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McCain plans to give control of health care back to the patient-consumers
Republican candidate’s goal is to make the best care available to all through insurance reform.
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Republican presidential candidate Sen. John McCain from Arizona has proposed a plan that he believes will improve and ensure access to health care for every American.
His plan, outlined on his Web site and in speeches, specifies areas in which he proposes to change, including insurance reform, lowering health care costs and addressing the challenges of long-term care.
“The problem with health care in America is not the quality of health care, it is the availability and affordability,” he said in a video posted on his Web site.
Taxing premiums
Sen. McCain proposes to deregulate and use competition to improve the quality of health insurance. Easing regulations will allow consumers greater portability with their insurance and the option to cross state lines to purchase policies that best suit their needs.
“Americans need insurance that follows them from job to job,” Sen. McCain states on his Web site. “They want insurance that is still there if they retire early and does not change if they take a few years off to raise the kids.”
One change Sen. McCain proposes is to tax health insurance supplied by employers. This tax is estimated to generate approximately $3.6 trillion over the next 10 years. These funds would then be allocated to fund his insurance reform objectives, specifically through a $5,000 refundable tax credit for families and $2,500 for individuals that can be used to offset the purchase of private insurance.
“Allowing health care across state lines will permit more affordable health care for large numbers of individuals,” Douglas W. Jackson, MD, said. “The costs for similar plans can vary by two to three times as much in different states. This possibly may allow 10 million-plus more individuals the ability to afford and/or purchase health insurance.”
Walk-in clinics
Sen. McCain also would like to see an increased use of walk-in clinics, community health centers and medical IT to help reduce costs. “We need to understand that emergency room care is the most expensive in America,” he said in the video.
In a speech at the Lee Moffitt Cancer Center & Research Institute in Tampa, Fla., Sen. McCain said, “Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in Web technology to allow a doctor to practice across state lines, then let them.”
Medicare
In terms of Medicare funding, Sen.McCain also said in the speech that he advocates moving Medicare reimbursement from fee-for-service to outcomes-based, bundled payments for episodes of care.
“Government programs such as Medicare and Medicaid should lead the way in health care reforms that improve quality and lower costs,” he said. “Medicare reimbursement now rewards institutions and clinicians who provide more and more complex services. We need to change the way providers are paid to focus their attention more on chronic disease and managing their treatment.”
Thomas A. Scully, JD, senior counsel at Alston & Bird, senior adviser at Welsh Carson Anderson and Stowe, and former administrator of the Centers for Medicare & Medicaid Services (CMS), said, “I think that the more you bundle payments and the more you pay for performance, the better off you are.”
He said both candidates’ health care plans are sketchy, which is not unusual during a presidential election campaign. However, if Sen. McCain is elected, Mr. Scully believes he will be aggressive and creative on the Medicare side.
“The frustrating thing for physicians is that the Medicare system does not make any sense,” he said. “Every year they put a Band-Aid on it, instead of what the American Medical Association should be doing, which is take a step back and decide how to make a better system.”
Mr. Scully said he worked with Sen. McCain many times during his tenure at CMS. “He has been very involved in Medicare over the years; he understands it and has a very tough and smart health care staff,” he said.
Medical liability
Sen. McCain also proposes to remedy the malpractice lawsuit problem facing the country.
“We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols,” he said in his speech.
“Every patient should have access to legal remedies in cases of bad medical practice, but that should not be an invitation to endless, frivolous lawsuits.”
Other issues
The following are other issues of health care reform addressed by Sen. McCain:
Guaranteed access to care: Sen. McCain plans to work with governors to develop a best-practice model to ensure all patients have access to health coverage. According to Sen. McCain’s Web site, 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.
Health care quality: Sen. McCain proposes to emphasize prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology to reduce health care costs and improve quality of care. He also will dedicate more federal research to caring and curing chronic disease.
Drug costs: Sen. McCain will look to bring greater competition to the U.S. drug markets through safe re-importation of drugs and faster introduction of generic drugs.
For more information:
- Douglas W. Jackson, MD, can be reached at Memorial Ortho. Surgical Group, 2760 Atlantic Ave., Long Beach, CA 90806-2755; 562-424-6666; e-mail: jacksondw@aol.com.
- Thomas A. Scully, JD, can be reached at Allston & Byrd LLP, the Atlantic Building, 950 F St. NW, Washington DC 20004; 202-756-3300; e-mail: thomas.scully@alston.com.
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