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John McCain’s Plan For Healthcare System Reform Is Worse Than Barack Obama’s. Part 2

Stanley Feld M.D.,FACP,MACE

John McCain’s healthcare plan is not a healthcare plan. It would not put “Patients First”. His plan is designed to avoid further entitlement programs and to relieve employers of the obligation of providing healthcare insurance for their employees. The sound bites and slogans imply healthcare will be provided to all. His remarks have no substance. They are simply generalities. They do not deal with the basic problems in the healthcare system.

“John McCain Will Encourage And Expand The Benefits Of Health Savings Accounts (HSAs) For Families. When families are informed about medical choices, they are more capable of making their own decisions and often decide against unnecessary options. Health Savings Accounts take an important step in the direction of putting families in charge of what they pay for.”

What does “encourage and expand Health Savings Accounts” mean? There is no discussion of who is going to pay for the HSA’s. My view is Health Savings Accounts do not provide incentives for patients to be responsible for themselves. The healthcare insurance industry controls the money and the co-pays. It uses the money for its own investments. Patients can use the remaining money not spent for future healthcare need rather than owning the funds they do not use in a retirement plan. It is simply a delayed payment to the healthcare insurance company. With a high deductible there should be first dollar coverage after $6,000 is spent.

“ Specific Plan of Action: Ensuring Care for Higher Risk Patients”

“Plan Cares For The Traditionally Uninsurable. John McCain understands that those without prior group coverage and those with pre-existing conditions have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need.”

He does not propose how he is going to provide “high-quality coverage” to the uninsurable. What does “high quality coverage” mean? There is a large gap between where patients can be comfortable with healthcare coverage and patients’ anxiety about inadequate healthcare coverage. Inadequate healthcare insurance overage (under insured) is usually discovered after the fact.

“John McCain Will Work With States To Establish A Guaranteed Access Plan.”

“As President, John McCain will work with governors to develop a best practice model that states can follow – a Guaranteed Access Plan or GAP – that would reflect the best experience of the states to ensure these patients have access to health coverage. One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.”

John McCain should know that states already have high risk pools. The high risk pools have been unsuccessful. Patients with pre-existing illness are overcharged and underinsured by the healthcare insurance industry. The providers of the healthcare insurance are the healthcare insurance companies and not the states. The healthcare insurance industry is not in business to lose money. It sets the high risk premiums at high unaffordable rates. The criteria used to determine rates are not transparent. The only thing transparent about the healthcare insurance industry is its exorbitant profits from high premiums while it restricts patients access to care.

“John McCain Will Promote Proper Incentives. John McCain will work with Congress, the governors, and industry to make sure this approach is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs.”

To who are the incentives directed? John McCain’s incentives subsidize the healthcare insurance industry. He is not providing incentives to patients to promote wellness.

With a basic philosophy of decreasing government entitlements (privatizing Social Security and Medicare) and relieving employers of the burden of providing healthcare insurance, John McCain is not a patient advocate.

George W. Bush beat John McCain in the 2000 primaries because George W. Bush projected a greater grasp of America’s problems and a more compassionate personality. Unfortunately, neither perception of George W. Bush turned out to be correct. John McCain’s healthcare plan offers neither perception. I can not understand how anyone who sees the difficulty Americans are having in healthcare system could think John McCain’s healthcare plan would solve our healthcare problems.

John McCain should focus on patients, not the secondary stakeholders.


The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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