TAMPA — In the fight for the hearts and minds of middle-class voters, Sen. John McCain unveiled a health care overhaul that would focus on consumer choice and preventive medicine and avoid the government involvement proposed by his Democratic rivals.
McCain, the presumptive Republican presidential nominee, railed against government-run universal health care, saying it would have the same "inefficiency, irrationality and uncontrolled costs" as the current system.
"The key to real reform is to restore control of the health care system to the patients themselves," McCain said.
Government can provide leadership to solve problems, but "often it comes down to personal responsibility," he said.
A key element of McCain's proposal would be a $2,500 tax credit for individuals and a $5,000 tax credit for families to buy insurance independent of their employers, though workers could still opt to stay with their employer's plan.
Consumers would choose an insurance provider, inform the government of their selection, and the money would be sent directly to that insurance provider, McCain said.
Buying health insurance this way would allow people to remain with the same coverage and doctors even when they switch jobs.
"They'll have a medical home again, dealing with doctors that know and care about them," he said.
McCain said giving individuals the purchasing power would increase market competition among insurers, "forcing companies to respond with better service at a lower cost."
Similarly, he proposes lowering costs through increased competition by creating a "national market" for insurance companies. Now, each state has its own regulations, he said.
"Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it," he said.
McCain said a critical part of the plan to improve health care while making it more affordable is to shift the focus to preventive care that's cheaper than care of the ill. One way to do that, McCain said, is by changing Medicare reimbursement policies so that doctors are paid when their patients meet wellness markers, such as healthy blood sugar and cholesterol levels, instead of only when they provide treatment for diseases.
On the question of finding coverage for those with a pre-existing condition that makes them unable to find an individual policy, McCain said he would "work tirelessly."
"But I won't create another entitlement program that Washington will let get out of control," he said.
McCain said his concept is to create a nonprofit "guaranteed access plan" with federal assistance that would contract with insurers to cover high-risk patients.
McCain also talked about the need for medical malpractice reform, saying he would start with legislation to eliminate lawsuits against doctors that follow clinical and patient safety guidelines.
"If Sen. Obama and Sen. Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers," he said.
Even as McCain spoke, his critics were preparing their responses.
Aides to Rep. Kathy Castor, D-Tampa, handed out statements to reporters before the speech.
Speaking from her office in Washington, D.C., Castor criticized McCain's health care voting record during his years as a U.S. senator. In particular, she noted his votes against expanding the State Children's Health Insurance Program.
"It was a bipartisan proposal," Castor said. "One person that stood in the way was John McCain. He sided with President Bush in opposing access to the pediatrician's office for millions of children in America."
Bush had argued that the expanded version of SCHIP would have made the benefit available to people of higher incomes than was originally intended, people Bush said could afford to pay for their children's health care.
Democratic presidential candidate Hillary Rodham Clinton, D-N.Y., issued a statement Tuesday that blasted McCain for not indicating how he would pay for his proposals.
Clinton said McCain's tax credits to help people buy their own insurance would eliminate the incentives for employers to provide health care benefits. Clinton also said McCain's plan for a "guaranteed access pool" for people with pre-existing conditions would help insurers, not individuals.
"Virtually all high-risk pools today have waiting lists, high premiums, and scaled-back benefits," she said.
Times staff writer Lisa Greene contributed to this report. Janet Zink can be reached at firstname.lastname@example.org or (813) 226-3401.
Sen. John McCain's health care plan emphasizes giving more control to individuals and relying on market competition to lower prices. He proposes to:
• Offer a $2,500 tax credit for individuals and a $5,000 tax credit for families to buy insurance independent of their employers.
• Create a nonprofit "guaranteed access plan" with federal assistance that would contract with insurers to cover people who can't get insurance because of pre-existing conditions.
• Encourage competition among insurance companies and thus lower costs by establishing a national insurance market instead of regulating the industries state by state.
• Enact medical liability reform that would eliminate lawsuits against doctors who follow clinical and patient safety guidelines.
• Change Medicare reimbursement policies so health care providers are paid when patients meet wellness markers, such as healthy blood sugar and cholesterol levels, instead of only when they provide treatment.
The health care plans of Sens. Barack Obama and Hillary Rodham Clinton are very similar, with one exception. Clinton proposes requiring every person to carry health insurance. Obama mandates coverage only for children.
Both plans propose to:
• Leave in place employer-based private insurance. Some employers will be eligible for subsidized premiums.
• Create pools so individuals can buy their own insurance at group rates.
• Increase eligibility for the poor and children to enroll in initiatives such as Medicaid and the State Children's Health Insurance Program.
• Launch initiatives to increase technology and use more preventive care to lower costs.