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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