This side-by-side comparison of the candidates' positions on health care was prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc. and is based on information appearing on the candidates' websites as supplemented by information from candidate speeches, the campaign debates and news reports. The sources of information are identified for each candidate's summary (with links to the Internet). The comparison highlights information on the candidates' positions related to access to health care coverage, cost containment, improving the quality of care and financing. Information will be updated regularly as the campaign unfolds.
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John McCain |
| Party Affiliation |
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| Stated goal |
- Provide access to affordable health care for all by paying only for quality health care, having insurance choices that are diverse and responsive to individual needs, and encouraging personal responsibility.
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| Date plan announced |
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| Overall approach to expanding access to coverage |
- Remove the favorable tax treatment of employer-sponsored insurance and provide a tax credit to all individuals and families to increase incentives for insurance coverage; promote insurance competition; and contain costs through payment changes to providers, tort reform and other measures.
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| A. Requirement to obtain or offer coverage |
- No provision. Opposes mandates for coverage.
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| B. Expansion of public programs |
- Give veterans ability to use their VA benefits to pay for timely high quality care from providers in the best locations.
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| C. Premium subsidies to individuals |
- Provide a refundable tax credit of up to $2,500 (individuals) and $5,000 (families) to all individuals and families for the purchase of insurance.
- Provide income-related premium subsidies, in addition to the tax credit, to individuals enrolled in the Guaranteed Access Plan (see item "F")
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| D. Premium subsidies to employers |
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| E. Tax changes related to health insurance |
- Reform the tax code to eliminate the exclusion of the value of health insurance plans offered by employers from workers’ taxable income.
- Allow individuals owning “innovative multi-year policies” that cost less than the tax credit to deposit the excess into expanded HSAs.
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| F. Creation of insurance pooling mechanisms |
- Work with states to create a federally-supported Guaranteed Access Plan for people who are denied coverage due to pre-existing conditions. Premiums in the plan would be limited and financial assistance given to those below a certain income level.
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| G. Changes to private insurance |
- Promote competition and individual choice of insurance by allowing insurance to be sold across state lines.
- Encourage innovative multi-year insurance products.
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| H. State flexibility |
- Give states flexibility and encouragement to experiment with:
- Use of private insurance and per episode payments under Medicaid;
- Alternative forms of access, insurance policies and providers and different licensing schemes for providers.
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| Cost containment |
- Adopt malpractice reforms that limit frivolous lawsuits and excessive damages and provide safe harbors for practice within clinical guidelines and safety protocols.
- Promote competition among providers by paying them only for quality and promote use of alternative providers (e.g., nurse practitioners) and treatment settings (e.g., walk-in clinics in retail outlets).
- Invest in prevention and care of chronic illnesses.
- Increase competition and reduce administrative overhead costs of private insurance by permitting sale of nationwide insurance (i.e., not regulated by the states).
- Gradually equalize Medicare Advantage payments in the context of comprehensive reform.
- Require drug companies to reveal the price of their drugs; allow re-importation of drugs; and encourage faster introduction of generics and biologics.
- Provide consumers with more information on treatment options and require provider transparency regarding medical outcomes.
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| Improving quality/health system performance |
- Change provider payment to encourage coordinated care (eg., pay a single bill for high quality heart care rather than individual services).
- Provide Medicare and Medicaid payments for diagnosis, prevention, and care coordination and bar payments for preventable medical errors or mismanagement.
- Require transparency by providers with regard to medical outcomes, quality of care, costs, and prices.
- Establish national standards for measuring and recording treatments and outcomes and use technology to share information on "best practices".
- Promote deployment of HIT to improve chronic disease care and to allow doctors to practice across state lines.
- Where cost effective, employ telemedicine and clinics in rural and underserved areas.
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| Other investments |
- Support federal research related to science-based care and cure of chronic disease.
- Promote education of children about health, nutrition, and exercise.
- Support public health initiatives to stem obesity and diabetes and deter smoking.
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| Financing |
- Not yet specified although indicates that cost containment measures would make insurance more affordable.
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