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Candidates differ sharply on whether health care is a right
[October 28, 2008]

Candidates differ sharply on whether health care is a right

(The Pittsburgh Tribune-Review Via Acquire Media NewsEdge) Oct. 28--David Domino and Rosemary Prostko are being crushed by different ends of the same weight.

Health care costs for the 50 or so employees of Domino's New Kensington roofing company drain more than $400,000 a year off his bottom line. That's more than he spends on supplies, advertising or travel costs.

"The system is absolutely broken," said Domino, 44, of Mt. Lebanon.

Prostko, 64, a retiree living in Bethel Park, racked up $11,000 in charges for six hours of medical tests.

"Nobody wants something for nothing. I just don't want people to die" because they're worried about paying for medical care, Prostko said. She said she joined the Single Payer Coalition of Pennsylvania not because she's convinced government-run health care is the best system, but because something has to change.

If either John McCain or Barack Obama get their way, something will. The candidates' health care plans offer some of the starkest differences of the race for the presidency. In their debate Oct. 7, they revealed their starting points: McCain said health care is a responsibility; Obama said it's a right.

McCain's plan aims to make people less dependent on their employers for health insurance, using deregulation and tax breaks so people could buy their own insurance. Obama would use regulation to close gaps in the nation's existing employer-provided health care system, and set up a national plan as a safety net for those who fall through the cracks.

The current system grew because government decided not to tax employees' health benefits. McCain would remove that exemption, but offer a tax rebate -- $2,500 for individuals and $5,000 for families. The tax credit to individuals would offset the extra income tax on all but the most expensive insurance plans, McCain says.

People who don't have health insurance would get the tax credit if they buy insurance themselves.

"His plan is fairly radical," said Michael Tanner, a senior fellow at the Cato Institute, a libertarian-leaning policy group based in Washington.

To make insurance more affordable, McCain would allow anyone to buy insurance from a company in any state -- something that's illegal now.

Sen. Bob Casey, D-Scranton, criticized the idea as "send(ing) people out in the open market and (hoping) for the best."

"The concern I have with John McCain's plan is, A, it doesn't begin to cover enough people, and B, I think taxing health care benefits is going to undermine employer-based coverage," said Casey, an early Obama supporter.

Obama's plan requires large employers -- both campaigns have left such terms undefined -- to provide health insurance or pay an extra payroll tax. Revenue from that tax would help pay for a national plan from which the uninsured could buy coverage.

Insurance companies wouldn't be allowed to deny coverage to anyone based on a pre-existing condition under Obama's plan. In speeches, Obama frequently cites the experience of his mother, who had to fight insurance companies for coverage as she was dying of cancer.

"It's sort of like after you drive your car into a tree, you can pick up your phone and say, 'Hey, Geico,' " Tanner said. "I don't know that that works too well."

In part because the Obama plan includes a requirement that parents insure children -- the campaign hasn't said how it would enforce that -- Republicans have pilloried the plan as nationalized health care. That's an exaggeration, said Steven Mosher, a professor of health care administration and political science at Mary Baldwin College in Staunton, Va.

"If you drive a car, you have to have insurance, right?" said Mosher, who agrees with Obama that health care is a right.

Cost estimates for the candidates' plans differ wildly. Most experts agree McCain's plan is less expensive, but likely wouldn't cover as many people as Obama's plan.

Polls show more than 80 percent of Americans -- from small-business owners like Domino to fixed-income retirees like Prostko -- call for changing the health care system, Tanner said.

Those same polls, though, show support for contradictory solutions. Less government involvement and more government regulation both routinely get greater than 50 percent support, he said.

"This is people saying, 'Fix my health care system. I don't know how to fix it, but do something,'" Tanner said.

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