How McCain and Obama would reform America’s health care

(Sept. 17, 2008) With the national campaigns in full swing, focus is shifting to where Senators McCain and Obama stand on the nation’s most critical issues — including what to do about health care.

Details are still filtering in, but it’s clear that the Obama and McCain health care plans include major similarities as well as stark differences. Both presidential candidates agree that reform is needed to improve health care quality, reduce costs and increase access, but they disagree on how to do that.

Both candidates start with the understanding that the cost of health insurance has pushed beyond the affordability of many individuals and businesses. CBIA agrees and has consistently urged that cost be addressed in order to increase access to quality health care for more people.

We have urged state policymakers to reform health care by strengthening our market-based system and bolstering public programs that operate as a “safety net” for individuals who do not have access to — or cannot afford — private insurance.

Generally speaking, McCain favors improving the private-market system as well, while Obama leans toward more government intervention.

Here are highlights of the major points in both candidates’ health care plans, along with where CBIA stands:

Where the candidates agree:
Electronic medical records: Recognizing that traditional, paper-based medical recordkeeping is inefficient and diminishes health care quality, both candidates’ plans promote developing a national health information exchange system.

Disease-management programs
Since patients with chronic conditions account for the vast majority of health care spending, each candidate’s plan encourages the use of proven disease-management programs along with improved care coordination and integration.

Quality and cost transparency
To help consumers make better health care decisions, Obama and McCain want greater disclosure of data related to the cost and quality of care.

CBIA’s position: CBIA agrees with all three positions taken by the candidates. Greater use of electronic medical records will reduce costs by streamlining the system. It will also improve quality by reducing medical errors and duplications. Coupled with a greater focus on employer-based wellness programs, disease-management programs can improve our overall health status and ease the burden on the health care system. And consumers should have greater access to health care data to help them in their health care decisions.

Where the candidates disagree:

Obama’s plan
National health plan and health insurance exchange: Obama wants a national health care system modeled after the Federal Employees Health Benefits Program and made available to all individuals and small businesses. He’s also calling for a health insurance exchange program that would market private insurance to individuals. However, the benefit levels, costs, and requisite government subsidies for these proposals have not yet been defined.

CBIA is concerned that such an expansive, government-run health care program could ultimately lead to a national single-payer health care system. Therefore, more information is needed about the details of Sen. Obama’s proposal.

Employer tax: Obama’s plan would impose a tax on all but the smallest employers if they did not provide their employees with a threshold level of coverage. CBIA believes it’s unfair to single out employers — who are already paying the lion’s share of health care costs — rather than distributing these costs across a broader cross-section of health care consumers.

McCain’s plan

Reform Medicare and Medicaid payment systems: Without providing details on how, McCain says he will revamp the payment structure of both Medicare and Medicaid. CBIA believes this must include increasing reimbursement levels for both programs in order to reduce the shifting of costs from the public sector to the private sector, which effectively increases health care costs for private payers.

Potential compromise of small group reform laws: McCain would allow individuals to purchase health insurance across state lines. If this were to weaken Connecticut’s beneficial small group reform laws, then it would harm businesses under the protections of the state’s small-business health care rating laws. CBIA needs more information before it can establish its position on this proposal.

For more information about the candidates’ positions on health care, and CBIA’s perspective, contact CBIA’s Eric George at 860-244-1921 or eric.george@cbia.com.