Stinkin Thinkin! Part 1

Stanley Feld M.D.,FACP,MACE

Unfortunately John McCain has misrepresented Barack Obama’s positions on many issues. John McCain has changed his own position on many issues. He seems to have a meager or shallow grasp of most issues. He claims he is going to fight for the middle class but he has not defined what he is going to fight or a strategy to fight it. He has chosen a Vice Presidential running mate who is being sold to the public as a champion of the middle class. I believe this has been her appeal. However, I have not hear her define any substantive issues or strategies. He is running a campaign of symbolism rather than substance.

He has not spoken substantially about most issues. He does not seem to understand the needs of the middle class. He said on many occasions that the economy is basically sound. On September 17 he said he is going to clean up the financial mess. His plan is to appoint a committee like the 9/11 committee. He has also has stated he does not understand the economy. His campaign chairwoman says he would not make a good corporate CEO.

John McCain’s sound bytes are not even good. He is an embarrassment to the Republican Party. Nevertheless the “polls’ say almost 50% of us will vote for him. How can this be? How is it possible that he can be pulling the wool over the eyes of the American public?

On the issue of healthcare he is way off the mark. His major proposal is his tax credit to consumers.

“Senator John McCain’s top domestic policy adviser, former Congressional Budget Office director Douglas J. Holtz-Eakin, recently said in a conference call with reporters that Mr. McCain’s health care proposal would “put 25 to 30 million individuals out of the ranks of the uninsured, into the ranks of the insured.”

In an article released Tuesday, a panel of prominent health economists concludes that Mr. Holtz-Eakin’s projection is off by, well, 25 to 30 million.

Simple logic tells us there is no way to decrease the number of uninsured by 25 to 30 million by creating a tax credit of $2,500 per individual and $5,000 per family to buy healthcare insurance. The tax credit is insufficient to have very much impact. It is not even a good sound byte because healthcare insurance costs $6,000 per individual and $12,000 per family. The families will still not be able to afford healthcare insurance.

However, the sound byte represents a major tenet of his healthcare plan. Even if he was correct the common man would still be at the mercy of the abusive healthcare insurance industry. He has said nothing about correcting healthcare insurance industry abuse and inefficiency. The abuse is directly related to how the healthcare insurance industry calculates the healthcare premiums.

“The article, published in the journal Health Affairs, argues that “initially there would be no real change in the number of people covered as a result of the McCain plan.” After a short-term reduction of 1 million in the number of people without coverage, the number of uninsured would increase by 5 million after five years, the authors predict. There are currently 45 million people without insurance, or 15 percent of the population, according to the Census Bureau.”

This misrepresentation of the true effect of his policy is pervasive in all of John McCain’s campaign assertions. His healthcare policy will not create more competition among insurance companies. It will give the healthcare insurance industry more control of the premiums charged and an opportunity for great net profits. Have media sound bytes become more influential in decision making than logic and facts? I believe Americans are smarter than that.

“That, the McCain campaign asserts, would drive more people into the individual market, fomenting competition, reducing premiums and discouraging consumers from buying more coverage than they need or can afford. The economists wrote that many “people are likely to have far less generous policies than those they have today.”

The economists are from the University of Michigan, Columbia, Indiana University and Harvard. Their estimates of the effect of McCain’s healthcare tax credits are comparable to those made in July by the Urban Institute and Brookings Institution. The Urban Institute and Brookings Institute projected that 1 million people would gain coverage after one year under Mr. McCain’s plan, that almost 5 million people would gain coverage after four years, and that the number of uninsured would then creep upward.

John McCain is obsessed with the growth of entitlements like Medicare, Medicaid and Social Security. He is correct. They have gotten out of hand because of their defective structure. His goal is to shift these entitlements over to the private sector. The private sector loves his goal because it is an opportunity to increase profits.

John McCain should be asking why the entitlements are failing rather than giving them away to institutions that have abused systems such as the healthcare industry and the financial industry. These entitlements are failing because of their structure. These institutions will have to be restructured to correct their defects and inefficiencies. The current bureaucracies are incapable of creating initiatives linked to innovation and change.

Privatizing these institutions is not going to make things better for our middle class. John McCain’s plans will drive the middle class toward poverty for the benefit of big business. The pity is John McCain does not know the effect his plan is destined to have.

The strength of America is in a vibrant middle class with incentives to advance through education. It is in the creation of the desire and capability for upward mobility for the lower and middle class that will make us stronger. Government has to set rules that are fair to all and permit the lower class to rise to the middle class. People must have hope, security and goals. The middle class should not be conditioned to live in fear of war, economic collapse, and lack of adequate healthcare.

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