I was going to discuss why I don’t think the STAAR Act is particularly useful for combating antibiotic resistance, but McCain’s healthcare plan is so ridiculously stupid, it requires comment.
McCain’s proposal would give a five thousand dollar tax credit to every household to pay for healthcare. (It’s not clear how this would lead to the claimed $3.6 trillion in savings, since we ‘only’ pay $2 trillion annually for healthcare). The ultimate goal is to move away from an employer-based system. That means, in plain English, McCain’s ultimate goal is that you will have to pay the entire cost of your healthcare–something McCain’s people are trying to finesse.
For me, I would probably come out slightly ahead (around $950). Currently, I pay $188/month, and my employer pays $308/month, for a total of $496/month. Keep in mind that I’m a single, healthy guy (I don’t have the most expensive healthcare option)–I’ll get to family coverage in a bit. Doing all of the arithmetic, after McCain’s $5,000 credit, I would pay $952 annually instead of $1624.32 (currently, I get back 28% of the amount I pay–$2,256–as a tax refund). Now, let’s consider a family.
For the same healthcare plan, a family pays $500/month and my employer picks up roughly $750/month, for a total of $15,000 per year. Currently, that family pays $4,320 annually (don’t forget the tax deduction). Under McCain’s plan, that family would have to pay $10,000.
Oops.
Even if prices were to drop–and that’s a big if–it’s hard to see how they could drop to recoup the cost. And as Hilzoy and Jonathan Cohn both point out, if you have an existing condition, the ability to shop for a new insurance plan is limited at best.
The crazy thing about the healthcare debate is that this isn’t like trying to figure out how to go to the moon in 1961: other countries have figured out how to provide high quality healthcare far more efficiently to all of their citizens. We could just take the French plan, translate it, and slap a big, old U.S. of A. on the cover.
I’m only half kidding about the last bit.
On the other hand, the McCain plan is a great incentive to avoid getting married and having kids….
Where to begin!
The single biggest cost with a potential for savings without lowering what is already a poor standard of care is in administrative costs which are currently about 400 billion dollars a year. Insurance companies like to get a 25% markup above costs on individual policies. Self insured corporations (almost all large ones) pay administrative costs of about 5% above costs. Transfer from company paid to individual policies will mean McCain’s plan will increase, not decrease administrative costs!
Individual insurance companies will never have the buying power a single large supplier would have.
There is really no innovation insurance companies can apply to lower medical costs that hasn’t been tried.
Insurance companies make their largest profits by only insuring healthy people and jettisoning the sick, leaving them to the government or charity to cover. Nothing in McCain’s plan will prevent this. “Yes your premiums for the last period were $1000 a month but your daughter is conically ill and your new premium is $5000 a month.” If he relies on a high risk pool please point were this works.
McCain relies on the market to adjust coverage and costs. Even if it does it will take years to balance out. What do we say to the sick who die in the interim, “Sorry you died for a good cause”?
The uninsured? How? Currently we force hospitals to cover the uninsured by increasing the costs to the insured. These inflated costs are paid through the insurance companies where they will be subject to the mark up. Allowing the insurance companies to profit from the poor they don’t even cover.
This type of plan has never been tried any where. It is a huge risk to try it here on this scale.
A cynic reading this plan would have to say its driving force was to preserve the health insurance companies, not to provide quality health care at a reasonable price. Which, by the way, we already know how to do.
I never could figure out how it was supposed to help anyone when BUSH proposed the same (or very similar) plan.
Vote McCain, if eight years of Bush haven’t been enough agony for you!
Personally, I’d go for the Canadian, British or Swedish schemes before the French – France has been hugely over-funding it’s healthcare system, to the point where it is costing about a third of government spending. Still better than leaving the poor without any care at all though.
So McCain’s plan is to have everyone buy their own health insurance to let the market decide what health care is best. Of course the ironic thing is Americans can already do that and have overwhelming chosen to go with group plans available through their employer. So the market has already spoken; I guess McCain isn’t listening.
This issue is quite personal to me as my family ended up losing our employee offered health insurance and this has created quite a bit of stress. So now each member of our family has our own seperate health plan that we pay for out of pocket (for monetary reasons it worked out much better that way than having us all be under the same plan). Consequently we have to keep track of who’s plan covers what, which one’s have which deductibles, and this one bills us monthly and this one quarterly, etc. Yeah John, this idea is a real winner …
The biggest part of the problem is that certain folks live in a weird fantasy world where people are “wasteful” about healthcare when it’s not expensive.
People like McCain seem to seriously believe that it’s a pressing problem that if prostate exams were free, I’d get one every day, thus, irm, backing up the system.
Most of the people I know out in the big wide world who oppose socialized medicine all speak to one reason: because you have to wait in lines for things, because the system gets clogged up with all these *poor people* who, in their minds, run to the doctor for every little thing, because it’s free, rather than toughing it out like they should. Emphasis on “they”: It’s only *poor* people who they think should tough it out; if you’ve got money, you can go to the doctor for any trivial thing.
France has been hugely over-funding it’s healthcare system, to the point where it is costing about a third of government spending
They still pay half per capita what we pay and they cover everyone and have, by most measures, the best healthcare in the world. Why we can’t at least copy someone’s system is beyond me; seems we should be able to take the best features of several and combine them. But then conservatives don’t think we’re capable of that; why they’re so down on America’s abilities is also beyond me.
And BTW, Jefrir, isn’t that 1/3 way high? It seems to me that with the budget of France at around 228 billion, and healthcare costs at 3500 with 64 million people that would be about 22.4 billion for healthcare which would be about 1/10. Do I have that wrong or do you?
Either way they spend about half as much per capita as we do (which is similar to everybody else as well) so there’s no reason we shouldn’t be able to do as well. It does require the courage to cut the insurance companies out of the pie; they’re dead weight that costs us some 20-25% of our money right off the top.
I am a Canadian currently experiencing the US (non) system. Forget everything the insurance/pharma lobby tells you about Canadian medicare. It works, it’s good.
and consequently we have to keep track of who’s plan covers what