Friday Healthcare Blogging

In keeping with Joe Klein’s semi-plea to stick to issues, I’ll do just that and, just like Joe Klein, takea quick look at McCain’s healthcare plan. To wit:

John McCain wants to tax your employer-provided health care benefits. He wants to replace those benefits with an insufficient tax credit–$2500 for individuals and $5000 for families (the average cost per family for health insurance is $12000).

There is a positive, progressive tax aspect to this: wealthier people should have to pay for health insurance themselves, without tax breaks from the federal government.

But make no mistake: this plan will do little or nothing for those who do not have insurance now–unless they are young and healthy–and it may well hurt a fair number of workers, especially unionized workers, who get gold-plated benefits from their employers.

It will certainly do nothing for families with members who have pre-existing conditions or children with special needs–because it makes no provision to regulate the insurers, forcing them to cover all comers at “community” rates that don’t discriminate against the people who need health insurance most.

I think what bothers me the most about all of this is that John McCain has the gall to go around insisting Barack Obama is going to raise everyone’s taxes when, in fact, it’s John McCain who’s proposing a substantial tax increase on middle class workers. Indeed, based on an average healthcare cost, for a family, of roughly $12,000 per year, John McCain’s plan would increase your tax burden by roughly $4,800 every year.

But wait, you’re going to get a $5,000 tax credit to offset that! Of course, that really doesn’t make any sense does it? Why pass a new tax if you’re just going to offset it with a new credit? Is McCain looking to pass some sort of progressive tax wherein richer people pay a higher amount of taxes on their health insurance? Well no, because the tax applies to employer provided benefits. The pertinent point that McCain won’t want you to know here is that the tax credit will increase at the rate of inflation, while the cost of health insurance will almost surely increase by much more than that. In other words, over the course of 5-10 years the gap between the amount you pay in taxes and the amount credited back to you will grow wider and wider, and we’ll be looking at a very substantial tax increase.

The idea here is pretty simple, to completely dismantle the employer based insurance system. And that fits in pretty well with McCain’s overall thinking when you consider that John McCain and his adviseres think the problem with healthcare is that people have too much insurance. Which is fine, and there’s probably some merit to it, but McCain’s approach isn’t much better. Yes, some people do have more insurance than they really need. But some people have no coverage at all. McCain’s plan would dramatically decrease the former and dramatically increase the latter. It will do that because McCain wants to push more and more people into the individual market, where providers can more easily screen out high risk customers and pre-existing conditions. Or, in other words, the people who really need to be covered.

I don’t know if it’s kosher to say it, but no matter what David Broder tells you, John McCain is proposing a radical change in the way we structure our healthcare system in America. It will increase the numbr of people without coverage, it will make it hard for people who are really sick to get the treatments they need, and people will die because of it. I know we’re supposed to pretend like these policies don’t actually have real world consequences that affect people in substantial ways, but in this case in particular, that’s just not true.

And, as always, for better blogging about healthcare than you’ll ever see here, read Ezra.