In this series, we are trying to cut through some of the media hype in order to summarize the health care proposals put forward by the leading candidates for President.
Commentary by Aaron Lord MD, PGY-1
Our third post presents the plans of one Democrat and two Republicans.
John Edwards (D)
The “Edwards Plan for Universal Health Care” would create a system of regional, non-profit “Health Care Markets” — collectives of discount insurance plans. Individuals could choose from any one of these plans, and employers would be required to provide employees with one of them. As with other Democratic proposals, the plans would include a public program similar to Medicare. The “Market” would decrease overhead for employers (especially small businesses) by taking over much of the current redundant health-care paperwork.
According to Edwards, his plan would be funded by savings from the adoption of electronic medical records, increased efficiency from streamlined care, and repeal of Bush tax cuts.
John McCain (R)
This plan is similar to other Republicans’ in proposing a system of health care tax credits. In particular, a tax credit of up to $5,000 would allow families to buy health insurance, including plans from across state lines. McCain also proposes the same changes that other candidates have: insurance portability, tort reform, IT investment, and reform of Medicare reimbursement to focus on “diagnosis, prevention, and care coordination.” One point has particular relevance for our VA hospital: veterans should have “freedom to choose to carry their VA dollars to a provider that gives them the timely care at high quality and in the best location.”
The financing of his tax credits is not discussed on his web site, though the NY Times reports that “employers would no longer be allowed to deduct health care costs from their taxes under his plan.”
Mitt Romney (R)
Although as Governor he presided over Massachusetts’ attempts at universal health care, Romney does not support such a plan on the national level. Instead, he would increase the number of Americans who can purchase private health insurance by “establish[ing] federal incentives to deregulate and reform state health insurance markets.” He also proposes enhancing the Health Savings Account, investing in IT, and tort reform.
Since no new programs, government spending, or tax credits are proposed in his plan, he states the redirection of existing federal funds would suffice to finance his proposed changes.
Conclusion
It’s hard to believe that back in 2000 many voters felt discouraged at what they felt was the lack of difference between the Democrats and Republicans on national issues. This year offers major differences between the parties: Democrats proposing broad changes in health care delivery with increased government involvement, national coordination of health care services and expansion of government-run health insurance, with Republicans proposing much more incremental change through a series of tax incentives. With more Americans saying that health care is their top domestic concern for this election, it will be interesting to see how the cards fall come November.