Candidates and Costs 6/3/2008

Two Distinct Approaches to Overall Reform

John McCainExpanded coverage through individual insurance market with:

• Tax incentives• Changes to tax exemptions for employer-sponsored

insurance• Deregulation of state markets

The DemocratsUniversal coverage through:

• Mixed private-public group insurance• Improved private group insurance markets• Financing from government, employers, and individuals

Candidates and Costs 6/3/2008

Where the Candidates Agree(at least in title)

• Expansion of coverage• Health IT• Transparency• Malpractice reform• Prevention• Payment reform for coordinated care• Pay for performance• Comparative effectiveness

Candidates and Costs 6/3/2008

Where the Candidates Differ

McCain Clinton ObamaUniversal coverage

X X

Individual Mandate

X Children only

Employer pay or play

X X

Changes to employer benefit

tax exemption

X X

Regulation of insurance markets

X X

Financing Source

X X

Candidates and Costs 6/3/2008

Cost Containment Tools

McCain Clinton ObamaHealth IT X X X

Direct government negotiation of drug

prices

X X

Transparency—Price, Quality

X X X

Insurance national exchange

X X

Nationwide sale of insurance

X

Promotion of alt. healthcare providers

X

Chronic Care Coordination

X X X

HSA Promotion X

Candidates and Costs 6/3/2008

Cost Containment Tools (cont’d)

McCain Clinton ObamaComparative effectiveness

? X X

Prevention X X X

Payment reforms for value

X X X

Malpractice reform X X X

Drug re-importation X X X

Drug generics promotion

X X X

Direct Gov’t negotiation of drug

prices

X X

Candidates and Costs 6/3/2008

Polls: Health Care Important to Voters, Economy More Important

Pew Research Center Poll, May 21-25, 2008

70

75

80

85

90

Economy Education Jobs Health Care

(% "

Ve

ry Im

po

rta

nt"

)

Candidates and Costs 6/3/2008

Top Economic Concerns Ms. Magazine

LRP/Tarrance Group Battleground Survey, December 9-12 2007

0

5

10

15

20

25

30

Health Care Cost of Gas Budget Higher Taxes

(%)

Women Men