National Nurses United

NewsBriefs:FINAL 3 (No Notice) 8/21/08 8:59 PM Page 4 NewsBriefs What's at Stake in November on Healthcare B Sen. John McCain sen. mccain's healthcare philosophy looks a lot like the Bush administration's with its commitment to expanding the commercialization of healthcare, antipathy to public pro4 REGISTERED NURSE grams and regulation, and shifting of more of the financial costs and health risks from insurers and employers to families and individuals. First, he wants to eliminate the tax deduction for employer-sponsored coverage. For working individuals, the result would be higher taxes. For employers, it would make health benefits far less attractive, meaning the current decline of employer-based plans would become an avalanche as more businesses drop health benefits or sharply reduce them. The carrot McCain offers for those who lose employer coverage is a new tax credit that is, however, less than half the $12,000 current annual family average cost for private insurance premiums. McCain understands he will be pushing more people into the individual insurance market but, he argues, that would "force companies to respond with better service at lower cost." That's not, however, how the insurance market works. Insurers don't compete by lowering premiums or improving service. They compete by cutting their own costs by denying claims, cycling people into plans with higher out-of-pocket costs or fewer covered services, rejecting people with preexisting conditions, and dumping enrollees when they get sick. McCain's rhetoric about "putting individuals and families back in charge" in an unregulated market while undermining employer-based coverage and refusing to rein in the monopolistic practices of the giant insurers could make the current healthcare crisis worse. The potential consequences can be seen in recent data that emergency room visits W W W. C A L N U R S E S . O R G have increased by 32 percent this decade, mainly among those with insurance who can't get primary care appointments, along with a sharp increase in ER waiting times. Under the McCain approach, those numbers would likely soar, accelerating both healthcare costs and a faster spread of communicable diseases. It would also accelerate the growing divide in healthcare between the haves and have-nots, cementing the concept that you are entitled to all the care you can pay for. Deregulating Public Protections another way mccain says he'd cut costs is allowing insurers to sell policies "across state lines" bypassing existing protections that a number of states have established to set minimum standards in quality and benefits. Healthcare deregulation, however, has had the opposite effect on costs, facilitating massive mergers and the creation of large monopolies that have engaged in a frenzy of price hikes and profit taking while undermining basic standards. How would the regulation-averse McCain punish insurers that deny coverage or drop sick people? He wouldn't. Instead, McCain proposes to expand federal support for state "high-risk pools" that contract with private insurers. But those state plans are largely a failure, as the New York Times and the New Republic have reported. Almost all impose long waiting periods, up to a year, before allowing you to enroll, and give the insurers leeway to charge on average twice as much for coverage. And McCain J U LY | A U G U S T 2 0 0 8 OBAMA: ALLISON HARGER; MCCAIN: MARCN y almost any barometer, the past eight years have been a healthcare disaster. Premiums for families obtaining their health coverage through employers have shot up 10 times faster than workers' incomes. One-fifth of the respondents to a national survey said they'd gone without needed medical treatment the past year, a huge jump from the early years of the Bush administration, with the biggest rate of increase among those with insurance. More than 75 million adults, 42 percent of those ages 19 to 64, were uninsured or underinsured in 2007, up from 35 percent in 2003. That's just cost and access. No less severe is the suffering of people with insurance who have been denied procedures, barred access to diagnostic tests or specialists, excluded from buying policies because of a preexisting condition, or dropped when they got sick. All of which makes the November election especially critical. While neither of the two major presidential candidates supports the only reform that will solve the healthcare crisis—a single-payer, expanded, and improved Medicare-for-all approach—there are important policy differences between the two on both healthcare and its closely related partner, Social Security.

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