By Robert Nelb

“Change” has been the mantra of the 2008 election, so it’s no surprise that both candidates have offered major overhauls aimed at fixing our ailing health-care system. Yet the changes they propose could not be more different. Barack Obama has presented a plan that builds on the existing system to provide access to health care to all, while John McCain proposes expanding the free market health insurance that got us into the mess we’re in today. Any candidate can offer change, but only one candidate offers the change that we need.

Obama’s plan begins by providing all Americans access to the same quality, affordable health insurance that members of Congress receive through a new health insurance exchange. Rather than instituting a government-run system, Obama’s proposal is based on choice and equal opportunity: if you have health insurance you like, you can keep it and your premiums will be lower. If you don’t have health insurance, you’ll be able to get it through a combination of public and private options.

In sharp contrast to Obama’s incremental approach, McCain takes a gamble with the nation’s health by eliminating federal subsidies for employer-sponsored health insurance and leaving individuals to buy health insurance on their own. Families will be given a $5,000 tax credit to buy health insurance on their own, but the average family health insurance costs $12,000. As many as one in four Americans with employer-sponsored health insurance are expected to lose their coverage, and this plan will do little to address the problem of the uninsured.

A similar divide between the candidates emerges in their approaches to improving the quality of health care. Obama would implement several common-sense regulations to support prevention and eliminate exclusions based on pre-existing conditions. McCain, however, would eliminate consumer protections that help people with chronic diseases like diabetes and cancer get the care they need. In McCain’s original health insurance proposal, he rather ominously likened his model for deregulation in health care to the deregulation of the banking industry.

Moreover, despite McCain’s attempt to smear Obama as a tax-and-spend liberal, Obama’s plan is a better investment economically. A recent estimate from the Lewin Group found that the McCain plan would cost more than $2.05 trillion over 10 years, while Obama’s plan would only cost $1.17 trillion over ten years and cover an estimated 30 million more people. Most importantly, the benefits of Obama’s plan are most likely to go to those who need them most.

Young adults are the age group most likely to be uninsured, they are the group that will have to pay for the rising costs of health care, and without a greater focus on prevention, it is predicted that people in our generation may not even live as long as our parents. Now is the time to get informed, get engaged and vote as if your health depends on it.

Robert Nelb is a first-year student at the School of Public Health and a 2008 graduate of Yale College.


By Elizabeth Moore

Many Americans are rightfully concerned about the state of health care. Costs continue to rise, and almost 50 million people are without any form of insurance. John McCain realizes that the current state of health care is unacceptable and believes that it is entirely possible to make care accessible to all. His plans to implement health-care reform will result in a system that is comprehensive, cost-efficient and beneficial to the greatest number of people.

McCain’s plan to reform health care is based on solid principles that will ensure the success of future changes, as well as their long-term sustainability. McCain believes in the affordability of health care, as maintained by a competitive market that will keep costs low and options diversified. He believes in investing in new research and technologies that will bring better services to patients, while also making treatment more effective and cost-efficient. He believes in the security that a stable insurance policy provides. Most importantly, he believes in allowing people to choose the coverage that best fits their needs and lifestyles.

While preserving the continued option of employer-based health-care coverage, McCain’s plan mainly seeks to provide tax credits to individuals and families to be used to purchase insurance of choice. This direct refundable tax credit (essentially cash) will offset the cost of insurance by $2,500 for individuals and $5,000 for families. If the cost of insurance is less than the value of the credit, people will have the options of using the leftover money to roll into Health Savings Accounts or pay themselves for routine procedures. In order to ensure that the traditionally uninsured are able to find care options in the independent market, McCain plans to work directly with state governors to develop guaranteed access plans that will create reasonable limits on premiums, as well as extra financial assistance for the most needy.

The bureaucratic status quo is one of the main contributors to the current skyrocketing health-care costs and general failure of the system. Nine states, for example, currently have over 50 mandated benefits that consumers must pay for. Many of these benefits are inapplicable to the majority of buyers, forcing people to pay for services they neither need nor want.

McCain’s plan will streamline costs and benefit more people, because they will be able to choose the exact options that suit them best. This in turn will encourage competition and diversification among health-care providers and ultimately allow for ever-improving services. These potential results are positive, unlike those associated with Barack Obama’s plan, which will exacerbate long-term costs, discourage competition and improvement through extreme regulation of the industry and, most detrimentally, dictate absolute government control over consumers’ health choices and needs.

McCain does not believe that he has the right to tell people how to care for themselves or their families. He believes in making health care accessible for all such that people are able to afford the care they want, need and deserve.

Elizabeth Moore is a senior in Jonathan Edwards College.