Dueling med plans

McCain's offers consumers more long-term choice

Rocky Mountain News

Published October 13, 2008 at 1:26 a.m.

If there's one issue Coloradans have been intently listening to in the season of never-ending political debates - besides the economy, of course - it's probably health care.

A new Census Bureau report, after all, reveals that nearly one in five Coloradans under age 65 lack health insurance. The number jumps to 35 percent when only counting the Hispanic community.

And while that doesn't mean every one of those residents is in financial straits because of health care costs, one catastrophic medical crisis can send a family to the poorhouse.

Both political parties and their candidates are quick to agree that America's health care system is fractured. Both John McCain and Barack Obama are touting preventive care and better information technology to cut costs, and have proposed safety nets (though markedly different) to cover the hard-to-insure, such as patients with pre-existing conditions.

That's where the agreement stops.

How can voters wade through the health care rhetoric to pick the best offered solution? If you're uninsured, your focus is on securing adequate coverage. If you're insured, you want to know whether proposals will ding your wallet or the quality and scope of your coverage.

In either case, you probably value some degree of choice. If that's a high priority, we'd recommend John McCain's plan. Barack Obama's plan extols choice, too, but over time leads in another direction.

McCain's health care proposal hinges on a $5,000 tax credit for families ($2,500 for individuals) under which individuals could either keep their current insurance or go out and buy coverage, even shopping across state lines to get the best rates.

And under McCain's plan, if you don't spend the entire allotted amount on coverage, the remainder can be deposited in Health Savings Accounts (which McCain wants to expand).

The Obama plan, meanwhile, gives birth to a bouncing new bureaucracy: the National Health Insurance Exchange, which would offer private policies and a public insurance plan "based on benefits available to members of Congress" - generous benefits, in other words. All wanting insurance in the public plan would have to be covered under the same premium, without regard to lifestyle choices such as smoking that increase health risks. Obama's plan purports to maintain personal choice - and to some exent does at first - but a growing entitlement program will almost certainly crowd private insurers out of the market.

Over time, for that matter, some federal entity would have to decide what would be added and subtracted by the public plan - in order to control costs, among other reasons. Former Sen. Tom Daschle, a longtime universal health care proponent and Obama adviser, has touted his idea for a Federal Health Board to make those sensitive choices. That also makes us nervous.

Just as McCain and Obama were asked in the second debate whether health care is a right, responsibility or privilege, taxpayers should ask whether the dueling plans are wise, workable and winners for themselves and the economy.

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Gotta say, I like McCain's idea of a $2,500 tax credit for health insurance and being able put what was not used in a Health Savings Account. I currently have a very good health insurance, but it doesn't pay well for vision or dental. I could put that tax credit money in an HSA for co-pays and either better vision and dental insurance or toward glasses and the dental work I need. 

Just today, I paid $249 for four fillings - and that was my portion after insurance. I am looking forward to several crowns (at least three) and possible root canals (my teeth have really deteriorated over the last couple of years. I used to have such good teeth!). I have an appointment next month for the first crown - another $400 plus dollars after insurance. My portion will be over $2000 and that doesn't include root canals as my dentist doesn't do them. That will be billed separately. 

I bought new glasses last week. My portion was $628 for the exam and glasses. Again, that was after insurance. I could possibly have put off getting glasses, but I could tell there was a difference in my vision. I just wasn't seeing as well as I thought I should. My vision wasn't at a dangerous point yet, but when I am driving to work in the early morning hours when it's still dark, it's nice to know I can actually see what's on - and off - the road in front of me. 

My van needs work, and I will have to decide whether to have the dental work done or the van work. The van will probably win out, since I have to have transportation to get to work to pay for the dental work.

The glasses, the dental work, and the van work all happened in the same time frame. Had it been spread out, it wouldn't have been such a deal. But coming at pretty much the same time, and so close to Christmas, it's hard to deal with.

I'm lucky. I don't have to worry about keeping a roof over my head or whether I can feed the kids. I have insurance that is paying for part of my current vision and dental needs and pays well for my health issues when (God forbid) I need it. I can work some of my bills out so that I have more money to put toward the dental work. In fact, just sitting here gave me an idea of what I can do so that I can afford to do everything I need to do. Not everyone has that option.

I wish that everyone had at least basic health insurance, but I'm not convinced that it's the government's responsibility to provide it. The private sector can usually do things cheaper and better than the government. When the government gets involved in what the private sector can do better, it's usually expensive and a disaster. I'm not sure how a tax credit would work. Until I understand it and find it wouldn't be such a good idea, I have to think it would be better than for the government to provide health care of any sort. 

But that's just my opinion.