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    John McCain on Health Care

    WebMD asked Sen. McCain some questions about his health care plan. Below are his answers.

    [Editor's note: The answers below were either provided by the senator or sanctioned by him. These are the opinions of the McCain campaign only. Though edited for WebMD style, the answers remain untouched. WebMD does not endorse any specific political party, candidate, committee, idea, or belief.]

    1. What is the core principle of your health care plan?

    Access to quality and affordable coverage for every American. The McCain plan builds on the existing employer-sponsored system to enable families to choose the plan that best meets their needs. Under the current system, Americans receive a tax benefit for health insurance only if they receive it through their employers.

    Those who do not receive coverage from their employers or who have left the workforce are out of luck. Not only does our current health care system shut millions out of the system, but it also stifles the competition that can reduce costs and improve quality.

    The McCain plan will give the same tax benefit to those who get health insurance in the individual market as those who get it through their employer. This will enable Americans to fire their insurance companies if they are unhappy with their plans and seek out a better option, including those across state lines.

    The McCain plan will focus on reducing costs through reforms like reorienting the system around preventive care and wellness, implementing payment reform to reward quality and coordinated care, better managing chronic care diseases, investing in health IT [information technology], and finally enacting comprehensive medical liability reform.

    2. After what just happened on Wall Street, do you think people will be willing to forgo their employer-based insurance, an option in your plan, and instead rely on the open market for their health insurance?

    The McCain health plan builds on the employer-based system. Employers will have the same incentive to provide health insurance as they do today since they will continue to deduct the cost of health insurance they provide to employees. Nothing will change.

    In addition, payroll taxes will be protected from taxes under the McCain plan. Millions of American families with employer-sponsored coverage in all tax brackets with the same coverage as a “member of Congress” will now come out ahead with additional funds going into a portable health savings account. Importantly, younger and healthier employees with the McCain health care tax credit will have a bigger incentive to stay with the employers.

    For example, a 25-year-old employee in the 25% tax bracket with a ,500 tax credit could either purchase a policy in the individual market for the same amount or stay with his employer plan and receive a ,000 policy with an additional ,250 to invest in a portable health savings account. Why would people choose less benefits and less money?

    Finally, the McCain plan, through comprehensive cost-containment policies, addresses the single biggest threat to employer coverage — rising costs.

    What’s more, those millions of Americans who currently do not receive health benefits from their employers — and therefore also receive no benefit from the federal government — will receive ,000 per family to purchase health insurance, and they will have a wide range of choices because the McCain plan enables them to purchase health insurance across state lines.

    Recent abuses by Wall Street bankers and Washington insiders are no reason to abandon the commonsense principle that putting choice and options in the hands of the American people can improve the quality and affordability of health care.

    3. Your plan would offer a ,500 tax credit for individuals and ,000 for families. If people choose to shop for their own insurance, would this be enough to cover their costs?

    Currently, those Americans who do not receive insurance through their employers receive no benefit from the government at all, unless they qualify for Medicaid. Under John McCain’s plan, they will receive ,000 per family to purchase health insurance.

    A recent national survey found that when people purchase health insurance on their own, the average policy costs ,613 for singles or ,799 for a family. With millions more people in the market for insurance and demanding a fair price, including across state lines, insurance will be much more affordable and the credit will be a big help to them in obtaining coverage.

    Furthermore, the comprehensive cost-containment measures included in the McCain plan will reduce health care costs for every American.

    4. What is the main distinction between your plan and Sen. Obama’s?

    John McCain’s plan relies on individual choice, including keeping current coverage, to bring down the cost of health care and to enable all American families to receive the same tax benefits; Sen. Obama’s plan stifles individual choice with the aim of eventually funneling every American into European-style government-run health insurance.

    Sen. Obama’s proposal would dismantle the current employer-based framework in favor of a big new government bureaucracy. Obama would mandate that employers provide a ,000 plan to their employees or else pay a fine. According to a study in the National Bureau of Economic Research, an employer mandate of ,000 for family coverage would reduce wages by per hour and cause 224,000 workers to lose their jobs.

    To put this in perspective, the Obama plan would lose more than the 219,000 jobs created by American small businesses so far this year. The Obama plan would also build a 3 billion-a-year government-run health plan, shifting more control to lobbyist-filled Washington at a time when Medicare is broke and Congress has a single-digit approval rating. According to a recent analysis, the Obama employer mandate would raise employer taxes by nearly 6 billion.

    The McCain plan is different. John McCain recognizes that the main problem plaguing our health care system is spiraling costs, which is why his plan is focused on lowering costs and expanding affordability for all Americans. He recognizes that when Americans are given the choice and ability to choose their own health care plans, costs go down and quality goes up.

    5. How would you handle spiraling health care costs?

    The main reason that the great majority of the uninsured don’t have health insurance is because it costs too much. We need to work to get competitive forces moving in our health care economy, but we also need to level the playing field so everyone gets a fair break in purchasing coverage.

    John McCain would provide a refundable tax credit of ,500 for individuals and ,000 for families that they would get every year to use toward the purchase of insurance. The credit is refundable, which means you would get the full amount even if you owe less in taxes. And it’s available to you whether you get your health insurance at work, as the great majority of people will continue to do, or whether you buy insurance on your own or through new groups.

    Further, the value of that credit will be enhanced by the greater competition this r
    eform would help create among insurance companies. When coupled with reforms to spur innovation and flexibility in insurance options, millions more Americans will have the opportunity to buy affordable health insurance that is portable and secure.

    The McCain plan will take numerous steps to make health insurance more affordable by reducing costs, including: permitting families to purchase health insurance across state lines; lowering drug prices through reimportation and generics; reorienting our health care system around preventive care; updating our health care infrastructure with 21st century technology; promoting coordinated care; reforming the Medicare and Medicaid payment systems; promoting the availability of smoking-cessation programs; passing comprehensive medical-liability reform; and bringing more transparency to health care costs.

    6. How important is prevention to your plan?

    The real key to lowering costs is to change the way medicine is practiced in America — moving away from uncoordinated fee-for-service medicine that focuses too much on doing things to people and toward coordinated care that focuses on prevention and paying for quality outcomes. By rewarding quality, promoting prevention, and developing new models that deliver health care more efficiently and effectively, we can reduce health care costs for all Americans.

    Wise public-private partnership can make preventive care the standard. It can put the best practices of preventive care in action all across our health care system. Over time, high standards of care, consistently applied in every doctor’s office, hospital, and insurance company in America, will save lives. And every year, it will save billions in the health care economy, making medical care better and medical coverage more affordable for every citizen in this country.

    Prevention and maintenance should be encouraged as part of basic insurance so that when individuals are shopping with their tax credit for health coverage, they are able to find an affordable plan that offers access to important preventable measures.

    Wellness plans should be encouraged to reward and encourage healthy behavior. Plans should be allowed greater flexibility for providing financial rewards, including reduced premiums for healthy lifestyle behavior as well as surcharges for individuals who continue to elect unhealthy lifestyle behaviors such as smoking.

    It is imperative that we use educational tools and proven strategies to affect the behavior early in the lives of children. The challenge of childhood obesity is very serious. And there are many things that schools can and are doing to create a healthier environment for our children. Current strategies include removing vending machines, providing healthy, low-fat menus in school cafeterias, and providing more physical education and recess opportunities for children.

    However, each school has unique needs and challenges relating to the general physical health of students. Decisions about addressing childhood obesity should be made at the local level to ensure they reflect the needs of local schools and communities.

    7. You’ve heard the question before I’m sure — Many plans likely would not accept you with your pre-existing conditions, or be very expensive. How would your plan address pre-existing conditions, or people with chronic health conditions?

    John McCain believes that no American should be denied coverage simply because of a pre-existing condition. As president, he will create a new nonprofit “Guaranteed Access Plan,” or GAP, to help those who have trouble getting insurance. McCain will provide new funding and guidance for the states to create GAP plans that will allow people who are currently denied coverage to buy policies at affordable prices.

    This would not be another unfunded mandate to the states or a new federal entitlement program, but rather a partnership between the federal government, the states, insurers, patients, and the medical community.

    Indeed, a recent analysis indicated that over 0 billion in annual savings to state and local governments would be realized through the McCain health plan. Much of this can be attributed to savings to state Medicaid programs that would otherwise absorb medical costs by the population the GAP plan is designed to cover.

    Under a McCain plan there would be reasonable limits on premiums and additional assistance would be available to help people with lower incomes. Furthermore, there will be a review process in place to determine if the decision by the insurer to deny coverage was improper.

    8. How big a role do you see the Internet and technology playing in health care in the future?

    John McCain sees technology as a key to reducing costs and transforming our health care system. We can make tremendous improvements in the cost of treatment by using modern information technologies to collect information on practice patterns, costs, and outcomes. By simply documenting and disseminating information on “best practices,” we can eliminate costly medical practices that do not yield value and reward those that do.

    A better and smarter use of information technologies will lead to increased quality, better coordination, reduced errors, and lower costs. By reforming payment systems to focus on paying for best practice and quality outcomes, we will accelerate this important change.

    SOURCE: Sen. John McCain campaign.

    The content contained in WebMD’s “Health Matters in the 2008 Election” section is for informational purposes only. WebMD does not endorse any specific political party, candidate, committee, idea, or belief.


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