With 45.7 million Americans without health insurance or access to care, and with health care costs spiraling ever higher for individuals, employers and governments, health care reform has been a major issue throughout the 2008 presidential campaign. Both major parties’ nominees ─ Senator John McCain and Senator Barack Obama ─ have advanced well developed proposals to reform many aspects of the current health care system. This commentary analyzes the major elements of each of their plans.

The commentary was co-authored by Hilary Haycock, a director at Harbage Consulting, LLC and Peter Harbage, president of Harbage Consulting, who has more than a decade of experience working to improve health policy at the federal, state and local level.

The commentary begins with an overview of each candidate’s approach written from their own perspectives. While Sen. McCain calls for access to health care for every American, he does not outline a plan to achieve universal coverage. Instead, Sen. McCain’s health reform plan has three stated goals:

• Making health insurance innovative, portable and affordable;
• Ensuring care for high risk patients; and
• Lowering health care costs.

Sen. Obama does call for universal coverage in his health reform plan, which also has three stated goals:

• Providing affordable, comprehensive and portable health coverage for every American;
• Modernizing the U.S. health care system to contain spiraling health care costs and improve the quality of patient care; and
• Promoting prevention and strengthening public health, to prevent disease and protect against natural and man-made disasters.

The commentary details the diverse ways how each plan aims to reach those goals.

Interestingly, both plans address the same issues in health care reform, including:

• Containing costs in terms of expenses related to chronic diseases;
• Containing costs with respect to compensation of health care providers;
• Improving our understanding of the quality and costs of health care delivery;
• Containing costs by advancing health information technology;
• Containing costs by increasing the availability of both generic and re-imported prescription drugs;
• Increasing access to health care for Americans;
• Expanding the individual insurance market;
• Significantly changing how health insurers are regulated in the U.S.;
• Changing premium subsidies and the Tax Code;
• Changing public programs, notably Medicaid and SCHIP; and
• Funding the health care reform plans the candidates propose.

The commentary, however, explains how the candidates approach these issues from starkly different approaches and notes that the candidates seek different outcomes from their reforms.

After analyzing each aspect of the candidates’ reform plans, the commentary concludes:

“Sen. Obama’s plan builds on the existing system of both public and private coverage, and has pledged significant federal investments in subsidies and cost containment investments to make health care more affordable and efficient. His goal is cost-containment and universal coverage.”

“While Sen. McCain does not share the goal of universal coverage, his plan is no less far reaching. By reforming the tax code, Sen. McCain would shift coverage in America from the employer market where most Americans currently receive insurance to the individual market. In keeping with his philosophy of laissez-faire economics, the other elements of his plan largely rely on market forces and voluntary efforts by the industry to achieve cost savings and great efficiency.”

Access the complete emerging issues commentary on lexis.com.