With presidential politics mired in lipstick on varied animals, it’s time to force a break from the silliness and look at how the candidates handle issues of actual importance, such as health care. Eerily enough, in her criticism of John McCain’s health care plans last April, Elizabeth Edwards called his proposals “painting lipstick on a pig.” (Perhaps it is time to put that phrase to rest, and leave the poor pigs to their mud.)

Edwards’ major complaint, cosmetics aside, is that McCain’s plan would not apply to either her or McCain—or me. It does not include any provisions to keep insurance companies from denying coverage for preexisting conditions. Elizabeth, John and I are all fine, with affordable health insurance and the resources to pay for care. Well, the other two have quite a few more resources than I do, but I still can afford the health care I need, which makes me fortunate indeed. Had I been diagnosed with breast cancer and not had insurance, though, I would have been in a truly scary place, at risk physically and financially. That happens to far too many Americans with serious illness and it is just plain wrong.

Paul Krugman, in the New York Times, agrees, and wrote at the time of Edward’s comments, “It’s about time someone said that and, more generally, made the case that Mr. McCain’s approach to health care is based on voodoo economics — not the supply-side voodoo that claims that cutting taxes increases revenues (though Mr. McCain says that, too), but the equally foolish claim, refuted by all available evidence, that the magic of the marketplace can produce cheap health care for everyone.”

The McCain Web site says:  John McCain will reform health care making it easier for individuals and families to obtain insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people’s needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.

Sounds good until you realize that there currently is plenty of competition in the insurance market and we still have 45.8 million uninsured American citizens —in a country with a population of 305 million.  That means 15 percent of Americans are uninsured. And 21 percent of those are under 17. So more of the same seems a weak argument. Competition in the market has only led to continued increases in insurance and health care costs. What’s more, portability applies only to those people whose employers offer them insurance in the first place, which happens less and less in this damaged economy.

Barack Obama proposes simply to cover all Americans. In May, he said, “If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don’t have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness.”

The Obama site defines Obama’s Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress.

Obama’s plan is similar to one developed in Massachusetts  and instituted in 2006, which mandates coverage. Obama would subsidize costs for those at lower income levels through tax increases on those making more than $250,000.

Chris Hedges of Truthdig says neither candidate has it right, and that only a single-payer national health insurance system makes sense, citing a Harvard Medical School study that says this would save the country $350 billion a year. 

Still, we need to at least take baby steps, and proposing to shut down one of the country’s largest industries just isn’t going to happen overnight. Change will have to come incrementally, and Obama’s plan is a beginning. Canada went to a single-payer system in the 60s, so there is precedent for it happening. We need somebody with the courage and smarts to force that move. Obama’s 18-month focus on change is clearly the way to go, as evidenced by the fact that McCain is now using the same theme.

Whatever your politics, if you have a chance to visit with the candidates or their staffs, hold them accountable to health care change. More of the same is unthinkable. Make the candidates talk specifics on who they would cover and how. And make them stop talking about lipstick.  

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