By Peter Jo
Northwest Asian Weekly
The two issues that concern most Americans regarding health care are the number of uninsured and affordability. About 47 million Americans, or nearly one in six, are uninsured.
Compared to many other developed nations, the number of uninsured in the United States is embarrassingly high. As health care costs rise, the number of uninsured individuals threatens to increase.
Health care costs have skyrocketed in recent years. In the past eight years, employer-based premiums rose 100 percent. The cost to the worker for health coverage rose 143 percent; 10 percent in the past year alone.
Not only has the price for coverage outpaced the increase in employee pay and inflation, but the out-of-pocket costs (deductibles, co-pays, etc.) have also gone up 115 percent since 2000. The U.S. spends more of its gross domestic product on health care than almost any other developed country.
According to the Kaiser Family Foundation, Asian Americans are generally in better health and are less likely to have chronic disease than other ethnic groups. But of the 13 million Asian Americans in the United States, 18 percent (or 2.4 million) do not have health insurance. This is greater than the uninsured rate for white Americans at 12 percent. Asian Americans are also less likely than white Americans to have employer- sponsored coverage.
Sen. Obama’s plan
The heart of Obama’s plan is the development of the National Health Insurance Exchange which will include a new, public insurance plan as well as government regulated offerings from private insurers. Americans and businesses will be able to purchase one of these private plans or enroll in the public plan.
This plan will ensure eligibility for the millions of uninsured as well as offer the freedom to keep your current provider if you are already insured. While government oversight over the health insurance industry is daunting to some, the intentions are to lower costs and improve efficiency and portability.
Obama’s plan will not, as some have suggested, design a single payer system. Rather, it will allow competition among private insurers but guarantee benefits for ordinary citizens.
Rolling out a new government program has considerable expenses. Sen. Obama promises that by repealing President Bush’s tax cuts on people making more than $250,000, as well as the decreased expenditures associated with improved efficiency, this plan can be implemented without raising taxes for 98 percent of Americans.
Sen. McCain’s plan
McCain’s plan does not include a large new government initiative like the National Health Insurance Exchange. His goal is to put money back into the hands of Americans by offering a $2,500 tax credit to individuals who purchase health insurance ($5,000 tax credit for families) and encouraging them to shop the insurance marketplace across state lines. He believes that with cash in hand, competition for your dollars will lower costs, improve quality and thereby reduce the number of uninsured.
The marketplace does not traditionally make guarantees to serve all people. As such, there will still be some Americans that will not be able to acquire coverage. For these individuals, Sen. McCain proposes a Guaranteed Access Plan that would allow states to develop local models to ensure access for all people.
In the spirit of limited federal intervention, these plans would primarily be state regulated but McCain promises the cooperation of the federal government, as well as subsidies, to facilitate the process.
The actual benefit to individual voters depends on a number of dizzying calculations. Income, pre-existing health conditions, current insurance status, whether or not you own a business, your employer’s response to the proposals and other variables will determine your total out of pocket cost and insurance coverage. Even so, a recent analysis by the Lewin group may help guide your decisions.
Both plans would significantly reduce the number of uninsured across almost all income brackets. Obama would insure an additional 26.6 million while McCain would insure 21.1 million. Obama’s plan would promote a slight increase in employer-sponsored coverage while McCain’s plan would likely see a loss, as employees shop for more affordable private insurance.
Under McCain, the number of people under private insurance will increase while Obama will drive more people into public insurance. The average family’s health care expenditures will decrease under both plans but McCain’s plan will save three to five times as much Obama’s.
For example, a family making $50,000 to $75,000 will save $483 under Obama and $1,927 under McCain. A family making $30,000 to $39,999 will save $148 under Obama and $1,410 under McCain.
Either plan is likely to be helpful to most Americans as they are both departures from the current, broken insurance paradigm. Ultimately, your vote may depend on how you see the role of government.
John McCain will emphasize the free market economy and give you back more money to let you make your decisions. Barack Obama will move the private sector under the umbrella of the federal government to better regulate the industry. One candidate emphasizes choice; the other security. ♦
Peter Jo can be reached at firstname.lastname@example.org.