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HEALTH POLITICS: Still Think Health Care is Off the Table???

October 6, 2008 - 1:51pm

If you thought that the economic crisis had wiped health reform off the issues map, think again. Health care is red hot on the campaign this week.

Obama has been speaking about health care on the stump, arguing McCain has a "radical" plan that will shift costs to families. Obama is running at least four TV commercials on health care (see ads called "Coin," "Mother" "Two Extremes" and "The Ultimate Bridge to Nowhere"). We haven't spotted any health-policy focused ads from McCain, and we don't see any on his web site. (Please send us a link if we've missed it).

Obama attacks McCain's health plan on numerous fronts—how the plan to tax benefits and shift people into an individual market would probably have fewer patient protections than it has today; how McCain's plan would undermine employer-sponsored health plans, and the lack of protections for people with pre-existing conditions. In the ad called "Two Extremes" Obama also takes on the McCain campaign for accusing him of orchestrating a government-takeover of health care, and then outlines the way his own proposal will preserve the parts of the employer-based private system that work today while fixing what's broken.

While McCain doesn't have a corresponding health policy story line this week, the McCain team hasn't been sitting on the sidelines and has accused Obama of distorting their plan. Top adviser Doug Holtz-Eakin isn't denying that people with pre-existing conditions (a population that consists of millions) have trouble getting insured in the individual market, but promises the McCain would "work with governors" to develop an "optional model" of regulations to help.

We expect to hear plenty about health at the Town Hall style debate this week, and we hope both candidates address why fixing health care is also part of restoring our fiscal health.

If you want more than spin and sound bites to analyze the plans, here are a few tools. Both Health Affairs and the New England Journal of Medicine have had detailed looks at the rival plans, and the Kaiser Family Foundation has a tool on its web site that allows you to customize side-by-side comparisons of the candidates' positions on more than a dozen health issues. Newsweek's consumer columnist Jane Bryant Quinn chimed in this week, pointing out that you do get choices in the individual market—but the policies you get to choose from cover less and cost more. If you can find coverage at all. Tax credits McCain style, she says, will cost the insured more—and do nothing for the uninsured. Except maybe create more of them.

New America health policy director Len Nichols and colleagues will shortly release their analysis of proposals to allow people to buy insurance policies across state lines. The implications are far more complex than they seem on the surface yet have received relatively little attention. It's worth taking a good close look at the impact it would have on the cost, quality, and availability of health insurance, particularly for older and less-healthy people.