The nation’s economic turmoil has raised the stakes for healthcare reform even higher. Job loss will mean health insurance loss for many Americans. They will join almost 47 million others who have no access to coverage.
“The state of healthcare and the state of the economy are inexorably linked,” said Dr. Robert I. Field, chair of the Department of Health Policy and Public Health at University of the Sciences in Philadelphia
. “Over 12 million American jobs are connected to healthcare. With fewer people insured and government cutbacks likely, there will be less money in the system, which undermines a major engine of economic growth.”
Dr. Field is author of Health Care Regulation in America: Complexity, Confrontation and Compromise
, a comprehensive overview of government healthcare regulatory policy.
“When the healthcare industry ‘catches a cold,’ communities throughout the country get ‘pneumonia,’” he added. “If healthcare gets ‘pneumonia,’ it’s anyone’s guess where it could lead.”
The major presidential candidates have different views of how to reform American healthcare. However, under either Barack Obama or John McCain, the pressures for reform are likely to increase due to a growing number of uninsured, while the funds available to effectuate it are likely to shrink. Therefore, healthcare reform promises to be a major concern for the next administration.
In some respects, the two plans are not as different as they may seem according to Richard Stefanacci, founding executive director of the geriatric health program at University of the Sciences.
“In a comparison of the presidential campaigns, while there are many differentiating factors between the two proposals, there is also some common ground,” said Dr. Stefanacci, who serves as editor for Medicare Patient Management and Assisted Living Consult. “Regarding the common ground, both presidential proposals include investment in the use of technology, preventive care and primary care in an effort to decrease utilization while improving quality.
“Of course, there are several differences which follow a philosophical line of one campaign favoring the use of managed care plans versus a focus on governmental fee-for-service programming.”
Senator Obama proposes to expand the current system of employment-based coverage, with a mandate on most employers to offer insurance. Those without access to an employment-based policy would be permitted to purchase one through a government-mediated insurance exchange with subsidies for those with low incomes. However, critics warn that these subsidies could be extremely expensive. (The full Obama plan is available at www.barackobama.com/issues/healthcare/
Senator McCain would encourage coverage through the individual market rather than through employment. He would eliminate the favored tax treatment of employer-paid premiums and replace it with a tax credit of $5,000 per family that could be applied to an individual policy. However, critics warn that the private market may not be able to accommodate the new demand, and the tax credits could be expensive. (The full McCain plan is available at http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm
“In the short run, any changes are likely to be incremental,” commented Dr. Field. “The next president will have his hands too full with other emergencies to tackle an issue as sensitive and complex as health reform. However, looking down the road, we may have the next major government bail-out staring us in the face.”