or mismanagement how is he going to enforce that when he’s prevented medical malpractice law suits?
    “SMOKING: Promoting The Availability Of Smoking Cessation Programs. Most smokers would love to quit but find it hard to do so. Working with business and insurance companies to promote availability, we can improve lives and reduce chronic disease through smoking cessation programs.”
    The private sector is already offering these. Does he want tax payers to now pay for someone’s bad habits? That doesn’t sound like the “conservative” approach. Should the tax payer also pay for drug rehab as well? Or weight reduction programs?
    “STATE FLEXIBILITY: Encouraging States To Lower Costs. States should have the flexibility to experiment with alternative forms of access, coordinated payments per episode covered under Medicaid, use of private insurance in Medicaid, alternative insurance policies and different licensing schemes for providers.”
    Can’t states do that now? Define “encourage”. The states want more federal money to pay for healthcare now. Ok McCain, how are the states going to lower the costs to treat illegal immigrants?
    “TORT REFORM: Passing Medical Liability Reform. We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an invitation to endless, frivolous lawsuits.”
    So we should rely on the free market to lower health costs by eliminating the free market for medical malpractise law suits? Whose going to judge what’s frivolous and how? Maybe a court? And when the patient gets harmed through either negligence or accident or just because, whose going to pay for his medical expenses? I thought the insurance malpractice system (free market) was supposed to solve this? Wouldn’t doctors with higher claims pay more and that would force better methods to reduce claims? What percentage of healthcare costs now account from frivolous suits?
    “TRANSPARENCY: Bringing Transparency To Health Care Costs. We must make public more information on treatment options and doctor records, and require transparency regarding medical outcomes, quality of care, costs and prices. We must also facilitate the development of national standards for measuring and recording treatments and outcomes.”
    Boy, he wants a fight from doctors and hosptials doesn’t he? Don’t hold your breath on this one – never happen.
    Matt’s right – just talk no action. We don’t have a democracy, we have a political circus with voters clapping every time a clown does a trick for us.

  2. Maybe I’m missing something here. You cut the props out from under employer based coverage, and then give people 40% of the money to buy coverage themselves?
    You hope that some employers will continue offering coverage even though it is much more expensive after tax and you hope that “competitive forces” will bring down the cost of coverage by suspending state coverage mandates. And between the boat and the dock fall millions of people who presently have coverage and no free cash to make up the difference between the tax credits and the actual cost of private coverage.
    Say it ain’t so, John. This just isn’t a credible plan; it’s magical thinking on a grand scale. Details to follow?

  3. McCain is proposing to create a safety net for the uninsured American citizens who have not been able to buy health insurance because of pre-existing medical conditions, but he hasn’t explained how he woiuld keep the freeloaders from gaming the system or why any re-insurers would be dumb enough to get involved. I’ve seen a $7 billion price tag for his proposal, which would be ok for dealing with the long-time chronically ill who can’t get health insurance. But is that state or fed money, and where would it come from?

  4. McCain is trying to save the high quality of the US health care system through his plan. The problem is this high quality is expensive and even now offered only to those that can afford it (or afford the relevant health insurance).

  5. As a rule, the “for profit” motive and “free enterprise” are hard to beat when it comes to systems for allocating resources in a free society, but some institutions like healthcare should be exceptions to that rule.
    So many people have a stake in the healthcare economy. With the wealth comes political clout and powerful influence over public awareness. If you so much as talk about reigning in doctors or drug companies or health insurance, you’re branded as an advocate of socialized medicine.

  6. One major problem with McCain’s healthcare plan is that there are no price controls. What good will a $2500 tax credit do for the underinsured with chronic diseases? And moreover, what will he do about ensuring that those with pre-existing conditions will even get accepted by an insurer? This will certainly continue the healthcare crisis that we experience today, if not exacerbate it.
    I’m not sure I agree with mandates either, and I question the actual costs of either the Clinton or the Obama plan. This could potentially increase our national debt to the point of bankruptcy, accounting for over 300 million Americans in the country today.
    I wonder if anyone has asked all of them whether they’ve compared their plans with what other countries are doing, particularly Taiwan and Japan, both who seem to find the best of both the Democratic and Republican plans.

  7. Thank you for sharing this video. I’m glad the candidates are starting to discuss their health plans more. It’s very necessary.

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