Last night, in a speech to supporters in which he effectively claimed the Republican nomination, John McCain immediately mocked Democrats on one of their strongest issues: “I will leave it to my [Democratic] opponent to propose returning to the failed, big-government mandates of the ’60s and ’70s to address problems such as the lack of health-care insurance for some Americans.”
It was an odd choice of attacks, given that McCain has no real intention of addressing the problems of the uninsured if elected.
From time to time, McCain has made encouraging noises on the issue. He’s supported re-importation of medicine from Canada; he’s teamed up with Ted Kennedy on a “patients’ bill of rights”; and he’ll occasionally criticize HMOs and big pharm.
But TNR’s Jonathan Cohn reports today on the healthcare plan McCain unveiled in October, and labels the policy a “disaster.”
McCain, of all people, should be sensitive to the way America’s health care system fails some of its most vulnerable citizens. He is a three-time survivor of melanoma, the potentially deadly skin cancer. Although he was last treated for cancer six years ago — and although he takes all the right precautions, dutifully donning sunscreen whenever he’s outside — he’s still at a higher-than-normal risk of getting cancer again.
This sort of history doesn’t seriously affect people who get their insurance from big-time employers. In any large organization of relatively random people — say, the employees of the federal government, of which McCain happens to be one — insurers know that most of the people will be healthy, which means premiums from those folks will be sufficient to cover the relatively few with serious medical problems.
But if McCain were, hypothetically, to shop for insurance on his own, he would discover that insurers were far less accommodating. Cancer, even one in remission, would qualify as one of those infamous “preexisting conditions.” The insurers might offer him an exorbitantly priced policy or exclude coverage of anything related to cancer. Or they simply might refuse him coverage outright.
Either way, the very last thing McCain should want is to expose even more people to this sort of scrutiny — since, almost certainly, it’d leave even more of them uninsured. But it’s entirely possible — some would say likely — that’s what McCain’s reforms would do.
Wait, it gets worse.
The main point of McCain’s proposal is to change tax policy to make it easier for people to have more insurance options outside their employer.
But there are good reasons to think that’s not how it will work out. Absent a substantial restructuring of the insurance industry, the people with preexisting medical conditions — including melanoma survivors — would still struggle to find decent coverage outside of the workplace. So it’s quite possible that only relatively healthy people would opt into the individual market. Once these more robust specimens fled employer groups, however, the cost of insurance for those remaining behind would go up — since insurance becomes more expensive without the contributions of relatively healthy people to offset the costs of those with high medical bills. And, as the cost of the employer insurance went up, even more people would start dropping it (or their companies might simply stop offering it). Appearing on ABC’s “This Week” recently, McCain told George Stephanopoulos that “I want the families to make the choice.” But, for Americans who are sick or poor or both, the McCain plan could mean fewer insurance choices than they have now — or no choice at all.
This is quite a contrast to the approach Hillary Clinton and Barack Obama are now touting. Although the Clinton and Obama plans differ in some crucial details, most notably whether to require that all legal residents carry insurance, both plans would allow people to obtain insurance regardless of preexisting medical conditions. They would do so by giving everybody access to a purchasing cooperative through which both private plans and a new public insurance program would be available. The plans would have to meet minimum standards and benefits, along the lines of what federal employees get. In other words, while Clinton and Obama would let people buy insurance on their own, they would take steps to make sure decent insurance was available to these people. McCain would do the former, but not the latter.
No matter which Dem gets the nomination, this is a fight to look forward to. If McCain support for an unpopular war doesn’t undermine his campaign, his useless healthcare policy will.