Diary

Arm Yourself for the Health Care Debate

The health care issue is set to be one of the most important issues in the next four years if the rhetoric coming from both sides is to be believed. (I question whether it really be. Remember Social Security in 2000. We’ve done a great job on that in the last eight years.) Here is a cornucopia of information that you can use to arm yourself for the debate – not just for this election, but beyond.The Heritage Foundation did a through round up of the various studies of the McCain and Obama health care plans. The articles are link laden for those that really want to dig into this issue.

The McCain Health Care Plan: A Closer Look at Cost and Coverage by Greg D’Angelo and Paul L. Winfree

The McCain plan would reduce the number of uninsured and help control costs, yet it would, as currently designed, require considerable increases in federal expenditures. The coverage expansion would be driven by enrollment in individual private plans chosen by the consumer that could be taken from job to job. Cost-savings measures would result from an effective realignment of financial incentives. Primarily because the new tax credit would be much larger than the existing tax break from the income tax exclusion that it would be replacing, the plan would amount to a significant tax reduction, particularly for the middle class. Costs of the McCain plan could be controlled by replacing or capping the federal payroll tax exclusion for health insurance or by changing the structure of the tax credits, moving it toward budget neutrality.

The Obama Health Care Plan: A Closer Look at Cost and Coverage by Greg D’Angelo and Paul L. Winfree

The Obama plan would reduce the number of uninsured citizens, but it would not control costs in any significant way while demanding considerable increases in federal expenditures. Coverage expansion would be driven by enrollment in public plans in which the government would set benefit levels and provider reimbursement rates. Cost-savings would not come from fundamentally realigning economic incentives but would rely on dubious “if only’ propositions related to changes in health care delivery.


Robert Carroll, of the Tax Foundation, has an article in the Wall Street Journal entitled “Almost Everyone Would Do Better Under the McCain Health Plan”. He includes this Tax Foundation generated graph on the impact of the McCain plan tax credit.

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As you can see the health credit covers the tax impact and then some for everyone on the chart. It’s interesting to note that the Tax Foundation uses a $14,000 health plan when the average is a few thousand lower. Not to mention employers don’t actually cover the entire cost of a health plan (unless you happen to be extremely lucky).


Health Affairs has an article “Myths and Misconceptions About U.S. Health Insurance” by Katherine Baicker and Amitabh Chandra. The five myths are:

  1. The Problem With The Health Insurance System Is That Sick People Without Insurance Can’t Find Affordable Policies.
  2. Covering The Uninsured Pays For Itself By Reducing Expensive And Inefficient Emergency Room Care.
  3. Lack Of Insurance Is The Principal Barrier To Getting High-Quality Care.
  4. Employers Can Shoulder More Of The Burden Of Paying For Insurance.
  5. High-Deductible Health Plans And Competition, Not Government Action, Are The Keys To Lower Costs.

Go read the whole thing, you will find it very informative and enlightening.


Health Affairs also has another article up titled “The Politics of Paying for Health Reform: Zombies, Payroll Taxes, and the Holy Grail” by Jonathan Oberlander. Keep in mind when you read this article that universal coverage does not mean a single payer government plan. It simply refers to getting everyone health coverage of some sort. This article takes a very reasoned approach to what funding methods are available and the consequences (and politics) of each approach. Especially worthwhile is the skewering the article gives to the employer mandate model of financing.

Clearly, the employer mandate enjoys enduring appeal: like a zombie, it is a policy option that simply will not die.


I’ve noted before that Obama economic advisor Jason Furman was once a fan of the McCain style of health care plan, but I wasn’t aware that there were more. Economist Greg Mankiw points to a piece in the Wall Street Journal called “Obama vs. His Advisers: On health care, they once liked McCain’s principles” where they point to another Obama advisor that saw appeal in parts of the McCain plan. David Cutler once voiced concern over “tying [health care] to employment” and called for tax credits in a book he wrote four years ago.


Cato scholar Michael D. Tanner spoke at a conference for the Society for the Education of Physicians and Patients. There are a series of video available from the conference on YouTube.

Obama Healthcare – Part 1
Obama Healthcare – Part 2
McCain Healthcare – Part 1
McCain Healthcare – Part 2
Q&A – Part 1
Q&A – Part2

You can find more videos by other speakers at the conference by using the side bar on the right on YouTube. Lots of good stuff from this conference.


Arm yourselves. Information is power when you are debating.

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