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Americans Deserve a Real Health Care Debate

Americans Deserve a Real Health Care Debate

By Tom Coburn and Richard Burr - October 10, 2008

For a campaign that is offering a new kind of politics, it is unfortunate the Obama-Biden team has decided to sell its marquee policy proposal - a government-controlled health care plan - with the familiar Washington attacks that replace honest debate with scare tactics. Instead of telling voters what is new and positive about their plan, the Obama-Biden ticket is emphasizing the spurious charge that John McCain wants to "tax people's health insurance."

The American people have had enough and want the campaigns to confront the real problem: Health care is becoming less affordable and less accessible for millions of middle-class families. While health care premiums have gone up 78 percent from 2001-2007, workers' earnings have only risen by 19 percent.

The McCain-Palin solution is based three core principles. First, a person's ability to afford health care should not depend on whether they work for an employer who offers health insurance. Second, wealthy Americans with expensive health plans do not deserve a bigger tax benefit than working class Americans. And finally, workers should be able to pick the health care plan that best meets their needs, and they should be able to take it with them when they change jobs.

Our current tax code is fundamentally unfair and regressive. Lower income workers receive the least benefit, while wealthy Americans receive the most. Because tax rules are tied to employment (health care benefits paid for by employers are exempt from income and payroll taxes), if you leave your job, you leave your health care behind. Meanwhile, Americans who purchase their own health insurance generally do not receive a tax benefit.

Economists on the left and right agree that the status quo, which was set up in the 1940s, needs to change. The McCain-Palin solution would keep the employer deduction in place so employers would still have an incentive to sponsor health plans. They would provide a generous tax credit worth $2,500 for an individual and $5,000 for a family so all Americans could buy health insurance. Even the left-leaning Tax Policy Center has recognized that the change proposed by McCain-Palin will result in "a significant tax cut" for middle-class families. Moreover, Senator Obama's own Senior Economic Advisor, Jason Furman, endorsed McCain's proposal when he wrote that "we could scrap the current deduction altogether and replace it with progressive tax credits that, together with other changes, would ensure that every American has affordable health insurance."

Instead of addressing this proposal directly, Obama-Biden have launched an intellectually dishonest diversionary attack. Obama-Biden are pretending McCain-Palin want to do away with the current individual tax exclusion without replacing it with a far more generous tax credit. The fact is Americans in every tax bracket would enjoy enormous savings under the McCain-Palin plan, with lower income workers receiving the most benefit. Individuals earning up to $63,700 and receiving a $12,000 health insurance policy through their employer would enjoy a net benefit of $3,200 while wealthy Americans earning nearly $350,000 would receive $800 in net benefits.

McCain-Palin have offered a sensible and compassionate plan to help provide health coverage to the millions of Americans who are falling through the cracks of employer-sponsored health care. Obama-Biden, on the other hand, would decimate the private insurance market and cause 52 million Americans to lose their private insurance as employers dumped those workers into a government-sponsored plan that will be unworkable and unsustainable. Senator Obama wants to go in this direction. He said in a town hall meeting that, "If I were designing a system from scratch, I would probably go ahead with a single-payer system."

Government-controlled health care is a seductive message that, in practice, is most cruel to those who can least afford a way out. Much of Europe is moving away from the very form of government-control health care Obama-Biden embrace. Countries like the United Kingdom have learned the painful lesson that the only way government can control costs when it is in charge is by rationing care. In the UK, it is not uncommon for women diagnosed with breast caner to wait months for treatment. And we can't ignore the lesson from Canada where Canadians look for health care asylum in the United States, not vice versa. As the Canadian Supreme Court said in a ruling that exposed the inequities of government-controlled health care, "Access to a waiting list is not access to health care."

In short, government-sponsored health care will do for the health care economy what government-sponsored mortgages did to the housing market. The unintended consequences of government-sponsored health care would be catastrophic, particularly when Obama-Biden haven't explained how they'll fund the promises Washington has already made to seniors enrolled in Medicare and low-income Americans enrolled in Medicaid.

The charge that McCain-Palin don't want to debate health care and the economy is ludicrous. This is a debate they welcome and relish. By relying on typical Washington scare tactics and misinformation, Obama-Biden are running away from the very debate the American people deserve.

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Tom Coburn, M.D. is a U.S. Senator from Oklahoma and Richard Burr is a U.S. Senator from North Carolina.

Tom Coburn and Richard Burr

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