I just read McCain’s article in Contingencies on his health care plan. Although I agree in principle with some of his proposals, such as changing policies about pre-existing conditions and finding ways to provide access to health care insurance, his plan is deeply flawed.
First, his whole plan rests on reforming access in a patchwork of initiatives between health insurance providers and government programs. This is the wrong place to start. Moving chairs around the deck of the Titanic will not avert the disaster American health care is steaming toward. The foundational issue facing the United States is the health of the population. Setting national goals for improving and sustaining the health for Americans is where we have to start. For example, “Preventable diseases are prevented.”
The second flaw in McCain’s plan is the refundable tax credits. Although he says that these would apply to everyone, he still relies on the compliance of the health care insurers to cooperate fairly with the program. He fails to account for the fact, that despite their rhetoric of serving our health care needs, the first obligation of the insurers is still to their stockholders, and as the current financial crisis demonstrates, the unchecked acquisition of wealth by their executives.
This second flaw also seems to believe in a pie in the sky assumption that the American public will just automatically jump on board and use their credit to buy health insurance. With some 42 million uninsured currently in the nation, that seems a stretch of astronomical proportions.
The final objection I’ll mention here is the issue of pre-existing conditions. You can’t just ask the insurance companies to cut back on it. That’s like asking a methamphetamine addict to just use it only once a week instead of every day. They’ll promise, promise and promise to do it, but as soon as you leave the room… The practice of pre-existing conditions needs to be abolished by law, because the practice is a barrier to access to care, perhaps having greater impact than out-of-reach pricing.