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McCain rejects calls for universal health coverage
He offers solution based on free market; proposes tax incentives, individual focus
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Published: April 30, 2008
TAMPA, Fla.
Sen. John McCain rejected yesterday calls by his Democratic opponents for universal health coverage, instead offering a market-based solution with an approach similar to a proposal made by President Bush last year.
McCain's belief in the power of the free market to solve the nation's health-care needs sets up a stark choice for voters this fall, in terms of the health care they could receive, the role the government would play and the importance they place on the matter.
Democratic Sens. Barack Obama and Hillary Clinton have vowed government action to correct what they cast as a moral right for Americans to have health insurance. They favor mandates for coverage; McCain proposes tax incentives. Obama and Clinton would impose new regulations on insurers; McCain's plan is to avoid direct regulation. The Democrats would build on the current employer-based system; McCain would shift to a more individual approach.
In a speech at a cancer-research center here, McCain dismissed his Democratic rivals' proposals for universal health care as riddled with "inefficiency, irrationality and uncontrolled costs." He said that the 47 million uninsured Americans will get covered only when they are freed from the shackles of the current, employer-dominated system.
McCain's prescription is to attract workers away from their company health plans with a $5,000 family tax credit and a promise that, left to their own devices, they will be able to find cheaper insurance that is more closely tailored to their health-care needs and not tied to a particular job.
Under McCain's plan, $3.6 trillion worth of tax breaks over 10 years that would have gone to businesses for coverage of their employees would be redirected to individuals, regardless of whether they are covered by a company plan.
"Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs," McCain said. "It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost."
Health experts predict a robust debate once the general election begins, as growing anxiety about the cost of health care plays out against a backdrop of a worsening economy, higher gas prices and rising unemployment.
"Health will increasingly become reframed as part of the broader pocketbook and economic concerns," said Drew Altman, the president of the Kaiser Family Foundation, a non-partisan health-research group. "The real health-reform debate hasn't really begun -- the debate between the Democrats and the Republicans about the fundamental differences in how to reform health care."
McCain's proposal is similar to one Bush offered in his 2007 State of the Union speech. That plan, which would have replaced employer tax breaks for health insurance with a $15,000 tax deduction for married couples, flopped in Congress, failing to even get a committee hearing.
McCain's plan is aimed primarily at giving individuals the right to make health-care decisions, by granting the same tax breaks for insurance whether a person gets their policy from an employer or on their own. Aides call it a "radical" rethinking of health care that will drive costs down and give people more choice.
But it also leaves McCain open to the criticism that he is not doing enough for the poor and sick, who could face steep premiums and limited choices as they search for an insurance company willing to cover them. Critics of McCain's plan said that it will do little to help people struggling with health-care costs.
Unlike his Democratic opponents, for instance, McCain would not mandate coverage for people with pre-existing conditions who have not already been covered by a company health-insurance plan. Critics say that would leave millions of people without coverage.
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