Healthcare: Where McCain , Obama stand

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Where they stand on health care, as adapted from an analysis by the Kaiser Family Foundation.

JOHN MCCAIN

OVERALL. Begin taxing employer-sponsored health benefits as income, instead providing a tax credit of $2,500 for individuals and $5,000 for families to increase incentives for insurance coverage. Contain costs through payment changes to providers and tort reform.

INSURANCE POOLS. Work with states to create a federally supported Guaranteed Access Plan for people denied coverage due to pre-existing medical conditions. Financial assistance would go to those below a certain income level.

CHANGES TO PRIVATE INSURANCE. Promote competition by allowing insurance to be sold across state lines. Encourage multiyear insurance products.

COST CONTAINMENT. Adopt malpractice reforms that limit frivolous lawsuits and excessive damages. Promote less expensive alternatives such as walk-in clinics in retail outlets. Invest in prevention and care of chronic illnesses. Increase competition by permitting the sale of nationwide insurance not regulated by states.

COST OF THE REFORMS. $1.3 trillion over 10 years, according to the nonpartisan Tax Policy Center; campaign says cost containment measures will pay for it.

BARACK OBAMA

OVERALL. Require that health insurance be provided to all children, and require all employers to offer health benefits or contribute to a new public program. Create the National Health Insurance Exchange, through which small businesses and individuals without access to other public or employer-based programs could enroll in the new public plan or in approved private plans.

INSURANCE POOLS. Require participating insurers to offer coverage on a guaranteed issue basis.

CHANGES TO PRIVATE INSURANCE. Prohibit insurers from denying coverage based on pre-existing conditions. Children up to age 25 could continue family coverage through their parents’ plan.

COST CONTAINMENT. Invest $50 billion toward adoption of electronic medical records. Promote competition by regulating the portion of premiums that must be paid out in benefits. Promote generic drugs and repeal the ban on direct price negotiation between Medicare and drug companies. Require hospitals and providers to publicly report measures of health care costs and quality.

COST OF THE REFORMS. $1.6 trillion over 10 years, according to the Tax Policy Center; campaign estimates $50 to $65 billion per year when phased in. Much of financing expected to come from system savings; additional revenue to come from discontinuing tax cuts for those with incomes over $250,000.

What the next president will face

• Controlling spiraling costs of health insurance
• Expanding access to health coverage
• Reining in growth in Medicare and Medicaid budgets
• Modernizing record keeping and tracking treatment outcomes
• How health care costs have increased since the last presidential election

The uninsured

2004: 43.5 million
2008: 45.7 million

(2007 sample)

5 percent increase in uninsured people

U.S. health care spending

2004: $1.9 trillion (15.9 percent of GDP)
2008: $2.4 trillion (projected; 16.6 percent of GDP)

29 percent increase in spending

Medicare costs

2004: $309.3 billion
2008: $460.7 billion (projected)

49 percent increase in spending

This is the second in a continuing series examining where the presidential candidates stand on key campaign issues – and how those issues affect Long Islanders. The series will examine: The economy, the environment and climate change, immigration, the wars in Iraq and Afghanistan and homeland security.

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