"The Right Rx" By Senator John McCain

"I believe the key to real reform is to restore control
over our health-care system to the patients themselves. To that end, my reforms
are built on the pursuit of three goals: paying only for quality medical care,
having insurance choices that are diverse and responsive to individual needs,
and restoring our sense of personal responsibility." -- John McCain

"The Right Rx"By Sen. John McCain
National Review
May 1, 2008

What exactly is the problem with the American health-care system?

The problem is not that Americans don't have fine doctors, medical technology, and treatments. American medicine is the envy of the world. The problem is not that most Americans lack adequate health insurance. The vast majority of Americans have private insurance, and our government spends many billions each year to provide even more.

The biggest problem with the American health-care system is one of cost and access, and as a result tens of millions of individuals have no insurance. For example, we currently spend for about 2.4 trillion dollars a year on health care. A decade from now that number, under current projections, will double to over four trillion dollars.

The Obama and Clinton response to these problems is to promise universal coverage, whatever its cost, and the massive tax increases, mandates, and government regulation that it imposes. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We'll have all the problems, and more, of private health care -- rigid rules, long waits, and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

I have a different approach. I believe the key to real reform is to restore control over our health-care system to the patients themselves. To that end, my reforms are built on the pursuit of three goals: paying only for quality medical care, having insurance choices that are diverse and responsive to individual needs, and restoring our sense of personal responsibility.

American families know quality when they see it, so their dollars should be in their hands. When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices. Health Savings Accounts are tax-preferred accounts used to pay insurance premiums and other health costs. They put the family in charge of what they pay for, and should be expanded and encouraged.

Americans also need new choices beyond those offered in employment-based coverage. They want a reformed system so that wherever you go and wherever you work, your health plan goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn't cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. And if a church or professional organization wishes to sponsor insurance for its members, they should be able to do so. The bottom line: Health insurance would be yours and your family's health-care plan to keep without worrying that it will go away along with your job.

The value of that credit -- 2,500 dollars for individuals, 5,000 dollars for families -- would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again.

Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost. Again, choice and competition are indispensible to real reform that brings costs down and broadens access while maintaining quality.

But we also need to ensure that those without prior group coverage and with preexisting conditions, who have the most difficulty in the individual market, have access to the high-quality coverage they need. As with other problems our nation has faced, states have taken the lead in experimenting with ways to cover the "uninsurables" and give us a window into what works and what doesn't work. I will consult with the governors to solicit their ideas about a best practice model that states can follow -- a Guaranteed Access Plan or GAP -- and work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs. The details of a Guaranteed Access Plan would be worked out with the collaboration and consent of the states that wish to participate.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. Right now, there is a different health-insurance market for every state. Each one has its own rules and restrictions, and often guarantees inadequate competition among insurance companies. Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it. We need to break down these barriers to competition, innovation and excellence, with the goal of establishing a national market to make the best practices and lowest prices available to every person in every state.

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in web technology to allow a doctor to practice across state lines, then let them.

Effective reform must also deal with another source of needless cost and trouble in the health care system which comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform, and those reforms should eliminate lawsuits directed at doctors who follow clinical guidelines and adhere to patient safety protocols.

If Sen. Obama and Sen. Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers. They can't have it both ways.

Finally, we must personally do everything we can to prevent expensive, chronic diseases. Our rights in this country are protected by our personal sense of responsibility for our own well being. Cases of diabetes are going up, not only in the baby-boom generation, but among younger Americans obesity, diabetes, and high blood pressure are all on the rise. Parents must impart to their children a sense of personal responsibility for their health, nutrition, and exercise.

We can build a health care system that is more responsive to our needs and is delivered to more people at lower cost. The "solution," my friends, isn't a one-size-fits-all-big government takeover of health care. It resides where every important social advance has always resided -- with the American people themselves, with well-informed American families, making practical decisions to address their imperatives for better health and more secure prosperity.

Read The Full Op-Ed In National Review

WHAT THEY'RE SAYING ABOUT JOHN MCCAIN'S HEALTH CARE REFORM PLAN

McCain Plan "Could Lead To Some Of The Most Constructive Changes To The System In Decades":

The Wall Street Journal: "...John McCain Delivered Another Speech Yesterday On Health Care That Offered A Sophisticated Set Of Policies That Could Lead To Some Of The Most Constructive Changes To The System In Decades." (Editorial, "McCain's Progress," The Wall Street Journal, 4/30/08)

· Heritage Foundation: "McCain Has It Exactly Right With His Policy Proposal." "Sen. John McCain issued a call to action on health care reform today. Despite what some political pundits and liberal critics in the media claim, McCain has it exactly right with his policy proposal. The McCain plan would expand personal, portable private health insurance, not through government mandates or regulations handed down by Washington but by harnessing patient choice and private competition." ("The Right Call To Action On Health Care Reform," The Heritage Foundation's "Foundry" Blog, 4/29/08)

· Miami Herald: "McCain's Ideas For Lowering Healthcare Costs Have Long Been Advocated By Experts In The Field." "McCain's ideas for lowering healthcare costs -- including disease management and wellness programs -- have long been advocated by experts in the field." (John Dorschner, "McCain Offers High-Risk Plan," Miami Herald, 4/30/08)

· The New York Times: "McCain Detailed His Plan To Solve The Nation's Health Care Crisis." "Senator John McCain detailed his plan to solve the nation's health care crisis in a speech here Tuesday, calling for the federal government to give some money to states to help them cover people with illnesses who have been denied health insurance." (Michael Cooper And Kevin Sack, "Federal Money In Health Care Plan From McCain," The New York Times, 4/30/08)

· The Wall Street Journal: Tax Credit For Health Insurance "Most Sweeping Aspect Of His Plan." "The most sweeping aspect of his plan would eliminate a tax break on health insurance that only goes to those who get insurance from an employer and replace it with a refundable tax credit for anybody with insurance. The credit would be $2,500 per individual or $5,000 per family, a sum comparable to the existing tax break, and the proposal is intended to be budget neutral." (Laura Meckler, "McCain Pushes A Health-Care Plan With Less Regulation," The Wall Street Journal, 4/30/08)

· The Washington Post: "McCain's Belief In The Power Of The Free Market To Meet The Nation's Health-Care Needs Sets Up A Stark Choice For Voters This Fall In Terms Of The Care They Could Receive, The Role The Government Would Play And The Importance They Place On The Issue." (Michael D. Shear, "McCain Offers Market-Based Health Plan," The Washington Post, 4/30/08)

Investor's Business Daily: McCain Plan "Would Put Decisions About Medical Treatment Exactly Where It Should Be -- In The Hands Of Families." "While Sens. Hillary Clinton and Barack Obama are wed to a paternalistic health care system designed by out-of-touch lawmakers and administered by unaccountable bureaucrats, Sen. John McCain proposed Monday a plan that would put decisions about medical treatment exactly where it should be -- in the hands of families." (Editorial, "House Calls," Investor's Business Daily, 4/29/08)

· Business Week: "He Wants To Give Control Over The Health-Care System To Patients." (Catherine Arnst, "McCain's Health-Care Proposal," Business Week, 4/29/08)
The Associated Press: "McCain Wants Health Insurance Companies To Compete For Your Business" "Republican presidential candidate John McCain wants health insurance companies to compete for your business on the open market." (Libby Quaid, "McCain Seeks Tax Credit For Health Care," The Associated Press, 4/29/08)

· Business Week: McCain's Plan "Leans Heavily On Competition Rather Than Government Intervention." "Senator John McCain (R-Ariz.), the likely Republican Presidential nominee, stayed true to GOP principles Apr. 29 when he unveiled a health-care reform proposal that leans heavily on competition rather than government intervention." (Catherine Arnst, "McCain's Health-Care Proposal," Business Week, 4/29/08)

· Investor's Business Daily: "McCain Knows That If Choice Is Promoted Rather Than Curbed, The Power Of Markets And Competition Will Change The Health Care Industry For The Better." "Unlike the Democratic candidates who can't get beyond their devotion to increasing government authority, McCain knows that if choice is promoted rather than curbed, the power of markets and competition will change the health care industry for the better." (Editorial, "House Calls," Investor's Business Daily, 4/29/08)

· Reuters: McCain "CalledFor Greater Competition for Health Care Coverage For Americans." "Republican presidential candidate John McCain called on Tuesday for greater competition for health care coverage for Americans, saying more choices for insurance will drive down costs and improve the system." (John Whitesides, "McCain Pushes Choice As U.S. Health Care Fix," Reuters, 4/29/08)

· St. Petersburg Times: McCain Unveils Plan "That Would Focus On Consumer Choice And Preventive Medicine." "In the fight for the hearts and minds of middle-class voters, Sen. John McCain unveiled a health care overhaul that would focus on consumer choice and preventive medicine and avoid the government involvement proposed by his Democratic rivals." (Janet Zink, "McCain Offers Health Plan," St. Petersburg Times, 4/30/08)

· The Wall Street Journal: "McCain Aims To Introduce More Competition Into The System." "Sen. McCain aims to introduce more competition into the system, giving people more choice in insurance and the ability to keep it when they change jobs." (Laura Meckler, "McCain Pushes A Health-Care Plan With Less Regulation," The Wall Street Journal, 4/30/08)

USA Today: McCain Will Work "To Create Insurance Pools For People Who Have Trouble Getting Coverage." "John McCain said Tuesday he will work with states to create insurance pools for people who have trouble getting coverage because of pre-existing illnesses." (David Jackson, "McCain Health Plan Eyes 'Uninsurables,'" USA Today, 4/29/08)

Partnership To Fight Chronic Disease Executive Director Ken Thorpe: "Sen. McCain Is Right To Focus His Attention On The Rising Cost Of Health Care And We Applaud His Attention To The Role That Chronic Disease Plays In This Problem." (Partnership To Fight Chronic Disease, "PFCD Responds to Sen. McCain's Speech on Health Care," Press Release, 4/29/08)

McCain "Has Stark Differences With The Democratic Candidates":

The New York Times: Health Care "An Area Where [McCain] Has Stark Differences With The Democratic Candidates." "Senator John McCain plans to offer more details here Tuesday about how his health care plan would work for people with pre-existing health problems, an area where he has stark differences with the Democratic candidate." (Michael Cooper, "McCain's Health Care Plan," The New York Times' "Caucus Blog," 4/29/08)

Business Week: McCain Plan "Contrast Sharply With" The Democrats. "The plan contrasts sharply with those proposed by the Democratic candidates, Senator Hillary Clinton (D-N.Y.) and Senator Barack Obama (D-Ill.)." (Catherine Arnst, "McCain's Health-Care Proposal," Business Week, 4/29/08)

CNN: "McCain's Free Market Approach To Health Care Reform Is Very Different" From The Democrats. "McCain's free market approach to health care reform is very different from the proposals offered by the Democratic presidential candidates, Sens. Barack Obama and Hillary Clinton. Both of their proposals include more government mandates for health care coverage." (Scott J. Anderson, "Tax Credits At Heart Of McCain's Health Care Proposal," CNN, 4/29/08)

CNN's Dana Bash: "John McCain Made Clear One Of His Most Dramatic Differences With Democrats Who Want To Mandate Insurance Coverage." (CNN's "Lou Dobbs Tonight," 4/29/08)
Fox News' Brit Hume: "And John McCain Talks Health Care, Showing Sharp Differences With The Democratic Candidates." (Fox News' "Special Report," 4/29/08)

St. Petersburg Times: McCain "Railed Against Government-Run Universal Health Care." "McCain, the presumptive Republican presidential nominee, railed against government-run universal health care, saying it would have the same 'inefficiency, irrationality and uncontrolled costs' as the current system." (Janet Zink, "McCain Offers Health Plan," St. Petersburg Times, 4/30/08)

The Wall Street Journal: McCain Rejected Universal Health Care And Embraced A System With Fewer Regulations. "Sen. John McCain laid out his vision for the U.S. health-care system Tuesday, rejecting universal health insurance and embracing a system with fewer regulations in which consumers shop for coverage on their own rather than get it from an employer." (Laura Meckler, "McCain Pushes A Health-Care Plan With Less Regulation," The Wall Street Journal, 4/30/08)

The Wall Street Journal: "McCain Is Preparing To Frontally Assault Liberal Health-Care Assumptions." "It's true that individual subsidies might be required for some people with severe chronic illnesses who might have a harder time finding private insurance in this kind of world. So Mr. McCain sharpened his proposal for high-risk pools to cover 'uninsurables,' building on current insurance experiments in about two dozen states. Such provisions are crucial to a functioning market but also blunt a political liability that Democrats were eager to exploit in the fall's debates, suggesting that Mr. McCain is preparing to frontally assault liberal health-care assumptions." (Editorial, "McCain's Progress," The Wall Street Journal, 4/30/08)

The Wall Street Journal: "It Also Energizes The Intellectual Progress Conservatives Have Made In Recent Years In Their Health-Care Thinking." (Editorial, "McCain's Progress," The Wall Street Journal, 4/30/08)

In The Headlines:

The Associated Press: "McCain Seeks Tax Credit For Health Care" (Libby Quaid, "McCain Seeks Tax Credit For Health Care," The Associated Press, 4/29/08)

The Atlantic: "McCain's Health Care Plan: It's About You" (Marc Ambinder, "McCain's Health Care Plan: It's About You," The Atlantic, 4/29/08)

Bloomberg: "McCain Favors Aid For People Denied Health Coverage" (Aliza Marcus And Hans Nichols, "McCain Favors Aid For People Denied Health Coverage," Bloomberg, 4/29/08)

CBS News: "McCain Proposes Guaranteed Access Health Plan For 'Uninsurables'" (Andante Higgins, "McCain Proposes Guaranteed Access Health Plan For 'Uninsurables,'" CBS' "From The Road" Blog, 4/29/08)

CNN: "McCain Health Care Plan Emphasizes Personal Responsibility" ("McCain Health Care Plan Emphasizes Personal Responsibility," CNN, 4/29/08)

CNN: "Tax Credits At Heart Of McCain's Health Care Proposal" (Scott J. Anderson, "Tax Credits At Heart Of McCain's Health Care Proposal," CNN, 4/29/08)

Congressional Quarterly: "McCain Relying On Tax Credits To Fuel Wider Coverage, Competition" (John Reichard And Leah Nylen, "McCain Relying On Tax Credits To Fuel Wider Coverage, Competition," Congressional Quarterly, 4/29/08)

Fox News: "McCain's Cure For An Ailing Health Insurance System" (Mosheh Oinounou, "McCain's Cure For An Ailing Health Insurance System," Fox News, 4/29/08)

Heritage Foundation: "The Right Call To Action On Health Care Reform"("The Right Call To Action On Health Care Reform," The Heritage Foundation's "Foundry" Blog, 4/29/08)

The Miami Herald: "In Florida, McCain Focuses On Healthcare" (Beth Reinhard, "In Florida, McCain Focuses On Healthcare," Miami Herald, 4/29/08)

The Miami Herald: "McCain Pushes Tax Credits, Healthcare Reform" (John Dorschner, "McCain Pushes Tax Credits, Healthcare Reforms," The Miami Herald, 4/29/08)

The Miami Herald: "McCain Offers High-Risk Plan" (John Dorschner, "McCain Offers High-Risk Plan," Miami Herald, 4/30/08)

Pittsburgh Post-Gazette: "McCain Outlines His Health Care Plan" (Joe Fahy, "McCain Outlines His Health Care Plan," Pittsburgh Post-Gazette, 4/30/08)

Politico: "McCain Moves To Middle On Health Care" (Mike Allen And Jonathan Martin, "McCain Moves To Middle On Health Care," Politico, 4/29/08)

Reuters: "McCain Pushes Choice As U.S. Health Care Fix" (John Whitesides, "McCain Pushes Choice As U.S. Health Care Fix," Reuters, 4/29/08)

St. Petersburg Times: "McCain Offers Health Plan" (Janet Zink, "McCain Offers Health Plan," St. Petersburg Times, 4/30/08)

The Tampa Tribune: "McCain Health Care Plan: Tax Credits For Insurance" (William March, "McCain Health Care Plan: Tax Credits For Insurance," The Tampa Tribune, 4/30/08)

USA Today: "McCain Health Plan Eyes 'Uninsurables'" (David Jackson, "McCain Health Plan Eyes 'Uninsurables,'" USA Today, 4/29/08)

USA Today: "McCain Would 'Put Families In Charge' Of Health Care" (David Jackson, "McCain Would 'Put Families In Charge' Of Health Care," USA Today, 4/29/08)

The Wall Street Journal: "McCain's Progress"(Editorial, "McCain's Progress," The Wall Street Journal, 4/30/08)

The Wall Street Journal: "McCain Pushes A Health-Care Plan With Less Regulation"(Laura Meckler, "McCain Pushes A Health-Care Plan With Less Regulation," The Wall Street Journal, 4/30/08)

The Washington Post: "McCain Offers Market-Based Health Plan" (Michael D. Shear, "McCain Offers Market-Based Health Plan," The Washington Post, 4/30/08)