The Scientific Activist

I was excited when I saw that The New England Journal of Medicine had today published summaries by Obama and McCain of their health care plans, expecting something quite detailed to appeal to a highly critical expert audience. However, their summaries were still as general and vague as ever. Regardless, these new write-ups are still a nice resource for people interested in the two candidates' plans. You can read Obama's plan here, McCain's here, or see a pdf of both side-by-side here.

On many aspects, both plans--at least as they're presented here--are quite similar. Both stress preventative medicine, modernizing our infrastructure, etc., etc. However, two major differences are apparent. The first is a difference in basic philosophy. Although he doesn't explicitely say it in his NEJM piece, we know that Barack Obama believes that health care in the US is a right, and that comes through in his writing. McCain, however, believes that health care is a "responsibility" (whatever the hell that means), and he includes loaded language throughout his write-up about "government waste" and related conservative talking points.

The other major difference between the plans is more substantive. The centerpiece of Obama's plan is that he will expand health care access in part by giving all Americans the ability to buy in to a government health care plan and by mandating that all children are insured (and making that happen by expanding previously existing public health care programs). McCain's plan, on the other hand relies on a system of tax credits ($2,500 for individuals and $5,000 for families). Although McCain's plan would also tax health benefits, for the average American this increased tax would be less than the increased tax credit, thus appearing to save you money... in the short term. In the long term, however, McCain's plan will "raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections," according to an analysis published earlier this month in Health Affairs (see citation below). Counterproductively, these increased costs are predicted to cause the number of the uninsured to increase.

Obama's plan, however, will undoubtedly decrease the number of the uninsured. The only question there is by how much. So, although the candidates are both still a little light on the details, Obama's health care plan continues to look much more attractive and effective than McCain's.

Hat tip to Virginia Hughes.

PalMD has more at Denialism Blog

T. Buchmueller, S. A. Glied, A. Royalty, K. Swartz (2008). Cost and Coverage Implications of the McCain Plan to Restructure Health Insurance Health Affairs DOI: 10.1377/hlthaff.27.6.w472