So Romney can’t offer a credible alternative to the Affordable Care Act, since ObamaCare is based on RomneyCare. But there is a viable alternative that was proposed by John McCain, who beat Romney for the nomination in 2008 with this plan.
People were up in arms against McCain about how his plan would “tax healthcare” because it would treat employer health insurance contributions as taxable income, which they totally are.
But we can see now that McCain’s plan was way more honest about calling a tax a tax, and then spending to provide for the general welfare, by giving everyone a refundable tax credit to use with a regulated insurer on the national market, to buy as much insurance as they wanted, from a minimum level of treating common diseases and injuries at an ethical standard of care, without subsidizing abortion or contraception or sex change operations, to choosing a Cadillac plan with expectations of extraordinary care like organ transplants, aromatherapy, gym membership, and discretionary non-medical benefits like sex change surgery, contraception, pregnancy care, and other things only some people want and other people think should not be subsidized or even allowed.
McCain’s plan also would have smoothly moved people to individual plans and allowed businesses to drop coverage and focus on their business, without screwing over their workers, who would all smoothly transition to individual plans for no cost. Warren knows that businesses are burdened by the present system, that was the main reason she advocated for Single Payer. But McCain’s plan accomplishes that without mandating coverage or moving to single payer, just by offering these individual plans to everyone free of charge and automatically.
McCain should re-introduce his bill, he’s still a Senator. His bill was and is better, less coercive and offensive and expensive. Maybe Palin will pick him to be her running mate.
Palin was not the reason why I voted for Obama, it was McCain’s proposal to tax health care coverage by your employer as income!!!! You reminded me of this terrible idea, but my guess is it will be phased in anyway. I did not see the insurance coverage value on my 2011 W-2, will it be on the 2012?
Making it tax free was what led us into this mess. It never should have been tax free, it is income. It was the best plan to phase out employer provided health care and everyone on portable individual plans. Eventually it’d be financed by regular tax revenue of course, when there are no more employer-provided plans to be taxed.
Does that go for public employees as well? I think Part of the h/c mess is requiring hospitals to provide care for anyone, regardless of their ability to pay.
Yeah, their health insurance would be taxed as income too, just like private employees. And they’d all be in the same marketplace for individual plans if they choose to forgo the plan offered by the state or school district or whoever. And soon schools and cities and towns won’t have to be burdened with providing a health insurance plan to anyone.
What you fail to mention here is the actual dollar cost of the new taxes and the actual dollar value of the proposed tax credits. Let’s look at a the impact of McCain’s plan on a typical family:
An average yearly preimum for family coverage is about $12,000 with about 75% paid by the employer. If the employer continued to provide coverage, the average marginal tax rate is 25%, so they would face a tax increase of $2250. And still have to pay their share of the premium (another $2250).
But let’s say your dream comes true and the McCain program “encourages” your employer to drop your family’s coverage. So, now, you “get” to buy your own $12,000 plan “with” your $5,000 maximum tax credit. New annual cost of $7,000. An increase of $4,750 over your current cost for your share of employer-sponsored health care.
The numbers work out similarly for individuals.
McCain’s plan is unworkable, expensive and designed to destroy rather thatn build upon the employer-sponsored health care system that has served us fairly well.
Yes, people’s taxes would go up as they started to have to pay tax on that part of their compensation. The higher the value of their plan and the higher their tax bracket, the more they’d have to pay, while people with low-cost plans in low-paying jobs in the lower brackets would pay less. I never said everyone’s taxes would go down, but it’d mainly be the rich who felt a change in their taxes, the poor would be less affected. It’s just fair, rich people should pay for their compensation. Expensive plans shouldn’t be tax havens, they drive up the cost for everyone just to benefit the 1%. Pay income tax on your income.
And then people would have viable options once they start receiving their compensation entirely in cash, instead of in cash and health insurance. Their paychecks would increase by the amount of the employer contribution when they opt out of it, and they would take it to buy a much cheaper plan on the national market that suits them.
It hasn’t served us well, it has driven up health care costs and been a huge burden on employers and limits the freedom of the market. It is a cost sink that can’t be justified.
McCain’s plan is indeed designed to slowly replace employer-provided health insurance. So is Single-Payer. That’s something McCain and Warren have in common, slowly destroying employer-provided insurance. It’s bad and shouldn’t be defended. The difference is McCain’s plan gives people the money to go out and buy basic coverage they want from private insurers, keeping the basic system in place, while SinglePayer forces everyone to buy a giant expensive plan that includes huge blank checks to big pharma and radical extraordinary coverage. I’d accept a merger, a Single Payer/Public Option that only covered the bare minimum of expected care, and let people buy supplemtal insurance if they think they might ever want a heart transplant or gym membership.
Typically conservatives, traditionally anyway, favored the most simple and easy to execute plan of action that allowed gradual changes to improve society without destroying the pillars that society rested on. Think Burke or Disraeli or even Smith. Smith argued that health care was one of the few areas where government had a natural monopoly since there couldn’t be a market to allow for it since it was based on need rather than self interest and was unpredictable by the laissez faire model. While Burke and Disraeli never talked about health care both would argue its better to keep society together than to allow large quantities of the sick to go untreated. Single payer remains the simplest, most cost-effective and easiest way to ensure that everyone has equal access to high quality care. Supplementing a strong public system with private specialists would remove most of the glaring weaknesses in the Canadian model which is also more doctor friendly and efficient than the British model. Conservatives up north and across the pond have preserved and modified this program recognizing destroying it would be a disaster.
Republicans can come up with many different plans to keep their precious friends in the industry happy and the mandate was about the only way to preserve the HMO cartels (its not a free market people) while ensuring universal coverage. Any mandate-free alternative that preserves private insurance is bound to escalate costs and be less efficient than the status quo or single payer. Considering modern conservatives refer to themselves as liberals mugged by reality it seems that on this issue, and a few others (drugs, immigration, and climate change) they seem to be dogmatic ideologues that would make a Marxist blush.
It appears to me that modern conservatives are just paid shills doing homage to their paymasters. Even the pretense of intellectual honesty or integrity is long gone (see Eric Fehrnstrom).
These paid shills oppose ANYTHING that might help Barack Obama, no matter what the consequence. This is why attempting any sort of dialog or reconciliation is so futile. We’ve reached the point where the fact that Barack Obama and Mitt Romney agree that the ACA imposes a “penalty” rather than a “tax” is front page news.
I would say the mandate serves the paymasters by forcing Americans to buy a private product, opposing any change seems to me to be more about meeting the deranged purity tests if the Tea Party than anything else.
“The difference is McCain’s plan gives people the money to go out and buy basic coverage they want from private insurers, keeping the basic system in place, while SinglePayer forces everyone to buy a giant expensive plan that includes huge blank checks to big pharma and radical extraordinary coverage.”
Sending people as individuals onto a private insurance market is a great way to make sure that people get hosed. The case that single payer will be ‘giant expensive’ doesn’t stand up to scrutiny. Every place that has put together a single payer system has done so with much more efficiency than our current system (by orders of magnitude almost). Moreover, the single payer system that we already have in place (medicare) is currently more efficient than the private system, which is amazing when you consider the relative health of the participating pool of people in medicare. If medicare can do so well with that pool of people – medicare for all will only do better.
Even truly socialized medicine (as opposed to socialized insurance) does better than the private system – see England and, in the US, the VA.
http://prospect.org/article/health-nations/
I didn’t say it’d be cheaper in total to keep the private insurance system in place, I agree there is an added cost to having that layer of business but it gives those other advantages. People should have the freedom to buy the kind of plan they want, and not be forced to be insured for everything. For those people, they would find cheaper plans than other people.
I like the idea of bringing all routine care into SinglePayer where standard medicine is free, but making people purchase individual supplemental plans for extraordinary efforts like transplants and controversial things, and taxing employer contributions.
You said. “SinglePayer forces everyone to buy a giant expensive plan that includes huge blank checks to big pharma and radical extraordinary coverage. ”
Everyone is ‘forced’ to be covered by Medicare. It’s very popular and nobody’s complaining. The GOP gave the private market access to the program (Medicare Advantage) on the assumption that whatever the government can do, the private market can do better. The result was pretty much proof positive that the private market can’t compete – Medicare Advantage had to be subsidized (something the conservatives should abhor, but what’s a little hypocrisy between friends).
Many government services are mandatory in terms of you’re obligation to pay for them. Defense, Police, Education, Fire protection. Most western democracies add Healthcare to that list. “Forcing people” is a red herring. Try to avoid paying for the police you probably don’t actually use.