WASHINGTON — While health care has been a key issue in this year's presidential campaign, plans from both Barack Obama and John McCain are light on details when it comes to the most important aspects of the health system, including controlling costs, and improving efficiency and productivity.
The candidates have presented a wish list with very little detail on how they would accomplish the “fundamental change needed for our delivery system,” said Paul B. Ginsburg, Ph.D., president of the Center for Studying Health System Change, at a briefing sponsored by the Alliance for Health Reform.
Economists have estimated that over the next decade, U.S. health spending will double from $2.2 trillion to $4.3 trillion. Dr. Ginsburg, along with Princeton University economist Uwe Reinhardt and former Centers for Medicare and Medicaid Services Administrator Dr. Mark McClellan, said that rising costs are largely being driven by variations in practice, growth in volume, and intensity of services.
Senator Obama has said that he favors health information technology, transparency of price, promotion of quality care, chronic care coordination, payment reforms for value, malpractice reform, and promotion of generics.
Most of these are old, but not worthless, ideas, said Dr. Reinhardt, James Madison Professor of Political Economy at Princeton.
He called Senator McCain a “true radical” for his proposal to eliminate the tax exemption for employer-provided health insurance. Individuals who purchase insurance on their own would instead receive a $2,500 tax credit; families would receive $5,000. “This is almost un-American—to take away a tax preference,” said Dr. Reinhardt.