Short and sweet: Health care

What amazes me most about the ongoing health care debate is the finality with which some politicians and their pundit supporters dismiss the idea of universal health care, and especially single payer plans, with the nail-in-the-coffin reminder that “You don’t want the government running your health care, do you?”

And folks who don’t stop to think about it may agree, because they certainly don’t want the government running their health care, nosiree.

So I guess they’ll be turning down Medicare when they retire.

Unless they, like Joe Barton, are members of Congress, in which case they already have government-run health care. Doesn’t seem to bother him at all.

It’s been understood for years that the abysmal state of our health care system is a drain on our national economy, not to mention a drain on the health and pocketbooks of the millions of American citizens who have no health care coverage.

Who do you think pays for those emergency room visits by the uninsured?

America is the only major industrialized nation that does not provide some form of universal health care for its citizens. But this year, happily, we are offered some real ideas for fixing the health care system. And the reader is well advised to listen, learn and then choose.

The New England Journal of Medicine, a respected and non-partisan publication, has published its evaluation of the proposals by Barack Obama and John McCain, and I want to describe the main points here, in the order they are listed by the Journal.

John McCain’s plan:

Proposes to make employer-paid health insurance premiums taxable to the employee;

Provides for $2500 per worker or $5,000 per family refundable tax credit for those purchasing private insurance;

Creates a high-risk pool for persons who are unable to purchase that insurance; promotes less comprehensive insurance policies;

Proposes to deregulate insurance markets;

Proposes to reform Medicare to make bundled payments for episodes of care and pay on the basis of outcomes.

Barack Obama’s plan:

Proposes requiring employers (except very small businesses) to either offer insurance to employees or pay a tax;

For the uninsured and small businesses, would create a new national health plan similar to Medicare, and establishes a new national health insurance exchange that would offer choice of private insurance options;

Mandates that all children must have coverage (expanding the SCHIP program);

Would provide subsidies to lower-income Americans to help them afford coverage;

Would expand coverage, financed through the payroll tax, letting tax cuts for families making over $250,000 expire, and savings from electronic medical records, disease management, and other system reforms;

Would regulate private insurance plans to end risk rating based on health status;

Proposes to insure business against the costs of workers’ expensive medical episodes.

These, again, are the highlights. For each of the candidates there are other proposed measures to control costs and improve quality, but the ones I’ve reported are selected by the Journal as “key elements” of the respective plans.

However you get there, universal health care is not just a do-good, feel-good, help- the-afflicted issue. It’s a bread and butter issue for the country.