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Might As Well Vote
October 15, 2008
Everybody’s talking about the election. I don’t have much confidence in Obama and none at all in McCain, but I have looked into their positions on health issues. Here’s my scorecard.
So the net effect would be to push people from group (employer) plans on to individual plans, which have worse benefits. Jane Bryant Quinn of Newsweek says this would be hard on elders, women, and people with chronic illness. Overall, Quinn says, McCain’s plan would probably lead to one million more people getting coverage (out of about 45 million uninsured).
Obama’s plan seems a bit better better. It focuses on getting more people covered and would involve government in paying for “catastrophic care,” the really expensive stuff that drives up the price of health insurance for all. Medicare-like coverage would be made available to some people under 65. Obama says that about 30 million more people would be covered, at a cost of perhaps $60 billion a year at first. (It may drop if bargaining power helps control expenses.) So it’s not single-payer, but it’s something.
War as a Health Issue
Unfortunately, neither candidate seems to want to end these occupations. Neither will commit to avoiding more wars, although Obama says he will talk with people before he bombs them. Obama wants to move troops from Iraq to Afghanistan, but it is hard to see that as much of an improvement. But at least he doesn’t want the troops there for 100 years, as McCain has suggested.
Slight advantage: Obama
Big advantage: Obama
Future of Medicare
McCain does not want to start taxing the rich again; Obama does. So right there, Medicare has a better chance with Obama. But we would still need to make major changes in the system, moving it more toward self-management and healthier environments, and away from the focus on drugs, surgery, and heroic end-of-life care.
A Commonwealth Fund article points out that Medicare was originally intended as the first step toward health coverage for all, a single-payer plan. Perhaps Medicare could be made more sustainable and be expanded to the rest of the population. A 2003 Pew poll found that 72% of Americans favored government-guaranteed health insurance for all, and the number is probably higher now.
McCain would never go there. Would Obama? Probably not. But who to vote for is your call.
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