After John McCain unveiled more details on his healthcare plan yesterday in Tampa, the Politico ran this headline: “McCain moves to middle on health
April 29, 2008

After John McCain unveiled more details on his healthcare plan yesterday in Tampa, the Politico ran this headline: “McCain moves to middle on health care.” Given that any policy proposal aiming for the “middle” is perceived as moderate and sensible, the spin on McCain’s plan was obviously positive.

But spin aside, the policy itself leaves much to be desired.

Senator John McCain detailed his plan to solve the nation’s health care crisis in a speech here Tuesday, calling for the federal government to give some money to states to help them cover people with illnesses who have been denied health insurance.

Mr. McCain’s health care plan would shift the emphasis from insurance provided by employers to insurance bought by individuals, to foster competition and drive down prices. To do so he is calling for eliminating the tax breaks that currently encourage employers to provide health insurance for their workers, and replacing them with $5,000 tax credits for families to buy their own insurance.

His proposal to move away from employer-based coverage was similar to one that President Bush pushed for last year, to little effect. And his call for expanding coverage through market-based competition is in stark contrast to the Democrats’ proposals to move toward universal health care coverage, with government subsidies to help lower-income people afford their premiums.

The good news is, the contrast between McCain’s approach and the Democrats’ approach couldn’t be greater. For voters concerned about healthcare, there’s a clear and distinct choice.

The bad news is, McCain’s plan is pretty awful, and probably won’t receive much in the way of scrutiny.

About a week ago, McCain, sensitive to criticism he’s received from Elizabeth Edwards (among others), told George Stephanopoulos, “We’re not leaving anybody behind.”

The problem, not surprisingly, is that he’s leaving all kinds of people behind. TNR’s Jonathan Cohn took a close look at McCain’s proposal and concluded, “His great new plan isn’t new or great. And it still wouldn’t help Elizabeth Edwards get decent insurance.” After reviewing McCain’s patchwork solution for people who can’t get insurance due to pre-existing conditions, Cohn added that McCain’s approach is “absolutely preposterous.”

Just to add one thing to Cohn’s analysis, there’s also the not-inconsequential matter of affordability. McCain wants to discourage employers from offering employees healthcare, and replace subsidies with $5,000 tax credits. In turn, Americans could go and get their own insurance, detached from their job. (That is, unless you’ve ever been sick, and private insurers don’t want you.)

What McCain didn’t mention is that “average cost of an employer-funded insurance plan is $12,106 for a family, according to the Kaiser Family Foundation, a health policy group. Paul B. Ginsburg, the president of the Center for Studying Health System Change, a nonpartisan research organization financed by foundations and government agencies, said, ‘For a lot of people, the tax credits he’s talking about would not be enough to afford coverage.’”

Hilzoy summarized the situation nicely:

So, in a nutshell: McCain plans to eliminate tax breaks for employers who offer health insurance. In exchange, he will offer employees less than half the cost of the plans they now have. If their employers eliminate care, they will have to swallow the difference. But those employees are the lucky ones. They will only have to cough up $7,000 or so. People with preexisting conditions or serious health risks will have to pay $100,000 as a down payment, and $14,000 a year thereafter.

But hey: at least he’s going to cut the gas tax! […]

It’s easy to make health policy when you don’t allow little things like facts to constrain you: when you can wish away chronic diseases, pretend that corporations are completely unresponsive to changes in the tax structure, and describe programs that leave people with hundreds of thousands of dollars in health care costs as “making sure that they get the high-quality coverage they need.” It’s just not particularly helpful. Plus, it would be even better with ponies.

As McCain “moved to the middle” of the road on healthcare? Only if the “middle” is the area in which bad policy proposals get run over.

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