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Momma said wonk you out

PRESCRIPTION.

Another health care ad from the Obama campaign. As I said earlier, I'm not sure what any of this does for their proposal, but as an attack, it's confident and effective.

More than that, it understates the case against McCain's health care plan. In year one, you'll have to pay that tax, and the tax credit will roughly offset it. But the tax credit grows with inflation. Health spending grows much more quickly. By year five, your tax credit will have shrunk. Sharply. But health spending will be up, and so your tax increase will have expanded. Substantially. With every passing year, you pay more in taxes and receive less from the tax credit. The plan's savings -- minimal already -- are frontloaded and its costs are delayed. It's a pretty dirty trick.

Meanwhile, you'll be on the individual market. Where the insurance is worse, and more expensive. It's really quite amazing. McCain has managed to build a health care plan that's a bad deal from a medical standpoint, an insurance standpoint, a cost standpoint, and a tax standpoint. Even insurers don't really win, because patient dissatisfaction with the individual market will almost certainly hasten real reforms. It is, as far as I can tell, a lose-lose-lose-lose-lose health care plan. A rare feat. For more on the tax side of this, though, see my post from the weekend.



COMMENTS

It's really quite amazing. McCain has managed to build a health care plan that's a bad deal from a medical standpoint, an insurance standpoint, a cost standpoint, and a tax standpoint.
Which means that as this is pointed out to the voters, John McCain has built himself a health care plan that's bad from a political standpoint.

Thus, the attacks.

... patient dissatisfaction with the individual market will almost certainly hasten real reforms.

"John McCain's plan will lead to real healthcare reform!"

I think the approach on all of these health care attack ads are wrong. Blah, blah, blah, it's expensive and a tax hike and blah.

John McCain's plan will take away whatever insurance you have no. You will no longer have insurance from your employer.

That's really scary for a lot of people. Everyone is so used to employer=insurance that anything affecting that is really quite radical (in either direction). But if you want to attack McCain's plan, the way to do it is to not talk about how it will raise your taxes, because in most cases it won't. In most cases, employers simply won't offer a company plan for health insurance. That's really all you need to say to sink his plan, and it has the virtue of being true.

Are you sure the credit applies towards the Federal income, Social Security and state income taxes that John McCain thinks I should owe? Even if it did, it wouldn't cover the taxes on my combined medical, dental, pharmacy and vision coverage. However, I don't think the credit does apply towards the tax. The credit is for the self insured, for whom it REALLY won't cover the cost.

Klein,

As someone on the individual market (for my family of five), and I can tell you, once again, your view is gibberish.

It saved me money to end my employer-provided plan, in terms of monthly costs, and go directly with, in our case, Humana (Humana One Autograph).

It saved me money to have the difference between the two (employer vs individual) deposited into an HSA.

It will be tax advantageous when I file my taxes each year to do all this.

Do I want more competition for my family's insurance dollars?

Yes, so I'm voting McCain.

Do I want other people to be paying the same taxes on the money they use for insurance, as I do?

Yes, so I'm voting McCain.

Do I want flexibility, adaptability, and job-portability?

Yes, so I'm voting McCain.

Try getting your facts right. First steps, stop playing video games, get yourself some actual responsibility (i.e., family, mortgage).

Next steps, stop being a demagogic stooge.

Oh, wait, I forgot: you are paid to be one. Then never mind.

But at least try to get your facts correct.

Why does Ezra write "you'll be on the individual market"? McCain's proposal affects the tax treatment of insurance from the perspective of workers, not employers, right? If company XYZ spends, say, $11,000 per employee in order to attract and retain high quality talent under the status quo, why would this change under McCain's proposal? Anybody know?

"Even insurers don't really win, because patient dissatisfaction with the individual market will almost certainly hasten real reforms"

Hmmm... maybe that's not a bad idea. Perhaps we need real pain and destruction before we can agree on real reform.

I don't know what world you're living in, Matthew, but I have also experienced both insurance through an employer and buying my own individual policy--and it was literally 5 times more expensive to buy individual health care. And I don't even have a "pre-existing condition" or a chronic disease to make it more difficult to get coverage. McCain's plan is nothing short of insane from a purely logical perspective, but personal experience tells me it's insane, as well.

Policy Wonk: Employers will stop offering health insurance because under McCain's plan, they will no longer be able to deduct the portion of your premium they pay from their taxes. This will hugely increase their cost to provide health insurance, so most will stop.


Matthew: I don't know what kind of craptastic insurance your employer gave you, but I pay $280 per month to insure a family of six with excellent coverage. On the individual market that would cost several times as much--I've checked. But I won't be able to insure my family on the individual market at any price because three of us have pre-existing conditions.

Steve: I just spent an hour googling. In fact employers would continue to be able to treat health insurance costs as a fully deductible business expense under McCain's plan. The decline in employer-provided coverage would result from the effects on the insurance market likely to flow from the tax and regulatory changes proposed by McCain . To oversimplify somewhat, buying health insurance for workers would be a less effective means of attracting and retaining talent, largely because the removal of the tax exemption currently enjoyed by workers would make employer-paid premiums less valuable to those same workers. Firms will spend less on something if that something is less effective than it used to be.

Enough McCain!

Let's get back to the Obama love...

http://www.youtube.com/watch?v=fLprurE7EVI

"It saved me money to end my employer-provided plan"

Um, do you really need to be told that an anecdote is not data? Even assuming that what you write is true, it's supremely silly to generalize from your specific case to the market at large.

Sheesh.... Can we get some smarter monkeys, please?

Again, I point out that this plan does not address the widespread discrimination against people with chronic or rare diseases who are now (legally) deemed an uninsurable underclass undeserving of health care. Passage of the recent GINA (Genetic Information Non-discrimination Act) legislation made it illegal to discriminate against disorders recognized as genetic, but it is still perfectly LEGAL for insurance companies to discriminate against all others, both with exorbitant premiums or outright denials of service. I don't feel that either candidate has adequately addressed this (with all due respect to the Obama supporter in the other thread, he has not provided sufficient detail to assure me that the insurance lobby won't be manipulating the rules under his plan). McCain's plan is a joke and anyone who believes that buying private insurance is less expensive than employer-subsidized plans ((if you can even get it with pre-existing conditions) is either outright lying or purchased a private policy that is the equivalent of swampland in LA. I realize the point of the post was to shill for a candidate and not to present factual info, but still wish him good luck if he should ever actually have to collect in any meaningful way on his "bargain basement" policy. Pretty devestating to get what you paid for when it is one of your family members who requires serious medical attention.

Again, I point out that this plan does not address the widespread discrimination against people with chronic or rare diseases who are now (legally) deemed an uninsurable underclass undeserving of health care. Passage of the recent GINA (Genetic Information Non-discrimination Act) legislation made it illegal to discriminate against disorders recognized as genetic, but it is still perfectly LEGAL for insurance companies to discriminate against all others, both with exorbitant premiums or outright denials of service. I don't feel that either candidate has adequately addressed this (with all due respect to the Obama supporter in the other thread, he has not provided sufficient detail to assure me that the insurance lobby won't be manipulating the rules under his plan). McCain's plan is a joke and anyone who believes that buying private insurance is less expensive than employer-subsidized plans ((if you can even get it with pre-existing conditions) is either outright lying or purchased a private policy that is the equivalent of swampland in LA. I realize the point of the post was to shill for a candidate and not to present factual info, but still wish him good luck if he should ever actually have to collect in any meaningful way on his "bargain basement" policy. Pretty devestating to get what you paid for when it is one of your family members who requires serious medical attention.

Who to make the fool first;

PaulB allow me, using actual rating tables from the largest carriers in a couple western states, to inform you that a healthy individual under 35-40 pays considerably less for individual insurance then group. I could get into the actuarial underpinnings of this but your ignorant monkey ass wouldn’t understand a word. Go play with your banana.

Steve, naïve lil boy, you might pay $280 a month to insure 6 put your also losing out on $9000 a year of pay you would otherwise receive if your employer didn’t provide insurance. In regards to your any price comment I feel sorry for your family, having a dolt as head of house hold must make life tuff. You start your “story” by saying you are insured at work, if your not making that up then you are protected by a little Federal law called HIPAA. Since you obviously can’t read ask someone to tell you how it guarantees you and your family can purchase individual insurance no matter your pre-existing conditions as long as you don’t have a substantial gap in coverage. If you go to anther employer plan and don’t have the 60 day gap they can’t apply pre-ex to you either. When you tell lies like this do you expect to get away with them?

14All I’ll call BS on your story. You either don’t know how to price insurance or aren’t including the true cost from your employer.

Michele how ironic a comment void of facts and honesty degrades others for a lack of honesty. Do I need to spell HIPAA for you to get a clue and look it up? Look at a rating table I an sell top quality individuals plans to 20 year old males for under $100 a month. That alone proves you are a LIAR!

Nate dear, your assuming you would see the first dollar of money your employer saved leads me to believe that you live in some obscure dreamworld.

Eli knows a lot of formerly 20 year old folk, who bought private individual insurance who are now stuck with it and the associated premiums for 40 year olds. In other words don't confuse the teaser rate with the balloon payment.

Insurance is a BUSINESS. as soon as you start looking at it as some preconceived Right we all are to have you lose objectivity.
#1- all of you who compare the cost of your group plan through work to an individual plan dont know what you are talkig about. your employer covers AT LEAST 75% of premium by law. so if you are paying $280/mo the actual cost is probably over $1000! think COBRA-- how any people do you know that say how HIGH the rates are? the law says you can keep your healthcare for up to 18months but your employer no longer has to contribute. NOW compare individual to group rates!
#2- pre-existing conditions.
if i get in an accident in my car and THEN run down to Allstate and get a policy on that car, what are they going to say when i submit the claim for the accident?
a fire breaks out in my house and does substatial damage. I THEN run down to State Farm and put home owners on my house. how much money will i get from them on the fire claim??
obviously, the answer to both of these examples is ZERO!
however, when I have a heart attack and THEN decide that i want health insurance, the insurance company is the bad guy for turning me down??
the reason individual plans are less expensive is SELECTIVE RISK!!
you want to see high rates?? FORCE the insurance companies to HAVE to take everyone...they Must raise premiums to cover the claims..Oh, and since Obama will be paying for them with YOUR tax dollars...hmmmm???
also, by the way, most states alrady HAVE a high risk pool insurance available to those who have been DECLINED by mainstream insurance carriers.

if your not making that up then you are protected by a little Federal law called HIPAA.

Our illiterate parasite is no better than George W. 'you can get universal healthcare at an emergency room' Bush.

He's like MRSA, without the charm.

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About Ezra Klein

Ezra Klein is an associate editor at The American Prospect. An archive of his articles for The American Prospect can be found here.

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