South Florida Hospital News
Sunday May 31, 2020

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October 2008 - Volume 5 - Issue 4




The Candidates Plans, Are There Differences?

The presidential campaign is finally in the home stretch but many of us still feel some confusion over the positions of the candidates. Healthcare practitioners have a vested interest in the Republican and Democratic health plans for their patients, their families, and themselves. One thing is certain; each plan is different and will have long lasting impacts on the financial viability of our country as U.S. healthcare is at a current cost of $2 trillion per year.

John McCain’s plan would replace the current tax-free status of health insurance coverage provided by employers with refundable tax credits for Americans worth $2,500 for each individual or $5,000 for families. The emphasis for this plan is on self-determination and a belief that patients will choose the insurance coverage that is the most cost effective for their needs. For those who cannot afford health insurance, the McCain plan will work with governors to set up state plans. McCain’s proposal is aimed toward insurance companies and states covering the cost of healthcare while increasing individual’s choice in a free market.

Barack Obama’s plan keeps employer health insurance in place and offers a tax credit for small businesses to assist them in providing employee coverage. Businesses that don’t provide coverage will contribute a fee to the new National Health Insurance Exchange. The Exchange would provide insurance at reasonable costs for those who cannot get employer coverage or afford a private plan. Other cost effective incentives would be through improvements in electronic health information technology systems, opening up patient purchase of drugs from abroad and regulation of the small group of mega-insurance companies that control over one third of the national market.

In McCain’s plan, who will be able to afford insurance when the average plan is more than $10,000 a year? How will the average-size employers in our tough economy be able to afford insurance for employees when the tax-free status is lifted? Will the unemployed or those with pre-existing conditions be able to afford insurance or make an informed choice? By contrast Obama’s plan builds upon the existing system of employer-sponsored insurance and expands the government’s role for children and those not eligible under existing government plans. According to Bivens and Gould (2008) of the Economic Policy Institute, Obama’s plan covers over 54 percent of the uninsured, while McCain’s plan covers less than 5 percent. However, Obama’s plan does this while increasing federal government involvement in health care.

Professional organizations such as the American Medical Association and the American Nurses Association have criticized the plans, although the ANA does endorse Obama for president. The AMA is very concerned about the primary care physician shortage in the country. Educational and practice overhead costs are taking a toll on the number of new doctors entering primary care. The nursing shortage is not addressed by the candidates although Obama does acknowledge the importance of nurses to the health care system. How can we implement new programs when the key players won’t be available to patients?

Giving a voice to patients and health care providers may help propel change. Our best chance is to voice our opinion through our vote on November 4th and stay informed after the election to ensure changes aren’t implemented without our input.

Pamela Wessling, Nurse Practitioner, Assistant Professor, Barry University, can be reached at (305) 899-3812 or
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