Sen. John McCain spent most of the last week trying to live down his pronouncement on the day of the stock market implosion that the “fundamentals of the economy are strong.”
Looks like he has a new task for this coming week.
In an article in the Sept./Oct. issue of Contingencies, the magazine of the American Academy of Actuaries, McCain wrote, “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.”
Obviously those words were crafted long before this week and McCain’s new found conversion to the notion that regulatory oversight in the financial markets at least might have some value after all.
But if the meltdown of our healthcare system is not as glaring as the cracks now running through Wall Street, they are no less severe for tens of millions of Americans.
At a time when one-fifth of Americans have told pollsters they self-ration needed care and people are wiping out their savings to pay medical bills, the healthcare crisis does not look like it could get much worse.
And it’s worth recalling the Commonwealth Fund study this summer that 101,000 fewer Americans would die if we matched other industrial countries in health care quality and access barometers.
How does all that relate to McCain’s dreamy notion that we should tether our healthcare system to the same “vigorous” forces that made our banking system so successful?
McCain’s prescription for healthcare is to further unleash the hand of the private market in health care, and remove the what few nettlesome fetters — public oversight protections — exist now.
To that end, McCain’s health care plan has two central components:
1- Move people from group plan coverage, as some 60 percent of Americans now get if they have employer-paid health plans, to the individual insurance market. How he gets there is to tax healthcare benefits for working people in hope that younger, healthier workers will give up their comprehensive coverage to go buy cheaper, less comprehensive plans with higher out of pocket costs on the individual market.
That accomplishes two things. First, it discourages individuals and families from using health care services that they have to pay more for, promoting even more self-rationing. Second, it undermines employer plans, as employers will be left with the more costly less healthy workers to cover. The result, intended of course, is to prod employers to scale way back in what coverage they offer or, more likely, eliminate coverage entirely.
To McCain, borrowing from the rightwing healthcare policy think tanks, this is the way to cut health care costs, by pushing more people out of the health care system, no matter how brutal and inhumane the results.
2- Wipe out existing minimum standards on insurance companies some states have adopted. The McCain plan would permit insurers to evade all requirements that have been won by nurses, and other healthcare activists, in states across the country.
In California, the list of minimum coverage insurers must provide, for example, include mammography, prostrate cancer screening, minimum maternity stays, independent medical review of care denials, hospice care, direct access to an OB/GYN, breast reconstruction, colorectal screening, AIDS vaccines, and diabetic supplies.
Not exactly frills, and most won against the bitter opposition of the insurance industry. The minimum maternity stays, to name one, followed a scandal of a series of reported infant deaths from jaundice in the 1990s as big insurers were increasingly kicking new moms and their babies out of the hospital just a few hours after birth. Presumably, that’s an example of the “worst excesses of state-based regulation” John McCain thinks we need to dump.
