A Crucial Decision

Jake Crest Health Guide
  • I'm worried.

    My wife, Mandy, and I are firmly middle-class. We're not going to retire ultra-wealthy, but we really don't expect to be living in cardboard boxes either. We have dreams of perhaps making one more move and buying a nice little house somewhere closer to the ocean where we can take walks along the sand and pursue our online careers, even in retirement, in an place where we want to be instead of a place where we just happened to land. We talk about this a lot, but with the housing crash, and the Wall Street crash, it's starting to seem more and more like just that... a dream.

    We both have faith in our country. We believe that, while it will take some time, our investments will recapture most, if not all of their pre-crash value. We believe that eventually we will be able to sell our home for more than we paid for it. We believe-- as I said-- in America.

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    We are becoming concerned, however, that our dreams will never come true due to the ever increasing costs of private individual health care coverage. You see, neither Mandy or I work for a company that provides group health care, so we are forced to seek out coverage on our own.

    In this, one of the most critical election years ever, health care is the issue by which we judge our candidates and decide who gets our votes. Each of the two major candidates, John McCain and Barack Obama have made space on their websites to talk about their views on health care, and each candidate has posted their respective proposals on the issue.

    As for those proposals, a few things seem apparent to me. First, neither candidate gives any real details. There's not a single proposal by either candidate for which I can't think of a half-dozen questions that are not answered anywhere on their site. I don't let promises of tax credits or reduced premiums sway me. After all, it's easy to promise, but in the political minefield that is Washington DC, being able to make good on political promises normally only happens after a long hard swim in the Sea of Compromise followed by a rinse in the Shower of Quid Pro Quo.

    Instead, I believe that these proposals should be viewed as a yardstick by which to gauge the candidates' general leanings in terms of how they might attempt to influence the future direction of the health care industries.

    From what I can determine, the candidates positions can be summarized as such:


    John McCain believes that "The Key to Health Care Reform Is To Restore Control To The Patients Themselves." He wants to give every family a "$5,000 direct refundable tax credit" with which to purchase health insurance and to do what he can to promote competition among the various health care providers and insurance companies. McCain believes that competition will result in lower prices industry-wide and that lower prices for services will result in lower insurance premiums. He also promotes greater portability of health insurance, claiming that "families should be able to purchase health insurance nationwide, across state lines."

  • I have lots of questions about McCain's plan, but one question that immediately comes to mind is to ask what happens to the family that doesn't pay $5,000 in taxes? Will they still be given the $5,000? Does anyone know the answer?

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    Barack Obama claims that under his plan, "patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats." He wants to establish a National Health Insurance Exchange that would create minimum coverage standards that must be met by all insurance companies. In addition, "Insurers would have to issue every applicant a policy and charge fair and stable premiums that will not depend upon health status."


    Obama does not promise tax credits by which to pay for the premiums of these health insurance plans, but does suggest that as the reforms phase-in, the reduced costs of these plans could save a typical American family up to $2,500 per year. Tax credits will be available, based on an income sliding scale, to those who need it. In addition, as a way to encourage small businesses to offer health insurance to their employees, Obama has proposed a new Small Business Health Tax credit that will provide those businesses with refunds up to 50 percent of the premiums they pay on behalf of their employees.

    As with McCain's plan, there are questions-- lots of them. One that I have is that in reading through his plan, I really don't see anything that will make it easier for health care decisions to be make between patients and their doctors instead of being blocked by insurance company bureaucrats, as was quoted above. I have to make the assumption that by requiring all insurance companies to meet minimum standards in terms of coverage, that much of the guesswork about what is and what is not covered for a particular treatment would be eliminated. I suppose that will be true for many common illnesses and treatments, but I still have to wonder about what it will mean for the barrage of tests that doctors so often prescribe for MS patients.

    Bottom line: this is an issue that will not go away. It's only going to play a more significant part in the lives of all of us who live with MS and who must shop for insurance in the private market. I hope and pray that, whichever man wakes up president-elect on November 5th, he places the needs of folks like us high on his lists of priorities when working to restructure the health insurance options of all Americans.


    Note: Obama's full plan can be downloaded here. It goes into much more detail than the website. McCain does not offer a downloadable copy of his plan.

Published On: October 21, 2008