John McCain
proposed an overhaul of the nation's health care system
Thursday, aiming to give people more control, encourage
greater competition and lower costs.
The Republican
presidential candidate's plan contrasts sharply with his
Democratic rivals' proposals.
He focuses on
expanding access for individuals and families but would not
require people to carry health insurance. To varying
degrees, Democrats want to make health coverage
mandatory.
''The solution,
my friends, isn't a one-size-fits-all, big-government
takeover of health care,'' he told the Rotary Club of Des
Moines. ''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.''
He said of the
Democrats, ''They promise universal coverage, whatever its
cost, and the massive tax increases, mandates, and
government regulation that it imposes.''
His proposal
emphasizes payment only for quality medical care, and he
challenges doctors to do a better job managing care,
hospitals to operate more efficiently, pharmaceutical
companies to come up with better drugs, and insurance
companies to spend more on treatment and less on
administrative costs.
McCain added that
Americans must work to protect their own health and the
health of their children, doing ''everything we can to
prevent expensive chronic disease.''
His plan calls
for:
- Allowing people
to buy health insurance nationwide instead of limiting
them to in-state companies, and permitting people to buy
insurance through any organization or association they
choose as well as through their employers or directly
from an insurance company.
-Providing tax
credits of $2,500 to individuals and $5,000 to families as
an incentive to help them buy insurance. All people would
get the tax credit, even if they get insurance through
work or buy it on their own.
- Supporting
different methods of delivering care, including walk-in
clinics in retail outlets across the country and developing
routes for cheaper generic versions of drugs to enter
the U.S. market, including allowing for safe
importation of drugs.
Aides
acknowledged the plan would take time to implement because
of its scope. They billed it as a vision for change he
would work toward if elected.
''We don't know
the cost,'' McCain said. ''We expect there to be dramatic
reductions in costs.'' He said economic models including
choice-in-competition always show savings.
Aides said to
help pay for the overhaul McCain would end a provision in
the tax code that lets employers deduct the cost of health
care from their taxable earnings. Additionally, they
said, passing lawsuit limits to eliminate frivolous
lawsuits and excessive damage awards would help reduce
costs.
''He's going a
couple steps down the right path, difficult steps, and I
applaud him, but he's not quite gotten there,'' said
Laurence Kotlikoff, an economics professor at Boston
University who has consulted with both Republicans and
Democrats on health care policy.
Kotlikoff said
the amount of the tax credit should be tailored to each
individual based on that person's personal health
circumstances.
''I give him a B
or B-plus on this'' _ better than the grades he said he
would give to McCain's GOP rivals.
Mitt Romney wants
the government to help states lower premiums by
deregulating their insurance industries. He has distanced
himself from a 2006 law he signed as Massachusetts
governor that requires all residents to get coverage.
He says states should be free to craft the specifics of
their own programs.
Rudy Giuliani,
the former New York mayor, proposes an income tax
deduction of $7,500 per taxpayer to defray insurance costs
and a tax credit for poorer workers to supplement
Medicaid and employer contributions as part of
''market-driven'' expansion of affordable coverage.
Fred Thompson,
the former Tennessee senator, has not offered a plan.
Among Democrats,
front-runner Hillary Rodham Clinton has proposed
universal health care and called for a requirement for
businesses to obtain insurance for employees. Former
North Carolina Sen. John Edwards is seeking to achieve
mandatory universal coverage by 2012, while Illinois
Sen. Barack Obama is pushing for employers to share costs of
insuring workers and ensure that all children are covered.
(AP)