I can really sympathize with Joe Sixpack and all those hockey moms as they try to wade through the details of the ever-evolving McCain-Palin health care plan to determine how it will affect their health and their pocket books. Even organizations that hire experts to check the truthfulness of political claims are way behind the curve. It’s like competing in a marathon in which every other mile is run on quicksand. If health care weren’t such an important issue, the antics of the McCain-Palin comedy team might even be funny.

In the Vice-Presidential debate, Sarah Palin presented her version of the budget neutral tax credit for health care, saying that Senator McCain is

“proposing a $5,000 tax credit for families so that they can get out there and they can purchase their own health care coverage. That’s a smart thing to do. That’s budget neutral. That doesn’t cost the government anything . . .”

Does this sound a bit too good to be true?

Barack Obama seems to think so. In the second Presidential debate, Obama told the town hall audience that McCain

“says that he’s going to give you a $5,000 tax credit. What he doesn’t tell you is that he is going to tax your employer-based health care benefits for the first time ever. So what one hand giveth, the other hand taketh away.”

In response, John McCain told the town hall audience:

“if you do the math, those people who have employer-based health benefits, if you put the tax on it and you have what’s left over and you add $5,000 that you’re going to get as a refundable tax credit, do the math, 95 percent of the American people will have increased funds to go out and buy the insurance of their choice . . . “

Some fact checkers agreed and said:

“Obama’s suggestion that McCain’s health care plan is a wash for families is misleading. McCain offers families a $5,000 tax credit to help them buy health insurance. The corresponding increase in taxable wages would result in a much smaller cost than the value of the tax credit, at least at first. Over time, the value of the tax credit may diminish as premiums rise. However, the Tax Policy Center estimates that McCain’s plan would increase the federal deficit by $1.3 trillion over 10 years — mainly because it would lead to less tax revenue coming in, meaning it is a true tax break overall.”

Score one for John McCain? Not so quickly, because if the tax rebate is greater than the tax increase, how will the McCain-Palin health care plan be budget neutral?

That question was answered by a senior McCain policy advisor who told the Wall Street Journal that McCain “always planned to fund the tax credits, in part, with savings from Medicare and Medicaid,” federally funded programs that provide health care to seniors, poor families, and the disabled. Cut Medicare to pay for a $130,000,000,000 a year shell game. Just what the doctor ordered.

But it get’s even worse. What neither McCain, nor Obama, nor fact checkers emphasized in this second Presidential debate is the ways in which McCain’s stunningly radical proposal could change the health insurance landscape? All the financial projections cited above are based on the assumption that the relation between buyers and sellers of health insurance will not change. But if you believe this is true, I have a Bridge to Nowhere I’d just love to sell you.

Senator McCain’s plan is based on the assumption that individuals buying their own insurance will cut better deals than are currently being obtained by professional benefits managers backed by corporate market power. He also believes that consumers purchasing complex contracts for future benefits will be adequately protected in a market in which a state no longer has the power to regulate policies sold within its borders.

However, the experience of the nearly 10 million people currently insured in the individual health insurance market has demonstrated that this market generally provides healthy, low-risk people with less coverage at higher prices than does other segments of the market. More troubling, individual health insurance often is unavailable to high-risk individuals most in need of coverage. Why will it be different when employers, who no longer receive tax benefits when they provide health insurance for their workers, decide to abandon their employees to the tender mercies of this market?

And how will hard-working Americans who think they’ve purchased good coverage feel when they discover that their policies, written in states far from their homes, don’t cover serious illnesses they or their loved one just contracted. All that fine print that takes someone with degrees in medicine and law to decipher. If you don’t like the food, don’t go back to the restaurant. If you don’t like your health insurance, well, too bad, because now the uncovered bills will bankrupt you and no one will provide affordable insurance to someone with your medical history.

John McCain may argue that his statement that:

“Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation”

should be narrowly construed. But when one examines John McCain’s approach to health care reform in the light of his reaction to the current financial meltdown, his attempts to recast failed practices and policies in shopworn free-market rhetoric is reminiscent of Louis XVI of France, who “forgot nothing, and learned nothing.”



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