Monday, October 13, 2008

Voters want solutions as health insurance costs rise sharply


By SUZANNE KING
Special to The Star

Working two jobs isn’t exactly the way Dave Coffman envisioned his retirement.

But that’s how it’s turning out.

“I’m working basically because of health care,” said Coffman, 62, a retired school principal who lives with his wife in Lee’s Summit.

Until they qualify for Medicare, they have to buy private coverage. For now, their insurance bills amount to around $1,000 a month — including long-term care insurance, dental insurance and a health plan that has a $2,500 deductible. If he weren’t working two part-time jobs, Coffman said, there would be no way he could afford it.

“I never once thought about health insurance before I retired,” Coffman said.

Now it’s never far from his mind.

Like many Americans, Coffman says that health care will be a top concern as he casts his ballot in November.

“I know that each of the parties has a (health care) plan, but definitely we need something to help provide insurance,” Coffman said.

Coffman doesn’t want to see socialized medicine, but he wants to see a government that forces health care providers to hold the line on costs and helps the people who can’t afford them pay their health care bills.

At a time when 45 million Americans lack health insurance, Coffman is hardly alone. Even people who are insured are paying more all the time. In the past four years, according to a report in the New England Journal of Medicine, insurance premiums have climbed 35 percent, to $4,400 for an individual policy and $12,000 for a family policy.

“When people say they’re worried about health care, they’re not worried about where they’re going to find a decent doctor or medical care — they’re worried about paying for it,” said John McDonald, senior state director for AARP Missouri.

Certainly health care is on the agenda of Democrat Barack Obama and Republican John McCain.

Both candidates want to see a system that provides more affordable coverage to more people. And both talk about the need to cut costs; to improve efficiencies, partly through the use of information technology; to promote preventive care; to reduce errors; and to rein in medical malpractice lawsuits.

But the candidates’ fundamental approaches are vastly different.

Under McCain’s plan, individuals, not employers, would carry the responsibility for choosing and paying for health care.

Obama wants to shore up the current employer-based system by mandating more coverage and providing more subsidies.

“It’s a choice between adjusting the financing mechanism or a system of mandates,” said Maggie Nelson, manager for federal government and industry relations with Cerner Corp., the North Kansas City-based health care information technology company.

The McCain plan

Experts agree that McCain’s proposal is the most radical.

The senator from Arizona proposes eliminating the current tax exemption for employer-paid health insurance premiums — meaning people with job-based coverage would pay income tax on the premiums their employers pay, which are tax-free today. In exchange, he would provide a $2,500 tax credit to individuals and a $5,000 tax credit to families to buy their own insurance.

McCain’s camp argues that the system would give consumers more control, allowing them to keep insurance as they move from job to job, for example, while at the same time making them more aware of the true cost of going to the doctor.