New York Times Examines Business Organizations' Concerns About McCain's Health Care Proposal

Main Category: Health Insurance / Medical Insurance
Article Date: 08 Oct 2008 - 6:00 PDT

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Businesses, "typically a reliable Republican cheerleader," remain "decidedly lukewarm" about the health care proposal announced by Republican presidential nominee Sen. John McCain (Ariz.), according to trade group officials, the New York Times reports.

According to the Times, officials with groups such as the U.S. Chamber of Commerce, the Business Roundtable and the National Federation of Independent Business have raised concerns that the proposal -- which would replace a tax break for employees who receive health insurance from employers with a refundable tax credit of as much as $2,500 for individuals and $5,000 for families for the purchase of coverage through their employers or the individual market -- would "accelerate the erosion of employer-sponsored health insurance and do little to reduce the number of uninsured." In addition, they have raised concerns that the proposal "would impose particular burdens on small businesses and old-line manufacturers that are already struggling," the Times reports.

Officials with eight trade groups contacted by the Times said that the proposal would increase health insurance costs and prompt some businesses to drop coverage for employees. In addition, a recent survey of 187 business executives conducted by the American Benefits Council and Miller & Chevalier found that three-fourths of respondents believe the proposal would have a "strong negative impact" on their employees.

Bruce Josten, executive vice president for government affairs at the Chamber of Commerce, said, "To some in the business community, this is very discomforting," adding, "The private marketplace, in my opinion, is ill-prepared today with an infrastructure for an individual-based health insurance system."

John Castellani, president of the Business Roundtable, said, "One of the things we don't want to do is jeopardize 170 million Americans who do get insurance through their employers."

Helen Darling, president of the National Business Group on Health, said, "The last thing you want to do to the average working person, especially when you're bailing out big financial companies, is take something they hold near and dear partially away."

According to the Times, "health economists are ideologically divided over Mr. McCain's plan" and disagree over its potential effect on cost and spending, as well how many people it would insure (Sack, New York Times, 10/7).

Governors Criticize McCain Proposal
In other news, five Democratic governors on Monday during an event at the campaign headquarters of Democratic presidential nominee Sen. Barack Obama (Ill.) criticized the McCain health care proposal and promoted the Obama plan, the Philadelphia Inquirer reports. The governors said that the McCain proposal would prompt many businesses to drop health insurance for employees, limit requirements for health insurers and make coverage more expensive for many U.S. residents.

Pennsylvania Gov. Ed Rendell (D) said of the tax credits that the proposal would provide, "Please go out and find me a health care plan for a family of four for $5,000." According to New Jersey Gov. Jon Corzine (D), the proposal has similarities with a plan that President Bush has promoted for several years that "barely draws sponsors even among Republicans because it's such a failed concept."

Maryland Gov. Martin O'Malley (D), Iowa Gov. Chet Culver (D) and West Virginia Gov. Joe Manchin (D) also spoke at the event (Burling, Philadelphia Inquirer, 10/7).

Health Care as Election Issue
The Politico on Tuesday examined how, although "there were many who believed -- and hoped -- health care reform had recovered from its 1993 thrashing and would rise anew to become a deciding issue in 2008," the recent economic downturn has moved health care to "Nos. 3 and 4 on the lists of issues of most concern to voters." However, "proponents of the issue are hoping for a comeback Tuesday in the presidential debate at Belmont University in Nashville," according to The Politico.

The Partnership to Fight Chronic Disease has partnered with WebMD and Belmont to submit questions related to health care for the debate. In addition, the partnership has run ads on health care and has written letters to the editors of newspapers to promote the issue. The partnership also held a health care rally on Monday on the Belmont campus, as well as a health care reform breakfast and panel discussion near the university on Tuesday morning.

Andrew Kohut, president of the Pew Research Center for the People and the Press, said, "The health care issue has significant resonance with people, and it can be made an important discriminator between the two candidates," adding, "It's a big issue under the surface because of the overwhelming concern about the economy" (Cummings, The Politico, 10/7).

Health Care Advisers
The Politico on Tuesday also examined the backgrounds of the health care advisers to the McCain and Obama campaigns. According to The Politico, "McCain's team of advisers is dominated by free market advocates and government waste hunters," and "Obama's health care team reads like a who's who of broad reform advocates" from Capitol Hill and academia (Frates, The Politico, 10/7).

Opinion Pieces
Summaries of several opinion pieces that address health care issues in the presidential election appear below.

• Gilbert Welch, New York Times: Both McCain and Obama have "champion[ed] one of medical care's most pervasive myths": that, "like magic, preventive medicine will simultaneously reduce costs and improve health," Welch, an author and a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, writes in a Times opinion piece. According to Welch, McCain has said that, "by emphasizing prevention" and other measures, "we can reduce health care costs," and Obama has said that, "in the absence of a radical shift towards prevention and public health, we will not be successful in containing medical costs or improving the health of the American people." Welch writes, "It may sound like common sense," but "it is still a myth." The "term 'preventive medicine' no longer means what it used to: keeping people well by promoting healthy habits, like exercising, eating a balanced diet and not smoking," he writes. The "medical model for prevention has become less about health promotion and more about early diagnosis," Welch writes, adding, "It boils down to encouraging the well to have themselves tested to make sure they are not sick," and "that approach doesn't save money; it costs money." Welch writes, "If preventive medicine were effective in improving the nation's health, it might warrant these added expenditures," but "you can't assume it is," adding, "Early diagnosis may help some, but it undoubtedly leads others to be treated for 'diseases' that would never have bothered them." He writes, "Both presidential candidates need to challenge the conventional wisdom about preventive medicine" and "ask whether the path to a healthy society is the one that turns those who are well into patients anxious about their future" (Welch, New York Times, 10/7).
  
  
• David Gratzer, Wall Street Journal: The McCain health care proposal "is the right prescription for what ails our health care system," Gratzer -- a physician, author and senior fellow at the Manhattan Institute -- writes in a Journal opinion piece. The foundation of the employer-sponsored health insurance system "is crumbling," and the number of U.S. residents who receive coverage through their employers "has been shrinking" for decades, Gratzer writes. According to Gratzer, McCain "recognizes that a large part of the problem is that the tax code favors employer-funded health insurance" and "wants to fundamentally change the way the system works and instead give the self-employed and individuals a tax break for buying their own insurance." The proposal has some "flaws," but "Mr. McCain is fundamentally right on health care," Gratzer writes (Gratzer, Wall Street Journal, 10/7).
  
  
• Ruth Marcus, Washington Post: "Overall, Barack Obama's health care plan is preferable to John McCain's," as "Obama's approach ... would cover more people and would help those who have the hardest time obtaining insurance," but "McCain's plan is not the ill-intentioned monstrosity of Obama's ominous portrayal," Post columnist Marcus writes. "In important ways, it would be an improvement over current law, making a health insurance system that is now tilted in favor of the rich significantly more progressive," according to Marcus. She writes, "Tying insurance to employment makes little sense in a world where workers hop from job to job" and "favors better-off employees who, because they pay higher marginal rates, derive a greater benefit from not being taxed on their health insurance." Marcus adds, "Eliminating this distortion -- if done the right way, and that's a big if -- could help more Americans obtain insurance, push down costs and reduce the drain of health care costs on the federal budget." However, the McCain proposal has "serious flaws," she writes. Marcus concludes, "In a perfect world, the candidates could have a rational discussion about the merits of their two approaches. In this one, they are reduced to trading inflated charges about tax hikes and government-run health care" (Marcus, Washington Post, 10/7).
  
  
• Gary Andres, Washington Times: Partisan differences "create a prism through which citizens evaluate presidential candidates' positions on health care reform," and that "leaves independent voters -- always a key electoral constituency -- somewhere in between" the proposals of the two major candidates, Andres, vice chair of Dutko Worldwide, writes in a Times opinion piece. According to Andres, partisan differences "are most pronounced on issues related to the role of government in financing and regulating this sector," but "in other areas of health care -- like promoting prevention and coordinated care -- partisan differences shrink, highlighting some opportunities for bipartisan cooperation." In addition, "voters across party lines favor a focus on making health care more affordable over reducing the number of people without health insurance," Andres writes. He concludes, "So despite predictable partisan patterns in voters' views of many health care reform ideas, areas such as reducing costs and reimbursing for prevention draw strong bipartisan support and may serve as the foundation for legislative action in the next Congress" (Andres, Washington Times, 10/7).
  

Broadcast Coverage
WAMU's "The Diane Rehm Show" on Tuesday is scheduled to include a discussion about the health care proposals of the major presidential candidates. Scheduled guests include Leonard Burman, senior fellow at the Urban Institute and co-director of the Urban-Brookings Tax Policy Center; Julie Rovner, health policy correspondent for NPR; and John Sheils, senior vice president of the Lewin Group ("The Diane Rehm Show" Web site, 10/7).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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