Upcoming Elections

Well, since I've had some free time this weekend I thought it was important to read up on the presidential candidate's health care plans and to be completely honest, they are both very vague and mostly similar. As could be expected, they are worded in a way that would appeal to the broadest of groups but I can say the following about the plans:

- Obama's plan is very heavily dependent on the federal government. There will be a National health insurance "exchange" which he states would "help individuals who wish to purchase a private insurance plan". He goes on to state that the plan would act as a "wachdog" for private insurance companies and would act as a "standard".

- McCain's plan emphasizes the importance of placing the control of health care back with the "patient's themselves". The major way he plans to do this is to provide tax incentives in the form of $2,500 for individuals and $5,000 for families to find additional plans other than what their employers already provide. He also talks about a guaranteed access program (GAP).

I can find problems with each viewpoint.

First off, I feel that Obama's plan essentially expands medicare to the entire population which would likely do two things:
1. decrease the overall quality of care across the population (i.e. providing minimal coverage to uninsured while lowering standards for those who are insured already)
2. provide incentives for a further split between those who can afford quality care and those who cannot. In other words, his plan would drive a wedge further into the disparities already present in our system...

Okay, now McCain's program seems more concrete but is probably just a bandaid over the hemorrhage within our healthcare system. His GAP program is not fleshed out enough and the tax incentives will work for those who already pay taxes. Unfortunately, the under/uninsured patients will not see these incentives because they would be unlikely to even file taxes. So... they remain under/uninsured in the end. He also mentions expanding health savings accounts but doesn't say how he will do this.

The rest of their ideas are worth mentioning but are universal within each proposal, so they do not help in defining the candidate. They are:
- promoting preventative medicine
- increasing IT funding for advancement toward a universal medical record
- lower drug costs via reimportation of medications
- tort reform
- making healthcare available for traditionally "uninsurable" patients (i.e. pre-existing conditions).

It should mentioned that Obama makes a point to insure all children while this point is notably absent from McCain's website. This is a strike against McCain in my opinion.

Ultimately, I feel that neither offer a clear solution at this point and both plans make me a little depressed about where we are headed in the future but based solely on this issue, I would put my weight behind McCain. I can't see expanding an already very flawed system like medicare.

Check out the websites for yourself and I'd love to hear comments on this:

McCain

Obama


Neal Anson, MD