Where Do the Presidential Candidates Stand on Health Care?

Possible dealbreaker: Plan subsidies of $100 billion and $55 billion to jump-start universal adaptation of electronic medical records (EMR), repealing President Bush’s tax cuts for those earning more than $250,000 to pay for new plans, provides only half the initial subsidies. Cost savings to reduce premium cost by $2500 per family is predicated on $77 billion in savings from the EMR, $81 billion from prevention and disease management programs, and $46 billion from reduced administrative costs. Such cost savings have proven elusive in the past. Growing Social Security and Medicare entitlements make a massive new entitlement problematic.

Roles and Responsibilities of Individuals, Physicians, and Other Stakeholders

The following are excerpts from the American Medical Association’s questions to both candidates on how their health care platforms outline relationships among stakeholders:

Obama: Protecting and promoting health and wellness…is a shared responsibility among individuals, families, schools, employers, the medical and public health workforce, and federal and state and local governments.…Insurance companies have a critical role to play by reducing administrative costs, focusing on preventive care, issuing all Americans fair and reasonable premiums no matter any pre-existing conditions.…All of these parties must do their part, as well as collaborate with one another, to create the conditions and opportunities that will allow and encourage Americans to adopt healthy lifestyles.

McCain: Every participant in the health care system-doctors, hospitals, insurance companies, patients, drug companies, medical device makers, state governments, and the federal government-must be prepared to change to make the system more responsive.…The most important players in health care…are the patient and their health care provider-as everyone else merely plays a support role. Patients will have the opportunity to manage their health care dollars and risks.…Health care providers must be accountable to their patients by educating their patients regarding their health status, practice evidence-based medicine, and provide transparency regarding their costs and options for treating illnesses.

Impact on the Private Health Insurance Market

Obama: Would prohibit insurers from denying coverage based on pre-existing conditions (guaranteed issue); children up to age 25 could continue family coverage through their parents’ plan; would prevent insurers from abusing monopoly power through unjustified tax increases (KFF.org , 2007); in market areas where there is not enough competition, require insurers to pay out a reasonable share of premiums on patient care benefits; and require health plans to disclose the percentage of their premiums that pay for patient care as opposed to administrative costs.