Sunday, October 19, 2008

McCain (barely) wins the health care debate over Obama

This space has been critical of the policies and campaign of John S. McCain over the past several weeks, except for one.  McCain's health care plan, while not sufficient, is leagues better than the one proposed by Senator Obama.  Economist Greg Mankiw, while not choosing sides necessarily, begins a wonderful discussion here.

Obama is in favor of expanding the employer-based health insurance scheme which has grown up since World War II.  This has not been beneficial to the delivery and payment of medical care in the United States, has led to the skyrocketing costs and has acted as a drag on economic growth.  McCain is on the right track in his attempt to move away from the employer-based model.  My complaint with McCain's proposal is only that it lacks a mandate that all people pay for coverage.  If emergency care is mandatorily provided by health care workers and institutions, then payment for such services should be mandated as well.  Also, McCain is loathe to regulate the insurance industry and health insurance should be be tightly regulated, ie, comprehensive things need to be covered and not left to the whim of the insurer.

Obama, on the other hand, plans to tax employers who do not provide coverage for their employees, and also Obama would not mandate that citizens have coverage.  Furthermore, Obama has been in favor of expanding SCHIP, a form of welfare, to middle class families, which would only exacerbate the issue of increasing costs by having government instead of the consumer pay.  Each of Obama's proposals is completely, 180 degrees, reverse of the trend and incentives that should be put in place if access as well as affordability are to be addressed.

Hillary Clinton actually had the basic tenets of the debate down cold. Priorities should be 1) everyone is covered regardless of pre-exiting illness, 2) everyone pays something, to the best of their economic ability, into the medical system, 3) market forces be added to control costs and 4) employers are not responsible for providing insurance.

My auto and life and even disability insurance are not provided by my employer, so why is my health insurance?  By detaching health insurance from employers, the work force would become empowered with greater mobility which would act to allocate labor and intellectual resources in a more efficient manner.  No more would employees be shackled to a certain job because of health insurance or the presence of a pre-existing illness.  Could you imagine if the occurrence of two speeding tickets precluded someone from taking a job in another town for fear of not getting auto insurance?

Overall, both presidential candidates' health plans are severely and fundamentally lacking, however, McCain is closer to the desired goal of separating one's health insurance from one's employer.

No comments: