We face a choice on health care: We can reform the system through the mechanism that has made the American economy the envy of the world — free markets and competition — or we can promote more government intervention in the false hope that bigger government will be the elixir to our health-care ills.
I offer a conservative vision of health-care reform, while the Democrats offer their usual stew of government mandates and regulations, and the inevitable imposition of massive tax increases on Americans to pay for their “reform.” Back in 1993, I opposed President Clinton’s health-care proposal because I knew it would lead to more and more taxes, huge increases in federal spending, and the rationing of care for Americans. Today, I’m sure Democrats would gladly pass that plan in a heartbeat if they could only convince a skeptical American public to go along. But they can’t. Instead, Democrats are pushing incremental government control of health care, as we just witnessed with the S-CHIP debate, and hoping no one notices.
I reject this sleight-of-hand.
My reform to strengthen our health-care system preserves the most essential of American values — freedom. Conservatives believe in the pursuit of personal, political, and economic freedom for everyone. We believe that free people may voluntarily unite, but cannot be compelled to do so, and that the limited government that results best protects our individual freedom. In health care, we believe in enhancing the freedom of individuals to receive necessary and desired care. We do not believe in coercion and the use of state power to mandate care, coverage, or costs.
My plan is built on a simple premise: bringing spiraling health-care costs under control through market competition and personal responsibility will benefit consumers and patient care, increase coverage by making insurance more affordable, and strengthen American economic competitiveness across the globe. It empowers individuals and families so they have more affordable and portable insurance choices that meet their needs. It puts the needs of individuals and families first, rather than those of government and insurance bureaucracies. For example, it provides all individuals with a refundable tax credit of $2,500 and families with a $5,000 refundable tax credit toward the purchase of health insurance. It also rewards innovative insurance by allowing any money remaining to be deposited in tax-free Health Savings Accounts. It promotes robust health-care markets by, among other things, busting up geographic monopolies and allowing individuals and families to purchase insurance across state boundaries. Opening state insurance bureaucracies to national competition will encourage more innovation and lower costs in the health insurance market. As a recent Wall Street Journal editorial noted, if you “allow people to purchase policies across state lines, which is currently prohibited, …people [could] choose the coverage levels that best serve their needs, and … make insurance far more affordable for people in mandate-heavy states like New York and Massachusetts.”
Furthermore, Americans should have the option to purchase insurance through any willing, responsible provider, such as an association they belong to or the church they attend, if they are not satisfied with the choices offered by their employer. Again, I believe the more options folks have the better. Families place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets such as Wal-Mart are the most convenient, cost-effective way for families to safely meet simple needs, why should anyone stand in their way? I will not.
Our veterans should also have more health-care choices. They should not have to wait for access to a VA facility that is hours away. Under my plan, our veterans would have the option to control the means of financing their care - in an electronic card or other device — so they can choose the care that best suits their needs.
Along with veterans’ care, we must modernize other government health programs such as Medicare — a program now speeding toward bankruptcy — to improve quality and lower costs. Like most of our system, Medicare reimbursement now rewards institutions and clinicians who provide more and more complex services. I believe we need to change the way providers are paid to focus their attention more on chronic disease and managing its treatment. This is the most important care and expense for an aging population. And in a system that rewards quality, Medicare should not pay for preventable medical errors.
I am appreciative of the therapeutic benefits of modern pharmaceuticals, and seek to
harness market competition in order to lower pharmaceutical costs by fostering a more efficient process for bringing cheaper generic drugs to consumers sooner, and developing a workable system that permits the safe re-importation of drugs. However, in 2003 I strongly opposed adding another unfunded entitlement to the fiscal train wreck that is Medicare Part D by providing all seniors with a costly drug benefit, even those — like me — who can more than afford to pay for their medicine.
Of course, any real reform plan must deal with the trial lawyers who game the current system to maximize their profit margin while raising health costs for everyone else. We cannot let the search for high-quality care be derailed by frivolous lawsuits and excessive damage awards. We must pass medical liability reform, and those reforms should eliminate lawsuits for doctors that follow clinical guidelines and adhere to patient safety protocols. If the Democrats are sincere in their conviction that health-care coverage and quality is their first priority, than they will put the needs of patients before the demands of trial lawyers. But that’s about as likely to happen as Democrats keeping taxes low.
Finally, one thing left out of most reform talk is personal responsibility. We must personally do everything we can to prevent expensive, chronic diseases. Our rights in this country are protected by our personal sense of responsibility for our own well being. Cases of diabetes are going up, not only in the baby boom generation, but among younger Americans; obesity, diabetes, and high blood pressure are all on the rise. Parents who don't impart to their children a sense of personal responsibility for their health, nutrition, and exercise have failed their obligations. Also, parents are responsible for ensuring that their children are covered by health insurance and, under my plan, will have more options beyond what is currently available to them.
As with national security, voters in 2008 will decide in which direction our nation should move on health care. We should not cede the health-care issue to the Democrats. When presented with two competing visions on how best to reform our system, I believe voters will choose the conservative vision that empowers people, and frees our current out-dated health-care system from the heavy hand of government.
— John McCain is the senior United States senator from Arizona. He is currently running for the Republican presidential nomination. 
