Obama vs. McCain: debating healthcare

By David S. Kerr
For the Stafford County Sun
Published: August 27, 2008

Campaign 2008 is one of the most significant opportunities in recent history for Americans to choose the future direction of our country. Not only is there a difference in personality and style, but there also are clear differences between the two candidates when it comes to the issues.

One example is health care. Next to the economy and the war, health care is going to be one of this election’s pivotal issues. Americans spend approximately $2.5 trillion a year, roughly 20 percent of our gross domestic product, on their health care. This is the largest per capita spending of any nation on earth. Yet, roughly 47 million Americans (and a million of them in Virginia) have no health care coverage at all. 

Most Americans, those not yet eligible for Medicare or receiving Medicaid, get their health care through their employers, and if they feel anxious about their jobs, as many do right now, they also start worrying about losing their health insurance. This is one of the reasons the issue has risen to such prominence in this campaign. Americans are feeling vulnerable. 

In many respects the debate mirrors the 1992 campaign. Health care was the issue that helped put Bill Clinton in the White House. But as we all know, thanks to some inept handling of the issue by President Clinton, and then the election of a Republican Congress that wanted nothing to do with health care reform, the prospects for any substantive change languished.

Now, in a way, we’re replaying that scenario. This time, unlike 1992, both candidates are trying to be more specific in defining their approaches to dealing with health care. Both plans, though still notional at this point, reflect the candidate’s basic philosophy regarding the role of government in dealing with the health care issues.

John McCain, not surprisingly, supports a modified free-market approach. He proposes a tax credit of $2,500 for individuals and $5,000 for families that can be used to purchase private health care plans.  He thinks this is a nice clean way to improve access to health care, while at the same time keeping the government’s role to a minimum.

There are some weaknesses in this approach. For one thing, most private plans cost a lot more than the tax credits McCain is proposing. For most working families, those without employer coverage, this simply isn’t going to make any difference. There is also the concern that it might undercut existing employer-provided health care coverage.  If the government is subsidizing health care, why bother to provide what is becoming a progressively expensive employee benefit? 

McCain’s campaign, however, argues that this kind of approach will open up a new market for private plans and foster “creativity” in health insurance. Quite rightly, he argues that the current system is inefficient, paperwork heavy, and too focused on short-term care, and not enough on long-term wellness. He thinks his approach will help change that.

The McCain plan is concise and easy to understand—always good in a campaign. However, Barack Obama would argue that this is because there isn’t much to it. Obama’s approach is for a more active role for the government. He says his concern is for those Americans without coverage, plus those who may lose that coverage in a bad economy. To a nervous middle class, this is compelling.

What he proposes is a “national health plan” that would give Americans a choice between a private insurer or a government sponsored plan. The thinking is that the national program would be similar to the current Federal Employee Health Care Plans. Obama’s plan would probably be the most successful in guaranteeing health coverage and dealing with the issue of uninsured Americans.

However, there is the cost. McCain suggests it may cost $350 billion annually and says it will substantially increase taxes. Obama, on the other hand, thinks that a combination of improved efficiency in the administration and the delivery of care, and at the same time, doing away with the President’s tax cuts for richer Americans, can make up the difference.

Both plans have merit.  McCain is the first Republican candidate since Richard Nixon to actually talk about health care. Obama thinks the McCain approach is too narrow, doesn’t help the uninsured, and doesn’t go far enough. 

Clear differences, clear choices in November.

David S. Kerr is an Aquia resident and a former member of the Stafford County School Board. Contact him at info@stafford countysun.com.