The Candidates on Disability - Part V: McCain and Healthcare

And to think that I thought I was done with this series!

OK, here's the deal on regulation/deregulation. Some states regulate health insurance more heavily than do other states. For example, my state might require medical insurance providers to cover prescription drugs while your state does not.

John McCain supports "deregulation." He would like people to be able to buy insurance across state lines. That sounds harmless, right? Maybe even a good idea? But what if you live in a state that requires medical insurance companies to cover things like pre-existing conditions, maternity care, expensive treatments for cancer, or prescription drugs? Your insurance policies are going to be more expensive than a plan that doesn't cover those big ticket items.

If you deregulate and allow people to shop across state lines, young, healthy folk are likely to buy cheaper plans to save money. That just makes good sense. (It's a gamble, of course. If you ride in a vehicle, breathe, or just tend to age chronologically, chances are you will need your medical insurance at some point. Perhaps for something that's not covered.)

But if the healthy people are getting their health insurance elsewhere, then all that are left in the truly comprehensive plans are . . . the elderly and the sick. And those plans are going to get a lot more expensive.

The only way for a medical insurance company to stay in business will be to move to a state with less regulation and not offer those treatments that aren't cost-effective.

This is very bad for people with pre-existing conditions and disabilities.

But wait, there's more.

While still having the option of employer-based coverage, every family will receive a direct refundable tax credit - effectively cash - of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider.

Sounds good, right? Two big problems. First, if you choose to participate in your employer-based program, you'll be taxed on that benefit as if it were part of your income! (This will drive people out of employer-based plans and to private plans, see above.)

Second, you have to be able to pay for your plan up front, with the government "refundable tax credit" coming later. Say you don't have a few thousand dollars (or more, if you're older, female, or otherwise harder to insure) lying around in your checking account. What do you do?

BusinessWeek reports:
The Commonwealth Fund, a nonprofit that studies health-care issues, estimates that McCain's plan would reduce the number of uninsured Americans by 1.3 million over the next decade, at a cost of $1.3 billion, while Obama's plan would reduce the uninsured by 34 million and cost $1.63 billion. The Lewin Group, a health-care market researcher, figures that McCain's proposal would cost $2.05 trillion over 10 years, and Obama's would cost $1.17 trillion. Both campaigns dispute all these estimates, saying costs would be lower and coverage higher.

If you have a disability or you love someone who does, and you want to make sure that your family is insured, and that your insurance pays for the treatments you need, then McCain's plan is scary for you. According to a report from the nonpartisan Commonwealth Foundation in MedScape Medical News, "The McCain plan encourages people to move into the free market, which may benefit some. But there are a whole variety of structures in the McCain plan that are ill suited for people with chronic needs, such as cancer patients. It would allow or even encourage the loosening of state regulations that currently protect people with chronic illnesses."

The links above, to McCain's campaign website, the BusinessWeek report, and the Medscape report are very interesting. Also very informative is the October 7th Diane Rehm Show. And I highly, highly recommend Jane Bryant Quinn's Vetting McCain's Health Plan in the October 13th edition of Newsweek. It's a quick and easy read. Please check it out!