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Do IT this week: Layering
Tax credit suggested for insurance plan
By Tracy Wheeler
Beacon Journal medical writer
Published on Friday, May 02, 2008
CLEVELAND: The vast majority of working Americans get their health insurance through their employers. But John McCain, the presumptive Republican nominee for president, wants to offer people a $5,000 tax credit to take control of their insurance themselves.
''The key to real reform is to restore control over our health-care system to the patients themselves,'' McCain said. ''The health plan you choose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep.''
McCain continued his weeklong rollout of his health-care plan Thursday morning at the Cleveland Clinic.
Clinic President and Chief Executive Delos M. ''Toby'' Cosgrove has invited all three of the top presidential contenders — McCain, and Democrats Hillary Clinton and Barack Obama — to be part of an ongoing discussion about national health-care policy. McCain was the first to accept.
The U.S. senator from Arizona said that helping consumers choose their own insurance plan would increase competition and drive down insurance costs.
Under McCain's plan, families would receive a $5,000 tax credit — $2,500 for individuals — every year. Consumers would choose their insurance provider, then inform the government of that selection by mail or e-mail.
The $5,000 would be sent directly to that insurance provider.
Critics contend that McCain's plan would increase the number of uninsured Americans — now at 47 million people — because it would remove tax deductions for employers that provide insurance to their employees.
Without the tax incentive to provide health insurance to workers, many companies might abandon the practice, some experts say.
Even with the tax deduction currently in place, the Kaiser Family Foundation found that more than 8,000 Ohio companies stopped providing health coverage between 2001 and 2005, affecting more than 515,000 workers.
''It may not kill — but it certainly is going to hurt — group health plans,'' said J.B. Silvers, director of research at Case Western Reserve University's Health Systems Management Center in Cleveland.
Uninsured problem
Such a shift in how working Americans obtain health insurance could be problematic for people with pre-existing and chronic health problems, Silvers said.
''If they backed it up with real heavy-duty regulation to make sure there was no discrimination and open enrollment, no matter what, then you could say, 'OK, why not?' '' Silvers said. ''But unless you're willing to do that, you're going to have people who don't get insurance. It won't deal with the uninsured problem.''
McCain acknowledged that problem, though he didn't offer a firm solution. He said he would work with governors ''to solicit their ideas about the best way to provide insurance to those denied coverage under current practices.''
Critics also doubt that a $5,000 tax credit is enough to help working families. In fact, they say, it will wind up costing most families more.
According to the Kaiser Family Foundation, the average cost of a family policy is about $12,000, with employers picking up $8,800 of that amount. Under McCain's plan, that $8,800 contribution by employers could be replaced by a $5,000 tax credit.
McCain drew a distinction between his plan and that of his Democratic challengers, both of whom are offering versions of universal health care. Such plans, McCain said, ''will replace the inefficiency, irrationality and uncontrolled costs of the current system with the inefficiency, irrationality and uncontrolled costs of a government monopoly.''
Robotic surgery
During his visit Thursday morning, McCain got a chance to practice his surgical skills with a robotic surgical system.
McCain met Dr. Tomislav Mihaljevic and heart surgery patient Connie Karcher of Perrysburg, who underwent heart valve surgery two weeks ago. Had her surgery taken place 18 months ago, Karcher's chest would have been cut open. By using robotics, though, Mihaljevic explained that Karcher's repair was performed through four 1.5-inch incisions in her side and groin.
Later, McCain learned about the Clinic's MyChart system, which gives 135,000 Clinic patients direct access to their medical charts, including test results, upcoming appointments and prescription refills.
The Clinic also showed off its pilot project with Google Health, which is similar to MyChart but on a broader scale. MyChart is specific to a patient's information within the Cleveland Clinic system. Google Health consolidates a patient's entire medical history, pulling together information from different providers, including drug stores, doctors' offices and hospitals. The Google Health project has 1,619 participants.
Dr. C. Martin Harris, the Cleveland Clinic's chief information officer, told McCain that on a recent trip to California, he was able to check a patient's file, see that follow-up testing was needed and e-mail that patient, who was vacationing in Germany.
Dr. Jim Young told McCain how the Clinic was able to alert all of its patients who were taking Vioxx within 24 hours of the news that the medication had cardiovascular side effects.
McCain visited hospitals in Miami, Tampa and Allentown, Pa., this week before his trip to Cleveland.
''It's not the quality of health care in America that's the problem,'' he said Thursday. ''It's the cost of health care in America that is the problem.''
Tracy Wheeler can be reached at 330-996-3721 or tawheeler@thebeaconjournal.com.
CLEVELAND: The vast majority of working Americans get their health insurance through their employers. But John McCain, the presumptive Republican nominee for president, wants to offer people a $5,000 tax credit to take control of their insurance themselves.
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