The American people will have a clear choice this fall between two sharply contrasting visions for health reform.
Republican John McCain wants to create a patient-centered health-care system that gives people more choices of more affordable care and coverage, with new subsidies to help people purchase portable health insurance.
In contrast, Democrat Barack Obama would expand government's role in our health sector and impose new taxes on businesses and limits on individuals, with government dictating decisions about coverage.
We learned during the last major health reform debate in the Clinton era that Americans want control and security. But they are losing both as the number of people getting insurance through their jobs declines.
In a nation where four in ten workers change jobs every year, Sen. McCain says we must modernize our health sector to fit this mobile economy. He would give people more options to get health insurance that they can keep with them as they move from job to job, and he would provide new help to 46-million Americans who are uninsured.
The crucial link is giving everyone the same tax break for buying health insurance, whether they get their policies at work or on their own.
John McCain would offer every family a refundable tax credit worth $5,000 a year to help them purchase health insurance ($2,500 for individuals). Credits also would make the system fairer, giving a single working mother who is getting no help today real money to buy insurance.
The credit is refundable so people get the full amount even if they owe less than that in taxes. Lower- and middle-income families who are shut out of the system will benefit the most, but virtually everyone who gets a tax break today for job-based insurance would come out ahead as well.
John McCain also believes that people would be able to buy more affordable insurance if they were not trapped by expensive mandates and burdensome regulations in many states that drive up costs and drive out competition.
This new national market for health insurance, coupled with the portable tax credit, would open up opportunities for people to buy policies across state lines and through new kind of groups, such as professional organizations, labor unions, or churches.
Insurers would have to compete for the business of tens of millions of new customers by offering the best coverage at the best price. Economists have estimated that 12-million more people would obtain health insurance with this change alone – without the federal government spending a dime.
Finally, Sen. McCain wants to help people who have trouble buying health insurance because of pre-existing conditions. He would create a Guaranteed Access Plan that would provide new incentives and funding to the states for public-private partnerships that would give people new options of affordable coverage. Whether people have trouble getting health insurance because of their health status or income level, or both, they would receive additional help.
In contrast, the reform plan offered by Sen. Obama is a grab bag of failed policies from the past that have been proved to drive up costs and deny people choice.
He would require employers to provide coverage or pay a new tax – a jobs-killing combination. He would let people wait until they are sick to buy health insurance, driving up prices for everyone. He would expand taxpayer-funded programs like Medicaid and the State Children's Health Insurance Program. He would require everyone buying coverage in his new National Health Insurance Exchange to have benefits dictated by government. And he would create a major new government insurance program that would quickly drive private plans out of the market.
The bottom line is choice and control. The American people will have a clear choice this fall.