29. April 2008 by Jon Moss.

by Libby Quaid

Republican presidential candidate John McCain wants health insurance companies to compete for your business on the open market.

He would offer families a $5,000 tax credit to help buy insurance policies.

“Millions of Americans would be making their own health care choices again,” McCain said in remarks prepared for delivery Tuesday at the H. Lee Moffitt Cancer Center & Research Institute in Tampa.

“Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs,” he said. “It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.”

His campaign called the speech a major policy address, though McCain has talked about the same ideas for several months. What’s new, according to adviser Doug Holtz-Eakin, is that McCain will give more examples of how his policies would work.

Still missing: The total cost of the plan and an estimate of how many people it would help. There are more than 40 million people in the United States who don’t have health insurance.

“So, a little more detail, but remember, it is April, and the election’s in November, so not everything will happen tomorrow or this week,” Holtz-Eakin told reporters Monday.

Under McCain’s plan, anyone could get the credit, and those who like their company health care plan could choose to stay in it. The credit would be available as a rebate to people at lower income levels who have no tax liability, Holtz-Eakin said.

To pay for the tax credit, McCain would eliminate the tax exemption for people whose employers pay a portion of their coverage, raising an estimated $3.6 trillion in revenues, Holtz-Eakin said. Companies that provide coverage to workers still would get tax breaks. McCain would also cut costs by limiting health care lawsuits.

The goal is to move the health care industry away from job-based coverage toward competition among health insurance companies on the open market.

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7. April 2008 by Jon Moss.

Hillary Clinton	Barack Obama	John McCain
	CLINTON Requires everyone to have insurance. Insurers must sell to all who apply. Large employers would offer coverage or pay a portion of workers’ costs. Small employers would be exempt but could get tax incentives to provide coverage. A new public plan, “Health Choices Menu,” similar to the federal employees’ program, would be designed. A refundable tax credit would help pay for coverage. Premiums’ cost would be limited to a percentage of income.	OBAMA Requires all parents to have coverage for their children. Insurers must sell to all who apply. Large employers would offer coverage or pay into a fund. Small employers would be exempt but could buy coverage in a new system with subsidies available to some businesses. Creates a new plan for the uninsured and businesses that is similar to the federal employees’ health program. For employers who offer insurance, the government would pay for very expensive care, if employers agree to pass savings to workers.	McCAIN Ends tax-free health benefits offered through employers and replaces with a tax credit of $2,500 for individuals and $5,000 for families to purchase health insurance. Allows consumers to buy insurance from sellers in any state, which could be cheaper. Allows businesses and the self-employed to band together to buy insurance through associations, which they cannot do now in some states. Sets limits on medical malpractice awards. Allows importing prescription drugs from other countries.
The cost	Estimated $110 billion a year when phased in. Would be offset by cost savings, such as limiting tax-free health benefits for those earning more than $250,000 and ending recent tax cuts that income group received under President Bush.	Estimated $50 billion to $65 billion a year, with much of the cost coming from savings in the health system and ending tax cuts for those making more than $250,000 a year.	The campaign has not estimated costs.
Sources: USA TODAY research and the Kaiser Family Foundation

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7. March 2008 by Jon Moss.

A growing number of business groups have embraced the idea of requiring individuals to purchase health insurance. Supporters of an individual mandate, including Democratic presidential candidate Hillary Clinton, contend it is necessary to achieve universal health care and spread the burden of health care costs more fairly.

Clinton’s rival, Barack Obama, says it is unfair to force people to buy insurance they can’t afford and argues that most people would buy insurance if the cost is reduced. In recent weeks, the National Small Business Association, the National Business Group on Health — representing large employers — and the National Retail Federation have endorsed an individual mandate. The National Federation of Independent Business has not taken a position. The NFIB helped kill Clinton’s 1993 health care plan because it required all employers to provide insurance.

The U.S. Chamber of Commerce opposes an individual mandate, as well as an employer mandate. Both Clinton and Obama would require employers to provide health insurance or contribute to their coverage by paying money to the federal government. Both would exempt small businesses from this mandate, but they haven’t specified what the size threshold for that exemption would be. They also would provide subsidies or tax breaks to low- and moderate-income individuals to help them buy insurance. Likely Republican nominee John McCain opposes mandates. His health care plan focuses on reducing health care costs

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27. February 2008 by Jon Moss.

In an effort to increase the funding and efficiency of health care for Native Americans, the Senate voted 83-10 to approve legislation intended to provide the group with greater access to health care services — including screening and mental health programs.

Native Americans typically experience higher death rates due to alcoholism, drug use, diabetes, cardiovascular disease and suicide rates, according to reports.

In addition to expanding tribal access to Medicare and Medicaid, the bill — which would authorize approximately $35 billion for Indian health care programs over the next 10 years — would also enhance programs at the Indian Health Service, help construct and revamp health clinics on reservations, and attempt to recruit more Native Americans into the health care industry, according to reports.

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26. February 2008 by Jon Moss.

Post-primary polling shows small business owners and their employees are a significant voting segment equal to, and larger than, well-established voting blocs like veterans and union members.The National Federation of Independent Business, the nation’s leading small business advocacy association, conducted one national survey and six state-specific surveys Tuesday, polling Democrats in California, Missouri and Arizona, and Republicans in California, Missouri and Georgia. Not only did the results illustrate this voting bloc’s significant presence, it showed health care to be one of the most important issues to small businesses.

Polling data from the four states show the impressive strength and bandwidth of small business owners and their employees:

• In California, small business owners and employees made up 28 percent of the Democrats who voted on Super Tuesday, versus union members who were 24 percent.
• In Missouri, small business owners and employees comprised 32 percent of the Republicans who voted, versus 21 percent¹ who were veterans. On the Democratic side in Missouri, small business owners and employees were 28 percent, versus 16 percent who were union members.
• In Georgia, small business owners and employees were 38 percent of the Republicans who voted, versus 19 percent² who were veterans.
• In Arizona, small business owners and employees made up 31 percent of the Democrats who voted, versus 13 percent who were union members.

“More than ever before, small business men and women made up a significant voting bloc on Super Tuesday. It is clear they are a voting segment that should receive the same attention from candidates as other groups, including veterans and union members,” said Todd Stottlemyer, NFIB president and CEO. 

Despite their significant presence, the issues that matter to small business owners and their employees have been overlooked by the presidential candidates. In fact, the national survey found that 81 percent of owners and 52 percent of employees do not feel the candidates are adequately addressing issues that are important to them, especially health care. Presidential candidates are not effectively considering and reaching this significant voting segment, a group that grows each year as corporate downsizing impacts large employers.  

The rising cost of health care is a major concern for small business owners and their employees who continue to be squeezed by premium increases and state mandates. Nationally, 51 percent of small business owners and 47 percent of their employees say they have had difficulty keeping up with the cost of health care. And both groups feel that the presidential candidates are not saying enough about health care on the campaign trail.     
 
“The research shows that health-care reform is a top concern for America’s job creators, and they are desperately seeking help from the next president,” continued Stottlemyer. “Small business owners and employees are bearing the overwhelming burden of a broken health-care system that needs real reform. Candidates from both parties need to address this crisis head on. Because when you fix health care for small business, you fix it for America.”

-NFIB survey results

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23. February 2008 by Jon Moss.

NY Times article illustrates some of the differences between Clinton’s & Obama’s healthcare reform ideas:

 Brandy Coons is what health economists call a free rider.

She may not fully appreciate it, but her decision to go without health insurance , like millions of similarly situated Americans, has become central to the pre-eminent policy dispute of the Democratic presidential campaign.

Ms. Coons, a 23-year-old waitress who rents a room and rarely eats out, said she could probably afford a high-deductible policy if she gave up her gym membership and spent less on her amateur photography. But she chooses instead to gamble against the odds of confronting a bankrupting catastrophe.

“I’m young and in pretty good shape,” Ms. Coons said one recent afternoon, on her way to the treadmill at the Fitness Factory in Midtown Atlanta. “I looked at Blue Cross Blue Shield. But the only thing I could see myself really needing it for are prescriptions and dental because there are so many free clinics, or a hospital visit really isn’t all that expensive.”

She continued, “The insurance premium was more than what I would pay for my prescriptions, so I just decided not to deal with it.”

Senator Hillary Rodham Clinton contends that the only way to achieve universal health coverage, and to make the marketplace fair and efficient, is to require that everyone have insurance. That would include people like Ms. Coons, who may not currently rank health care above other needs and wants.

Senator Barack Obama , Mrs. Clinton’s rival for the Democratic presidential nomination, shares her goal of insuring all Americans. But he says that a mandate could mean financial devastation for middle-class families if the government did not first adequately reduce the cost of insurance.

Both candidates express confidence that by pumping at least $110 billion into subsidies and tax credits they can make policies affordable for all. The difference is that Mr. Obama insists he will be able to lure all of the uninsured simply by dangling the carrot of low premiums; Mrs. Clinton believes there will always be some free riders who respond only to a government stick.

Neither campaign has provided enough detail about its plan to enable more than guesswork about how it might influence consumers like Ms. Coons. They have not detailed what kind of subsidies would be needed or who would be entitled to them. Mrs. Clinton has not fully explained how she would make everyone comply with her plan or exactly how she would cap the amount a family would have to spend on premiums.

Each candidate would raise the money needed to subsidize premiums by rolling back President Bush’s tax cuts for high earners, taxing businesses that do not insure their workers and reducing costs through electronic record keeping, preventive medicine and chronic disease management.

But there is little certainty about how much those initiatives might save, or when. Nor can it be known if the savings would offset the potential cost of new technology and drugs and the cost of providing care to the newly insured. There are also questions about whether the new savings and tax increases would be enough to subsidize insurance for all who need help.

Both candidates are backed by teams of prominent economists from top universities and policy groups. But with little real-world precedent to guide them, their assessments are necessarily an amalgam of statistical modeling and back-of-the-envelope calculation.

“In a campaign, people put out proposals that aren’t highly specified, that don’t have enough detail to model them effectively,” said E. Richard Brown, director of the Center for Health Policy Research at the University of California, Los Angeles, and an Obama adviser. “These numbers are based on a lot of assumptions.”

In speeches, debates and dueling advertisements, Mrs. Clinton and Mr. Obama have brandished projections that even their originators acknowledge are tenuous.

Mrs. Clinton, for instance, has charged repeatedly that Mr. Obama’s plan would leave 15 million people uninsured. Doing so, she has said, amounts to Democratic apostasy. “I don’t want to leave anybody out,” she said in Thursday’s debate in Austin, Tex.

But the economist who devised that number, Jonathan Gruber of the Massachusetts Institute of Technology , said that while he felt strongly that a mandate was needed to achieve universal coverage, he was less firm about his projection. “There is a lot of margin for error around that estimate,” Mr. Gruber said.

Mr. Obama, meanwhile, maintains in a television advertisement that his plan will “cover everyone.” That claim is disputed by some of his own advisers, including Mr. Brown, who recently calculated that the Obama plan might leave behind two million free riders.

“That’s the number we would expect to continue to be uninsured unless they’re forced to buy coverage,” Mr. Brown said.

Article continues….

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