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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

McCainCare Equals BushCare

In non-Jeremiah-Wright related political news, John McCain has re-released his health care plan, and the bottom line is that if follows George W. Bush’s most recent proposals, which were assessed by most health care experts as representing some point along the spectrum that leads from unserious to dangerous.
Like Bush’s plan, McCain’s focuses on replacing the employer subsidy for health care with tax incentives for the individual purchase of health insurance. Thus it arguably represents an attack on the very idea of group health insurance purchasing, throwing federal resources into subsidies for the expensive and highly discriminatory individual market. This is somehow supposed to hold down costs.
Like Bush’s plan, McCain’s does nothing to restrict pre-existing condition exclusions and other “cherry-picking” practices of health insurance companies, which both restrict coverage and boost costs. Indeed, by creating a national market for health insurance policies, McCain would virtually guarantee that companies will begin to migrate towards states with exceptionally weak regulations governing pre-existing conditions and other discriminatory practices. Indeed, the idea seems to be that “excessive” state mandated coverage is the source of the current price spiral.
McCain does promise to provide what sounds like token money to promote private or state “high-risk pools” for the unfortunates who can’t get health insurance. But this is by far the vaguest part of his proposal, and offers at best a take-it-or-leave it opportunity for crappy policies at prices that may be prohibitive.
Reflecting most conservative health care “thinking” over the last decade or so, McCain’s plan is remarkably retrograde, taking the health care system back decades to one where individuals are essentially on their own without benefit of collective purchasing clout. Politically, the whole point will be to breezily describe the McCain plan as “market-based” (indeed, that’s in the title of the Washington Post article linked to above), while attacking Democratic universal plans as “socialized medicine.”
It’s appropriate that McCain’s big health care speech yesterday was introduced by former Sen. Connie Mack (R-FL), a lobbyist for health insurance companies, which under the McCain plan would enjoy new taxpayer subsidies with virtually no accountability for what they provide.
McCain’s health care plan represents yet another area in which his efforts to claim “distance” from George W. Bush are, well, counter-factual. If he’s the “change” candidate on health care, it’s small change, and for the worse.

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