Reforming the Health Care System: May the Best Candidate Win
With rising gas prices, a struggling economy and higher health care premiums, many Americans are struggling to pay for higher health care and insurance costs. Health care is a top concern for registered voters and therefore a vital issue for the presidential candidates. The candidates’ health care platforms touch on reducing high costs, lowering the number of uninsured Americans and repairing a broken delivery system, including a Medicare program on the verge of bankruptcy and a Medicaid program too expensive for many states.

How do the candidates plan to tackle these challenges?

Lowering the Costs of Health Care:
Republican candidate John McCain and Democratic candidate Barack Obama share a common goal to lower the cost of health care, although their strategies differ (see chart below).

OHA’s Take: Any attempt to lower costs must focus on preventive medicine.

 

Decreasing the Number of Uninsured Americans:
Sen. John McCain suggests making it easier for individuals and families to obtain insurance. His plan uses competition to bring down insurance costs, making health insurance more affordable. McCain’s plan follows the current system of employer-based coverage, but helps offset insurance prices by providing a direct refundable tax credit of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Those who choose an insurance plan that costs less than the tax credit can deposit the remainder in expanded Health Savings Accounts for later health-related uses.

Sen. Barack Obama plans to offer a national health plan similar to what is offered to federal employees. He also will keep in place the current system of employer-based insurance policies, but lower the costs of premiums. Obama’s national health plan would guarantee eligibility to everyone, cover essential medical services and make premiums, co-pays and deductibles more affordable. Obama would also develop a National Health Insurance Exchange to create rules and standards for participating insurance plans to help ensure fairness, affordability and accessibility. The exchange would require all insurance plans be equal to or better than the national health plan.

OHA’s Take: Every Ohioan must have appropriate access to primary care beyond hospital emergency rooms.

Improving the Delivery System:
While both major candidates are focused on health care costs and the uninsured, neither candidate has spent much time discussing the overall health care delivery system. This includes the basic functions of management and coordination of care and the more complex tasks of improving efficiency, maximizing quality and making sure the system has the infrastructure to handle future needs. Specifically, candidates need to focus efforts on prevention of chronic diseases – cancer, heart disease and diabetes – to save lives and health care resources. Although costs and coverage are very important problems, nothing will be solved if the underlying foundation is broken.

OHA’s Take: No fix to the delivery system makes other efforts just Band-Aids on a broken system.

What will this cost?
Neither candidate has announced an extensive plan for financing his health care platform. Both parties count on unspecified savings within the health care system as the major source of funding. Obama also expects additional funds to come from discontinuing tax cuts for those with incomes over $250,000.

Both McCain and Obama see flaws in the health care system as a major problem in the U.S. and have crafted plans to reform the system, but it remains unclear the extent to which either candidate will make health care reform a top priority in 2009.