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OH, Did You Really Need Health-care?
By BOB HERBERT
Talk about a shock to the system. Has anyone bothered to notice the radical changes that John McCain and Sarah Palin are planning for the nation's health insurance system? These are changes that will set in motion nothing less than the dismantling of the employer-based coverage that protects most American families.
A study coming out Tuesday from scholars at Columbia, Harvard, Purdue and Michigan projects that 20 million Americans who have employment-based health insurance would lose it under the McCain plan.
There is nothing secret about Senator McCain's far-reaching proposals, but they haven't gotten much attention because the chatter in this campaign has mostly been about nonsense — lipstick, celebrities and "Drill, baby, drill!"
For starters, the McCain health plan would treat employer-paid health benefits as income that employees would have to pay taxes on. "
It means your employer is going to have to make an estimate on how much the employer is paying for health insurance on your behalf, and you are going to have to pay taxes on that money," said Sherry Glied, an economist who chairs the Department of Health Policy and Management at Columbia University's Mailman School of Public Health.
Ms. Glied is one of the four scholars who have just completed an independent joint study of the plan. Their findings are being published on the Web site of the policy journal, Health Affairs.
According to the study: "The McCain plan will force millions of Americans into the weakest segment of the private insurance system — the nongroup market — where cost-sharing is high, covered services are limited and people will lose access to benefits they have now."
The net effect of the plan, the study said, "almost certainly will be to increase family costs for medical care."
Under the McCain plan (now the McCain-Palin plan) employees who continue to receive employer-paid health benefits would look at their pay stubs each week or each month and find that additional money had been withheld to cover the taxes on the value of their benefits.
While there might be less money in the paycheck, that would not be anything to worry about, according to Senator McCain. That's because the government would be offering all taxpayers a refundable tax credit — $2,500 for a single worker and $5,000 per family — to be used "to help pay for your health care."
You may think this is a good move or a bad one — but it's a monumental change in the way health coverage would be provided to scores of millions of Americans. Why not more attention?
The whole idea of the McCain plan is to get families out of employer-paid health coverage and into the health insurance marketplace, where naked competition is supposed to take care of all ills. (We're seeing in the Bear Stearns, Fannie Mae, Freddie Mac, Lehman Brothers and Merrill Lynch fiascos just how well the unfettered marketplace has been working.)
Taxing employer-paid health benefits is the first step in this transition, the equivalent of injecting poison into the system. It's the beginning of the end.
When younger, healthier workers start seeing additional taxes taken out of their paychecks, some (perhaps many) will opt out of the employer-based plans — either to buy cheaper insurance on their own or to go without coverage.
That will leave employers with a pool of older, less healthy workers to cover. That coverage will necessarily be more expensive, which will encourage more and more employers to give up on the idea of providing coverage at all.
The upshot is that many more Americans — millions more — will find themselves on their own in the bewildering and often treacherous health insurance marketplace. As Senator McCain has said: "I believe the key to real reform is to restore control over our health care system to the patients themselves."
Yet another radical element of McCain's plan is his proposal to undermine state health insurance regulations by allowing consumers to buy insurance from sellers anywhere in the country. So a requirement in one state that insurers cover, for example, vaccinations, or annual physicals, or breast examinations, would essentially be meaningless.
In a refrain we've heard many times in recent years, Mr. McCain said he is committed to ridding the market of these "needless and costly" insurance regulations.
This entire McCain health insurance transformation is right out of the right-wing Republicans' ideological playbook: fewer regulations; let the market decide; and send unsophisticated consumers into the crucible alone.
You would think that with some of the most venerable houses on Wall Street crumbling like sand castles right before our eyes, we'd be a little wary about spreading this toxic formula even further into the health care system.
But we're not even paying much attention.
http://www.nytimes.com/2008/09/16/opinion/16herbert.html?_r=1&em=&exprod=myyahoo&pagewanted=print&oref=slogin
Copyright 2008 The New York Times Company
For this episode of On The Record, we speak with Tom Love, the Democratic candidate for U.S. House District 24 for the 2008 election.
What prompted you to run for public office?
I am an University of Texas alumni, a working man, a concerned husband, a father and a grandfather who has seen the "American Dream" slowly turning into the "American Nightmare."
We have become a nation that has far too long ignored its working peoples' needs and rewarded powerful special interests. Texans pay their taxes and are penalized, while multimillionaires get special tax breaks. We cannot become a nation that builds bridges to nowhere, yet constructs no pathway to our children's future.
My maternal grandmother told me about voting,"I will never forfeit a right that I worked so hard to obtain. Never allow democracy to vanish because it is not convenient to vote, or you will never get it back." My paternal grandfather was a Lamar County Judge and also instilled an interest in politics that my father passed on to me.
We need the commitment and backbone of the American people to solve this latest fiscal disaster of predatory lending.
What would you say are the primary issues concerning your area?
I am calling for the creation of a "Fair Deal" for the working men and women of Texas who pay their taxes in an era of multimillionaires getting unfair tax breaks, the outsourcing of American jobs to foreign countries and over $3 per gallon gasoline.
The Texas Legislative and Congressional districts were redrawn in a non-census year to represent partisan, ideological concerns, and Texans no longer had control over local issues.
Americans need to address the healthcare needs that have allowed 47 million Americans to go without healthcare. Policies that allow chronic illnesses and unsafe nurse-to-patient ratios weaken our hospitals ability to treat patients without private insurance intervention. Texans need to be able to build a pathway for their children's futures, not build bridges to nowhere as the Republicans have done. Teachers must receive better pay and be allowed to teach.
I pledge that I will work between the aisles and in whatever venue necessary to represent my district and its needs and concerns.
What are your qualifications for the position for which you are running?
I have real experience dealing with the real problems of Texans. As a small business owner, a financial services worker with the Texas Department of Human Services and a financial services supervisor, I have experienced firsthand the difficulties Texans have to pay their bills, maintain their homes, feed and clothe their children and teach American family values to the next generation.
I believe I can send a message that the working people of this state are tired of having partisan ideological differences and a culture of corruption that keeps Republicans, Democrats, Liberals, Moderates, and Conservatives from solving issues fairly.
I am a social progressive that believes in sound fiscal values.
How do politics affect your family?
We, like most other Texas families, have to work to provide the economic livelihood necessary to pay mortgages, car notes, credit cards to maintain credit worthiness, and care for our families.
We are spending, by one study, $720 million dollars a day for a war in Iraq that we have already "won." We continue to occupy Iraq without an exit strategy, while our troops and families suffer with repeated call-ups, extensions, redeployment, and post traumatic stress disorder without adequate medical care and try to survive in the face of predatory lenders and extreme economic hardship.
All these problems are causing crushing debt. It is time we solved these problems. We can. We will.
What is your biggest hope for Texas?
I hope and believe that we can rise above the ideological quagmire that has engulfed us and bring a new and greater shinning path to us and our posterity. We need not be in fear or dislike government, for we are the government.
And by the people, for the people, and with the American public, we will triumph over adversity. The unique experiment our forefathers created we must now protect, serve, and defend. With God's help, we'll solve the issues of our time and create a new direction for future generations.
I ask for your help in this long, difficult journey. I am under no illusion that I can take this path alone. With my wife of thirty two years, Marilyn, I take this journey. We need Americans to register to vote and vote for America. Vote to end the politics of division, lies and deceit. Vote to end the politics of disrespect and humiliation.
If you give us your vote, we will pledge to serve, protect, and defend our great land. And if you give us your vote, my heart will be your heart, my hand will be your hand, our voice will be your voice, and your dream will be our reality.
I speak today as a working man who loves his country and loves his God, who asks for your vote and requests your help.
