by Tom Condit; this article was originally published in Partisan issue no. 26, printed September 2008.

Health care in the U.S. is a disaster. We spend $230 million an hour on health care in this country, but 18,000 Americans die each year because they cannot afford health care. We have shorter life spans and more children dying in infancy than almost any other industrial country. There are 48 million people with no health coverage at all, and if things don't change there will be 67 million by 2018.

What do the presidential candidates propose to do about this?

McCain wants to spend a lot of money and leave things they way they are.

Obama wants to spend even more money and make things a little better.

Nader wants to save money and make things a lot better.

McCain's Plan

One of the major government subsidies to the health care system we have now is that employer health insurance payments aren't counted as taxable income, and worker contributions can be deducted from income before taxes are withheld. McCain wants to eliminate these exclusions. Workers with employer health insurance plans would pay over $100 billion a year more in taxes.

Instead, McCain wants to put in a direct, refundable tax credit. This would discourage job-related health plans and force people to individually shop for policies. The Tax Policy Center estimates that this will cost $1.3 trillion dollars over the next ten years. Because many people won't get new health insurance when their employer plan goes away, only 5% of those who will be uninsured in 2018 will gain coverage under this plan.

Obama's Plan

Obama wants to keep the present system of employer-sponsored insurance. He would supplement it by covering more people under MedicAid and the State Children's Health Insurance Program (SCHIP), plus a new federal insurance pool for people who don't have a plan at work and aren't eligible for public programs. Obama's plan would cost an estimated $1.6 trillion over the next ten years and extend coverage to about half the uninsured.

Nader's Plan

McCain's plan and Obama's plans are expensive because they include massive government subsidies to the insurance industry. Federal, state and local governments pay more than half of health care costs in the U.S., but our current system is a bureaucratic nightmare, wasting $350 billion--close to a third of all health care spending--on things that have nothing to do with health care--overhead, underwriting, billing, sales and marketing departments, huge profits and exorbitant executive pay. In addition, there is over $200 billion in computerized billing fraud and abuse.

Nader and Gonzales want to replace the billions in waste and the maze of public and private programs with a single system of publicly-financed health care. This is called "single payer" health insurance, and is like expanding MediCare to everyone. It would eliminate insurance company profits, get rid of all the red tape involved in determining who is eligible for what medical care, and make advertising and sales unnecessary. Everyone would be in and nobody would be out. The result would be better health care for everyone for less money than we pay now.

Which plan will you vote for?

Tom Condit was the Peace and Freedom Party nominee for California Insurance Commissioner in 2006.

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