McCain is the best candidate with a healthcare reform plan to modernize healthcare. His plan emphasizes the individual, rather than the employer which Clinton and Obama's plan do. McCain's plan will work similarly to car insurance. Instead of seeking health insurance from your employer, you will be able to shop from whomever you like. This is good because it will increase competition from insurers, spark product innovation and enable the member to take personal responsibility for his/her health.
Although I believe these are the right steps to bring healthcare into the next generation, the plan will ultimately fail because individuals cannot take care of themselves. Moving away from employer based insurance would likely result in an upward enrollment trend of high deductible products and HSA's. Individuals would become cost conservative by saving on copays and out of pockets by seeing the doctor less often. This would create an unbalance and lead to adverse health effects, reversing the efforts of preventive care. Late detection would lead to increased catastrophic events and eventually higher costs.
McCain's approach will start out on the right foot but will deteoriate over time. I am a firm believer of consumerism and invidual choice. In fact, McCain's plan is perfect for me, someone who is self-reliant and well informed. However, for the average person with medical conditions and pain, I'm doubtful of their ability to make informed decisions.
So who should be responsible for managing care: doctors or members?
You can find more details about the McCain plan, summarized below.
Goal
- Provide access to affordable health care for all by paying only for quality health care, having insurance choices that are diverse and responsive to individual needs, and encouraging personal responsibility.
Approach
- Remove the favorable tax treatment of employer-sponsored insurance
- Provide a tax credit to all individuals and families
- Increase incentives for insurance coverage; promote insurance competition
- Contain costs through payment changes to providers (e.g. reform the payment systems in Medicare with a preventive focus)
Action Plan
- No mandate for coverage
- Reform the tax code to eliminate the bias toward employer-sponsored health insurance, and provide all individuals with a $2,500 tax credit ($5,000 for families) to increase incentives for insurance coverage
- Families should be able to purchase health insurance nationwide, across state lines, to maximize their choices, and heighten competition for their business that will eliminate excess overhead, administrative, and excessive compensation costs from the system
- Insurance should be innovative, moving from job to home, job to job, and providing multi-year coverage.
- Allow individuals to get insurance through any organization or association that they choose: employers, individual purchases, churches, professional association, and so forth.
- Give American Veterans the freedom to choose to carry their VA dollars to any provider
- Require any state receiving Medicaid to develop a financial "risk adjustment" bonus to high-cost and low-income families to supplement tax credits and Medicaid funds.
- Promote competition among providers by paying them only for quality and promote use of alternative providers
- Change provider payment to encourage coordinated care (e.g., pay a single bill for high quality heart care rather than individual services).
Impacts to the Member
- Increased consumerism, decision making and personal responsibility
- Lower premiums and increased cost savings
- New innovative products: multi-state, multi-year, job to job
- Better access to provider costs and outcomes data
- Decline in employers offering health benefits
- Lower utilization – good (reduce unnecessary visits) and bad (adverse health from late detection)
Impacts to Payers
- Payers with robust self-serve internet capabilities will thrive. Those with poor technology will play a “catch up” game and enter a downward membership spiral.
- IT will focus on building internet sites with new individual insurance capabilities.
- Product Developers/Managers will be pressured to invent new products geared to the individual while finding price balances with employer sponsored plans.
- Increased enrollment in high deductible and HSA products
- Phase out of self-funded products
Impacts to Providers
- Providers who do not communicate outcomes and cannot coordinate care will be adversely affected.
- Increased coordinated care that is outcomes focused (single payment)
- Increased price/cost transparency
- Shift to alternative providers (e.g. chiro)
- Providers will use more technology to communicate patient outcomes
- Providers will battle the new payment approach
