Team McCain Conference Call: Health Care

posted at 1:40 pm on April 29, 2008 by Ed Morrissey

Team McCain began his rollout on health-care policy with a speech earlier today in Tampa, followed by a media/blogger conference call. They called McCain’s visit to hospitals a “tribute” to the excellence of American medical care, and hoped to bolter that excellence while reforming the insurance system to allow for better competition and broader coverage. He wants to look at the “experiments” in various states to use competition as well as a mandated safety net for those with pre-existing conditions.

Broadly speaking, he wants patients in control of their care. He wants establish portable health-savings accounts, remove state barriers to health insurance, and give tax incentives to push the uninsured to get into the system. They also want to focus on “wellness” and healthy living — which sounds a little intrusive, possibly. Tort reform will comprise part of this package to reduce the burden of litigation.

Questions:

  • Matt Lewis, Townhall: It’s easier to sell liberal ideas as opposed to free-market solutions. How do they plan to do the latter, and what about drug importation? — Fundamental difference of putting government in charge rather than the patients should be an easy sell. Choice and competition drive costs down, as does transparency. John McCain is “the best retail politician” today, and it’s not hard to sell people what they really want. Drug reimportation — he wants to embrace free trade and competition, so he’s open to it.
  • Dana Bash, CNN: How does this control costs? – 35% of the costs are in chronic conditions. Prevention will provide plenty of savings. Offer smoking cessation programs and get people to lose weight. Create a system that will improve efficiency in the clinics. Access to insurance will get people out of the ERs.
  • Adam Igner, NBC: What incentives would there be for employers to continue offering health insurance? — It attracts quality employees. In a competitive labor market, employers will still have to offer health insurance to attract the best talent.
  • Me: What about Medicare? — Yes, this intends to form part of Medicare reform. They want to revamp Medicare to move away from fee-for-services to pay-for-health-care, which will help control costs. Instead of tests and procedures, the focus will be on treatments and outcomes. There will be renewed focus on chronic diseases to drive down costs. Mandates on chronic-disease improvement? The Safeway experience is instructive. No co-pays on preventive efforts like weight loss and smoking cessation improvements, and it resulted in better health and lower costs overall. The focus would be on incentives, not mandates; price breaks, other offerings.
  • Pittsburgh Post: The $3.6 trillion in savings [over 10 years] would come from ending tax breaks for employer-based health care? — It will shift it from exclusion to credit, which means that some benefits will get taxed.

Interesting. There are items to like and dislike about this plan. I’m not sure I like the taxation on employer-based health care, as it would hit across the board and act exactly like a tax increase. It would at the same time provide a little more tax benefit for self-employed individuals, which helps free people from becoming health-insurance slaves to big companies, a subject on which I have quite a bit of experience. For the most part, it envisions market-based solutions, which puts it ahead of the plans from the Democrats, and it will at some point force badly-needed Medicare reform.


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Good grief.
I like parts of this, but taxing employer-provided health care benefits isn’t like a tax increase.

It is a tax increase.

If your taxes go up, see, and you made the same amount of money, your taxes… increased.

I’m not swiping at Ed, here, if that’s what it seems like. I’m swiping at the jackass democrat we managed to nominate for the general.

Sigh.

jdub on April 29, 2008 at 1:48 PM

They called McCain’s visit to hospitals a “tribute” to the excellence of American medical care, and hoped to bolter that excellence while reforming the insurance system to allow for better competition and broader coverage.

Give me some more corporate-speak b.s., please.

Tort reform will comprise part of this package to reduce the burden of litigation.

Even Maverick McCain, if he really means it, would never, ever, ever be able to reach far enough across the aisle to accomplish this. I also don’t like him tying tort reform to just health care — tort reform needs to go well beyond that. Not that it will ever come about.

BigD on April 29, 2008 at 1:52 PM

I’d rather that gov’t go after reforming the Insurance/Trial Lawyer “industry,” than the Medical Care Industry.

I think, that’s the root of the problem…It’s what’s driving the cost to begin with.

franksalterego on April 29, 2008 at 1:58 PM

BigD on April 29, 2008 at 1:52 PM

He’ll raise taxes first and promise tort reform later. It is the old Potomac two-step.

Valiant on April 29, 2008 at 2:07 PM

McCain will appeal to seniors first, as that’s his base of support. He won’t fix anything, he’ll just make sure the 65 and over crowd gets what they want.

leftnomore on April 29, 2008 at 2:45 PM

McCain should have been put out to pasture fifteen years ago, when he first started to Maverick his way around Washington. What the hell is wrong with Arizona anyway?

Snake307 on April 29, 2008 at 2:54 PM

What the hell is wrong with Arizona anyway?

Snake307 on April 29, 2008 at 2:54 PM

Illegals.

Onager on April 29, 2008 at 2:57 PM

I’m swiping at the jackass democrat we managed to nominate for the general.

Sigh.

jdub on April 29, 2008 at 1:48 PM

He hasn’t been nominated yet. I know most people think it’s already a done deal, but I don’t. There may yet be hope for a brokered convention. Look at what the Ron Paul supporters are doing in Nevada. Instead of slamming them, why not support their efforts to work within the law and save us from the travesty of a McCain nomination.

I respect McCain’s service to our country, but he certainly does not represent anything close to the mainstream of the Republican party base, and if he has cheated in any way (Washington state, Florida, Texas) or suppressed the vote using dishonest media, then he doesn’t deserve to be nominated at the convention.

Red Pill on April 29, 2008 at 3:07 PM

Red Pill on April 29, 2008 at 3:07 PM

The problem is there is no conservative leader out there willing to swipe the nomination from McCain. I do fantasize about a brokered convention. We have to keep him below 50% in the remaining primaries, even if it means voting for Paul (the lesser of 4 evils).

Valiant on April 29, 2008 at 3:13 PM

We have to keep him below 50% in the remaining primaries, even if it means voting for Paul (the lesser of 4 evils).

Valiant on April 29, 2008 at 3:13 PM

Or voting Democrat (Clinton) in teh Indiana primary.

Onager on April 29, 2008 at 3:33 PM

The biggest problem with individual insurance is that insurance companies often don’t want to provide coverage to individuals based on “pre-existing conditions”, no matter how small. After finishing school, I couldn’t get an individual plan because of a relatively minor and temporary health issue I had two years earlier. The campus clinic never made a definitive diagnosis, the condition went away, and all of the health insurance companies rejected me because of it. I spent over a year uninsured before I could find a job that included a group health plan in its benefits package.

Big S on April 29, 2008 at 3:36 PM

Or voting Democrat (Clinton) in teh Indiana primary.
Onager on April 29, 2008 at 3:33 PM

This doesn’t hurt McCain. It helps Hillary. Today, Rush suspended Operation Chaos. As I suspected, Hillary is going to swipe the nomination with the help of Republicans. I am voting for Paul next week in NC,

Valiant on April 29, 2008 at 3:48 PM

The biggest problem with individual insurance is that insurance companies often don’t want to provide coverage to individuals based on “pre-existing conditions”

Uh, if the condition is pre-existing you’re not looking for insurance you’re looking for a condition subsidy. Insurance, by definition, covers RISK – the possibility of something happening, not something certain to happen.

Incidentially, most individual insurance comapanis will cover you with a pre-existign condition if there’s no reoccurence of the condition for a defined period. That period varies by company but the most extreme is 10 years.

Alternatively, if the condition isn’t a threat to other body systems, a company will cover you but rider (exclude) that particular condition.

Onager on April 29, 2008 at 4:17 PM

Uh, if the condition is pre-existing you’re not looking for insurance you’re looking for a condition subsidy. Insurance, by definition, covers RISK – the possibility of something happening, not something certain to happen.

Not true. You have a very rosy view of insurance companies. They define “pre-existing conditions” down to the point that any prescription (even for medicines that have since been approved for OTC sales) are grounds for denial of coverage, with no options for an exclusion. In my case, no definitive diganosis was made because the condition subsided before my campus clinic could figure out what it was. I understand that this kind of situation is common, especially when people seek preventive care for minor medical issues; it is perverse that by focusing on such things, the insurance industry actually provides a disincentive for seeking preventive care. It’s idiotic.

Big S on April 29, 2008 at 4:47 PM

Not true.

Yes it is.

You have a very rosy view of insurance companies.

No I don’t. I’ve worked in the insurance industry (for a software vendor) since 1964 and I know full well how the majority of these companies work.

They define “pre-existing conditions” down to the point that any prescription (even for medicines that have since been approved for OTC sales) are grounds for denial of coverage, with no options for an exclusion.

“They” do NOT. Some may, but certainly not all.

I understand that this kind of situation is common, especially when people seek preventive care for minor medical issues;

Your understanding is wrong. And, just by the way, there is no such thing as preventative care for an issue that already exists. That is called, “treatment”.

the insurance industry actually provides a disincentive for seeking preventive care.

You need to contact an HMO. An HMO (health maintenance organization) operates more on the wave length you’re looking for. An insurance company provides a product that covers risk.

Onager on April 29, 2008 at 5:00 PM

Tort reform will comprise part of this package to reduce the burden of litigation.

If this happens (which I doubt. The DC insiders have too much wrapped up in the current tort system to want to reform it) then the bulk of the problem is solved. Get rid of frivilous law suits and costs will go down. The big reason that healthcare is so expensive because of the rise of malpractice suits and the rising cost of malpractice insurance. Granted, there are other reasons, but this is root of the issue and the basis of a solution, not a government take-over.

crazy_legs on April 29, 2008 at 5:10 PM

And, just by the way, there is no such thing as preventative care for an issue that already exists. That is called, “treatment”.

I’m talking about tests that were run years ago to look for the cause of a minor condition that my be a symptom of a mjor condition. That’s preventive care. When all tests come back normal, and an insurance company, many years later, still defines it as a “pre-existing condition”, there’s something wrong.

Big S on April 29, 2008 at 5:12 PM

Ed:

I’m not sure I like the taxation on employer-based health care, as it would hit across the board and act exactly like a tax increase.

No, it’s exactly the right move, and it won’t be a tax increase. It will effectively divorce health insurance (‘healthcare’) from employment, which has been an albatross around its neck.

History: The definition of health insurance as a employment ‘benefit’ stems from WWII, when, because of wage and price controls, employers could not offer raises. So they offered compensation in another way: ‘benefits’, principally health insurance. This has totally hamstrung the system ever since: instead of the individual choosing his insurance, he’s stuck with whatever his employer offers. For small employers, those options are extremely limited.

With a Section 125 plan, which presumably will still obtain, an employer can let employees pay for insurance pre-tax, even if the employees pay the full premium (they do anyway; it’s all compensation). Once health insurance is out of the employer’s hair (saving HR money), and the employees are out in the marketplace shopping for their own (as they do life, car, home insurances) everyone will benefit. And the tax deductions for individuals will help everyone, too.

Pre-tax insurance premiums, plus a tax deduction. What’s not to like?

MrLynn on April 29, 2008 at 5:44 PM

Wow, First one of these that he didn’t say something that really made me angry. Some of it re-confirmed that he is clueless about macro-economics, but that is to be expected.

If he would heed the advice of an actual conservative economist, that would be OK… Unfortunately, McCain’s arrogance will never allow him to take good advice.

But at least he tends to trust the market to provide solutions.

LegendHasIt on April 29, 2008 at 6:16 PM

I don’t understand what kind of service the insurance company is providing. I understand what doctors and nurses are doing, I understand what drug companies are doing, but why are you so in love with the insurance company?

mycowardice on April 29, 2008 at 6:54 PM

I don’t understand what kind of service the insurance company is providing.

for one thing, they’re preventing provider (yes, doctors and hospitals) fraud, something that is killing Medicare.

Onager on April 30, 2008 at 7:49 AM

for one thing, they’re preventing provider (yes, doctors and hospitals) fraud, something that is killing Medicare.

Onager on April 30, 2008 at 7:49 AM

That’s a very expensive watchdog for that fraud detection service.

mycowardice on April 30, 2008 at 8:47 AM