A very short email conversation today is making me wonder if I understand the health care proposals of the presidential candidates properly. I am going to type out how I have understood the proposed health care plans and if I am incorrect, I would like for someone to help me understand them correctly. (Be patient with me and use small words! 
)
First off I would like to say that neither health care plan being offered is my first choice. If you’ve visited this site frequently then you’ve heard my rantings of true universal health care and how I long for thee. A time when everyone gets their choice of hospital and doctor, no bills come in the mail, no preexisting condition will limit you, preventative treatments are covered, health care personnel are treated well and compensated well, yet our pocket books will be padded a little since the whole country is one big pool. Ahh….those will be the days. Needless to say, that is not an option. But I will still dream of the day when health care will be a right to all and not a privilege. Until then I will try my best to stay focused on what is being offered. For obvious reasons this will just be a general overview of the options. I do not claim to know everything about both of the stances nor do I know all the answers. That’s the reason for this exercise, for me to have better clarity of the big picture. So again, if I’ve got it wrong, tell me!!!
Option 1: From the republican platform
A tax credit of $2,500 for an individual and $5,000 for a family will be provided each year. If you are receiving health coverage from your employer, your $2,500/$5,000 tax credit will go directly to your health care provider to cover your monthly premiums. Whatever is left over will be put in a health care savings account. You can pull money from that account to go toward deductibles, copays, and to offset the increase in taxes (since employer paid premiums will be taxed). If you have money leftover at the end of the year it can stay in that savings account (accruing a little interest) and whenever a medical expense arises it is there when you need it.
It has been suggested by “experts” that large corporate companies will keep providing the same health coverage they currently provide if McCain is elected into office. These same “experts” believe that many small businesses that do currently provide health coverage for their employees will drop their employee health coverages if McCain is elected into office. The tax credits the employees receive will allow them to purchase individual insurance on their own.
If an individual or couple is on Medicare or Medicaid they are not eligible to receive the tax credit. (Note that parents can still receive the tax credit if their children are on Medicaid as long as they (the parents) are not on Medicaid.) But if a pregnant woman is on Medicaid or if someone over 65 is on Medicare, they will not be eligible for the tax credit. (Due to the simple fact that those are government funded health care programs.)
McCain has said that he would deregulate the health care companies so that you can purchase policies across state lines. This will make the market more competitive and reduce the cost of monthly premiums. (I’m adding my two cents here, take it or leave it, I don’t care. If we deregulate health care the same way we deregulated Wall Street won’t this cause us more problems down the road? Don’t we need a checks and balance form of accountability?)
Since individual health care policies are hard for people to obtain since they have strict guidelines about preexisting conditions, McCain has said he would work with states to provide Guaranteed Access Plans (GAPs). These GAPs would be for those who have preexisting conditions and cannot get an individual coverage plan. It is also for those who get laid off from their jobs and need coverage. These insurance pools are considered to have much higher premiums compared to individual and group policies. Since these are considered “high risk pools” the GAPs are off set by government funding, which is estimated to cost as much as $100 billion per year.
Under this plan parents/guardians are not required to insure their children. Although each state will continue to have a Children’s Health Insurance Programs (CHiPs) where low income families can afford to insure their children. This program will vary from state to state as it already does.
You do get to keep your current health insurance coverage (providing your employer continues to provide coverage). Remember not all small business’ will continue providing coverage if McCain is elected. It benefits the small companies best if their employees take the tax credit and purchase their own individual policy.
Employer paid premiums will be taxed. If you make $40,000 a year and your employer pays for your health insurance policy that is a $10,000 policy, then you will have to pay taxes on an income of $50,000 that year. For some people this might put them into a different tax bracket, making them pay higher taxes. And everyone high and low income people will pay the taxes on the full amount of their premiums, no discounts for those with a lower income.
Over time, the tax credit will not reflect the healthcare inflation, it is set to the Consumer Price Index. Health care inflation is generally more than the CPI. The “experts” mentioned above also worry that over time people who have opted for a cheaper individual policy might be in trouble later on down the road when insurance benefits decrease and the premiums increase, especially if they were to become sick. According to Consumer Reports, “The campaign would not estimate the price tag but says annual revenues would balance costs after 10 years. Others place the average annual cost in the first three years at $160 billion or more.”
Option 2: The democratic platform
For those who already have health care coverage, nothing will change except your monthly premium. Obama would help to lower that cost (although the amount or percentage of deduction is unknown). You would keep all your same doctors, hospitals, coverage policy, etc. Nothing but your monthly premiums being reduced financially would change.
For those without health coverage, he is offering a National Health Insurance Exchange policy, that is a federal health care pool like federal workers receive. This coverage would probably cost more than an individual policy (varies from person to person), but all policies have minimum standards that must be met, nobody will be declined, and your premium will not go up if you get sick. (Individual policy prices escalate with recurring illnesses. This policies premium would remain the same and so would the coverage when a major medical illness strikes.) This policy does include preexisting conditions at no added cost with no waiting period. It also includes preventative treatments, maternity and mental health care. Low income families would qualify for a subsidy or tax credit to help offset the cost. (This policy only gives subsidies to low income families so middle and high income families would not receive any financial assistance. Where McCain’s policy put high and low income families in the same bracket.) Those who are low income could have their children on a state CHiPs program and could receive subsidies for themselves. (i.e. Consumer Reports reported one low income family of four who’s children could be on CHiPs and the parents would pay $39/month each for their insurance premium after their subsidies.)
Obama does require all children to have insurance coverage. He is planning on expanding the eligibility guidelines on state CHiPs programs so they include a larger group of families. We don’t know how the government will enforce the mandatory insurance requirement.
Obama would like to cut coverage “loopholes” so people who get seriously ill can still seek treatment options such as chemo. He is implementing a minimum standard for all policies, not just the federal exchange policy.
There will be a subsidy or tax credit for small businesses that cannot afford to provide health care to their employees but would like to.
Big businesses that do not offer health benefits to their employees will be fined based on the number of employees they have. The money will go toward the National Health Insurance Exchange (NHIE) fund.
Over time, the NHIE policies will not rise due to major illness. According to Consumer Reports, “The campaign pegs the net taxpayer cost at $50 billion to $65 billion yearly; others think it could average $100 billion a year during the first three years.”
Both candidates
Both candidates would like to keep medical records online (electronic). This is so doctors can have easy and accurate access to each patients health records. Doctors will know allergies, past medical history, prescribed treatments, etc. quickly and accurately.
Both candidates want to lower costs of prescription drugs by encouraging more generic drugs be made available and at quicker rates. They will also make the market more competitive by allowing for medications to be purchased from other countries.
————-
Alright, that’s my perspective on the health care options. I don’t have a clue if I have everything right or not, but from the speeches, their online websites, and the November 2008 issue of Consumer Reports, this is what I’ve concluded. If you have corrections or additions please let me know.
*Two side notes: First one, I personally know three federal employees who do have the federal health insurance policy. All three did not have anything negative to say about the coverage. One mentioned the fact that due to being in good health, he probably pays for more coverage than he needs. One of my friends today mentioned her hubby’s uncle having federal insurance and not having a positive experience with it. Since this is a possible option for health coverage and you personally know someone with it, tell me their perspective. Personal experiences tell you more than reading guidelines and rules. They include items you might not think about or that aren’t mentioned in the basic overview writing.
**The second is a very sad side note: Millvina Dean, the last living Titanic survivor, who is currently 96, is having trouble paying for her medical expenses. Due to this financial struggle, she is selling the momentos from the day the Titanic sunk. The auction is in Devizes, England on Saturday. Guess there are other countries who need to improve their health care system too.
