Who Would You Rather Have as Your Doctor: McCain or Obama?

So, here’s the question.  I watched Debate #2 last night between presidential candidates Barack Obama and John McCain.  Since my post a few days ago in which I stated that John McCain’s health care plan is deeply flawed (and later my analysis of the American Medical Association’s “Voice for the Uninsured” health care plan is McCain’s plan on steroids), I’ve been thinking which candidate I would want as my doctor if I had a life threatening illness and that candidate’s plan were put into place?  In this case, assume your medical bills under our current “system” would easily end up between $250,000 and $500,000 to save your life.

To be fair, I’ve also read Obama’s plan.  If you read my posts “Health Care For All Americans” you know that I have a pretty strong opinion about what we need in the United States to have a healthy (or healthier) America.  I find Obama’s plan much more palatable, but still inadequate to meet my criteria, because as all plans I have read to date, it is derived out of an economic model based on managing cost and not in setting constructive goals for optimization of our health, then restructuring the health care industry and the government’s participation to meet those goals.

When the question was posed in the debate about what the candidate would ask the American public to sacrifice to put our nation back on a positive track, my answer, regarding health care, would be, first the health care industry, second the Federal Government and third, the American attitude that being healthy is exclusively a personal choice and not one of “We the people,” the concept of caring for one’s neighbor as well as one’s self is the highest common good.

Ironically, it may the the last one that is the hardest to change, because it infects the business decisions by those managing corporate health care as well as molding public policy at all levels because of the pervasive mythology that universal access is, one, too expensive, and, two, creates a malicious socialism.  My advocacy is that neither one of these cultural myths are true.

So,  back to my original question: If you had a life-threatening illness that would place on you a debt ranging from $250,000 to $500,000 to save your life, who would you rather have as your doctor: Dr Obama implementing his health care plan, or Dr McCain, implementing his?

I invite your responses!

John McCain’s Flawed Health Care Plan

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.