The Candidates on Health Care

John Lantos, MD
John B. Francis Chair in Bioethics

October 16, 2008

This week’s New England Journal of Medicine has articles (supposedly) by Barack Obama and John McCain, outlining their health care proposals. They show how the two candidates present radically different views of how to fix the health care system.

The centerpiece of Obama’s philosophy is, “Through a national health-insurance exchange, people without employment-based insurance or who work in small businesses will have a choice of private insurance policies at rates similar to those offered through large firms. To promote competition among insurers, we will also give patients a new public-plan option, providing the same coverage that is offered to members of Congress and their families.”

The centerpiece of McCain’s is, “to replace the current tax exclusion of the value of health insurance from employees' taxable compensation with a new refundable tax credit of $2,500 for individuals and $5,000 for families. Families can use the tax credit to continue their employment-based insurance or to find a plan that better meets their needs.”

In other words, Obama would build, as a safety net, a new public health insurance plan – perhaps an expansion of the Federal Employees Health Benefit plan – while McCain would rely upon the market to force insurance companies to develop affordable options.

Both plans are complex. Both candidates state, as a goal, that all Americans will have health care.

Joseph Antos, of the American Enterprise Institute, offers a critique of the Obama plan (Symptomatic Relief, but No Cure). David Blumenthal, of the Institute of Health Policy, critiques McCain’s plan (The McCain Plan for Health Insecurity). David Cutler and Gail Wilensky offer a video discussion of the future of health care.

Taken together, the essays and discussions offer a concise view of the opposing viewpoints about how to reform health care. Check them out!

To share your comments on the candidates’ proposals, click here.