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McCain's two health failings Monday, May 5, 2008 By John Brummett John McCain's health care plan fails only on its two essential points. First he wants all of us to measure up to our own personal responsibility on covering ourselves with health insurance. He proposes to take away our employers' tax credits for providing group health coverage for employees. He wants to give all of us that tax credit individually so that we could buy our own health insurance. As the theory goes, such a system would force health insurers to compete for our business by designing a wider variety of plans and more affordable ones. So let's take an imaginary friend, a man in his mid-50s, in reasonably sound health and a decade from Medicare. He's gainfully employed with a fine company that provides a solid health insurance plan, one that throws him into a pool with colleagues, many younger and, statistically speaking, less prone to medical expense. He's to that age where they say he needs to keep a vigorous check on a couple of his key anatomical parts and functions. He's had the occasionally awry medical finding. His blood pressure was a little high once, into what they call "prehypertension" levels. His triglycerides got way high, though maybe it was because he hadn't fasted. His liver enzymes showed up a little elevated, but the doctor said it surely was an aberration and perhaps the result of muscle inflammation from over-use from all the exercise he was getting. Truth be known, he once smoked, for 20 years, when he was young and certain of living forever. Another thing: He had cataracts, and one was fixed while the other was left alone, since it was not "aggressive" and hasn't worsened in a decade. But that's precisely the kind of thing that somebody in the health insurance industry is bound to call a "pre-existing condition," because, well, that's exactly what it is. This imaginary guy might find the direct health insurance market a bit unfriendly should he enter it individually without the cover of a pool of colleagues. That age and pre-existing cataract might run up his premiums, co-payments and deductibles. Or he might be shopped a cheaper plan that wouldn't cover cataract surgery at all. Or he might buy a plan and find his insurer balking if the cataract worsened. Or he might be lured into a low-cost plan that, for the second year, would shoot up its rates like a credit card, forcing him to pay much more or re-enter the unfriendly market, still carrying his pre-existing condition. An employer-based plan is much better for him. And it would be better in the long-run for all employees, since no one has yet managed to escape the inevitability and effects of aging. At the very time we all need to be in this together, McCain wants to put us apart. Now, to the second failed essential point: McCain urges all of us to get exercise, because that, he declares, will keep us from getting these conditions that require expensive medical treatments. It's good advice. Generally, fitness will indeed enhance one's health and hold down medical costs. Frankly, smokers of any age should pay more for health insurance. But a young man recently finished the Little Rock Marathon with a very fine time, then dropped dead of a heart condition. The former governor of Arkansas, Mike Huckabee, became a runner and got fit after the doctor diagnosed him with diabetes. But his running damaged his cartilage and he needed arthroscopic knee surgery. You can play tennis with a guy one week, then get a call from him the next that he's got multiple myeloma. Exercise is a great thing to do and champion. But it's not a cure for illness or injury, which can strike anywhere, anytime, anybody. ------- John Brummett is an award-winning columnist for the Arkansas News Bureau in Little Rock and author of "High Wire," a book about Bill Clinton's first year as president. His e-mail address is jbrummett@arkansasnews.com. |
