Comparing McCain and Obama on health care plans

WASHINGTON — About 45 million Americans have no health care coverage. Health care costs are growing much faster than the economy, accounting for 16 cents of every dollar spent in this country, twice as much as two decades ago.

And, despite spending far more than comparable industrialized nations on health care, the United States has above-average infant mortality, below-average life expectancy and the largest percentage of uninsured people, the non-partisan Government Accounting Office concluded in a January report.

"In short, our health care system is badly broken," the report states. "In fact, if there is one thing that could bankrupt America, it's runaway health care costs."

Presidential hopefuls Barack Obama and John McCain both want to address the problem - but they differ starkly in philosophy and strategy. In general, McCain seeks answers in the marketplace and Obama is searching for solutions through an expanded government role.

"They are two very different strategies for how we get affordable coverage," said Karen Davenport, director of health policy with the Center for American Progress, a progressive Washington think tank. "One is based on the idea that with greater purchasing power you can get better deals and drive down costs, and the other is based on the idea that individual consumers, if we're all out there shopping with our tax credits, will get better prices."

Here is a look at each candidate's approach.

MCCAIN

Key Positions

- Tax credit of $2,500 for individuals and $5,000 for families; cash would go directly to providers of health care insurance or into health care savings accounts

- Expand options for the use of medical benefits provided by the Veterans Administration

- Limit malpractice awards as a way to reduce insurance costs to doctors and hospitals

- Reduce state regulation of health care insurance to enable consumers to buy policies from a national market

- Require drug companies to publicize their costs and allow the importation of pharmaceuticals from Canada

- Establish a non-profit corporation to guarantee affordable insurance to patients who have been denied coverage by private providers

Cost

Not yet specified. It would cost roughly $450 billion a year, however, to provide $5,000 tax credits for each of the country's 75 million families and a $2,500 tax credit to each of the country's 30.5 million single heads of household (U.S. Census figures). McCain would pay for this in part by removing current tax breaks for businesses that provide health care insurance to employees. Access to health care coverage for all Americans, he contends, would result in additional savings in health care costs overall.

Record

Has spoken out against mandated health care coverage and in favor of importing pharmaceutical drugs from Canada. Voted against a 2007 Senate measure to expand federal health care coverage for children under the State Children's Health Insurance Program (SCHIP). The measure, which included a 61-cent increase in cigarette taxes, passed in the Senate 68-31 but was vetoed by President Bush.

In His Own Words

"We will offer every individual and family a large tax credit to buy their health care, so employers can spend more on wages, and workers don't lose their coverage when they change jobs ././. My plan attacks the real problems of health care - cost, availability and portability."

OBAMA

Key Positions

- Provide access to all uninsured Americans through a new federal insurance program with benefits similar to those provided to federal workers

- Create a National Health Insurance Exchange to help consumers and businesses buy private health insurance coverage at a group discount

- Require all employers to help workers pay for health care insurance

- Expand Medicaid and the State Children's Health Insurance Program (SCHIP) to cover more children, pregnant women, the disabled and the elderly.

- Spend $50 billion to help the health care industry shift to electronic records and upgrade information technology

- Allow children and young adults up to age 25 to remain covered by their parents' plan

Cost

An estimated $65 billion a year. Obama claims $100 billion a year is wasted by inefficient and poor quality care. Savings, he contends, would help offset costs, as would his plan for letting existing tax breaks expire for workers with incomes above $250,000 a year.

Record

As a state legislator, Obama sponsored legislation that expanded health care coverage to 70,000 children and 84,000 adults in Illinois. He co-sponsored the 2007 Senate measure to expand federal health care coverage for children under the State Children's Health Insurance Program (SCHIP). The measure, which included a 61-cent increase in cigarette taxes, passed in the Senate 68-31 but was vetoed by President Bush.

In His Own Words

"Every American has the right to affordable health care. I believe that millions of Americans who can't take their children to a doctor when they get sick have that right ././. And I believe that no amount of industry profiteering and lobbying should stand in the way of that right any longer."

Bob Deans' e-mail address is bobdeans@coxnews.com