Harness market competition for comprehensive reform
Comprehensive Health Care Reform: John McCain believes health care reform should address the rising costs that threaten families' budgets, business competitiveness, and government programs by making the entire system responsive
to the needs of American families. Families should receive quality, accountable care at lower costs by harnessing market competition.
Source: Campaign plan: "Bold Solutions for Economic Prosperity"
Feb 3, 2008
Preserve quality of health care by individual responsibility
Q: What would you do to curb the high cost of medical health care & to help those who don't have health insurance?
A: The real question is: How are we going to keep health care costs down, because we have the highest quality of health care in the world
in America today? And unlike the Democrats, I'm going to preserve that quality of health care, and at the same time stop the inflation & the skyrocketing costs of health care. And there's a couple of principles:
To make the recipient of the health
insurance much more responsible in health-care costs.
To address wellness & fitness.
To give every American family a $5,000 refundable tax credit so they can go anyplace in America to acquire the health insurance policy that best suits their needs.
And, if they've got money left over, then invest it in a health savings account.
Ronald Reagan said nobody ever washed a rental car. And that's true in health insurance. If they're responsible for it, then they will take more care of it.
Give individuals $2500 refundable tax credits for healthcare
Q: Your plan for lowering health care costs involves switching people from employer-provided health care to policies they buy on their own. There's concern that could lead insurance companies to cherry-pick their clients. You also want to limit the
amount doctors can charge for chronic diseases, which skeptics worry could make it difficult for people with diabetes, for example, to find doctors to take care of them. How would you deal with these two problems?
A: Last year, the
Medicaid inflation was 10%. No program in the world can survive under that. So of course we want to remove the employer tax, and tax incentives, and move it to the individual. Give the individual a $2,500 refundable tax credit, a family a $5,000 tax
credit. If you need to have people in special categories such as congenital diseases, we may have to set up a fund to care for those. But the key is, make health care in America affordable and available. Don't destroy it, as the Democrats want to do.
Control health costs so manufacturers stay competitive
Q: Pres. Bush said that GM & Ford need to produce a product that's relevant rather than looking to Washington for help. Do you agree?
A: I agree with that, but I think we in Washington have an absolute requirement to bring health care costs down.
The differential between Toyota and General Motors [due to healthcare costs affects each cars' cost by] $1,700. It's our responsibility to stop the cost aspects of health care, which is endangering the profitability and the competitiveness of our
Detroit workers. So of course they have to do it on their own. But it is our job to create a climate where we have both a safe and secure Social Security system but also health care costs under control so that they can be competitive with foreign
products. By the way, there are automobile manufacturers moving in the southern part of this country, as you know, that are doing very well because American workers are the most productive in the world.
No mandated universal system; no mandated insurance coverage
McCain says he thinks affordable health care can be made available to all Americans without a mandated universal system. McCain said that he doesn't think government-run systems such as those in Canada and in Europe will succeed in the US. "I think it's
a warmed-over proposal that we rejected back in the early 1990s and I'm certainly not interested in raising people's taxes," McCain said, adding he also is opposed to requiring everyone to buy health insurance coverage. "We've got to make health care
affordable and available. There's plenty of ways to do that."
He said he's been working on a plan "for a long time" but "it's a very tough issue." One way, he said, would be to expand community health centers and the S-CHIP program, offer tax
incentives for poor people, put health care online, medical malpractice reform and promote health savings accounts. However, he said, one problem getting everyone covered "is there's a lot of healthy Americans that say I just don't want health insurance.
Source: United Press International, "McCain sees room"
Jun 10, 2006
We should be able to reimport drugs from Canada
There are no incentives in the system today. How could pharmaceutical companies be able to cover up the cost to the point where nobody knows? Why shouldn't we be able to reimport drugs from Canada? It's because of the power of the pharmaceutical
companies. We should have pharmaceutical companies competing to take care of our Medicare and Medicaid patients.
Source: 2008 Facebook/WMUR-NH Republican primary debate
Jan 5, 2006
Include a health savings account in healthcare reform
There's a choice of having outcome-based treatment. If someone has diabetes, we should give the health care provider a certain amount of money and say, "Care for that patient. If at the end of that period that patient is well, we'll give you a reward."
We need walk-in clinics, community health care, and incentives for home health care. In Arizona, we adopted a proposal which incentivizes health care providers to keep people in home health care settings--dramatically less expensive than long-term care.
Source: 2008 Facebook/WMUR-NH Republican primary debate
Jan 5, 2006
The problem with health care in America is inflation
The problem with health care in America, it's not the quality. It is the inflation. In all due respect to your expert that we just saw, he's talking about the wrong aspect of this issue. The right aspect of this issue is inflation, if we could get it
under control and get it reduced so that health care costs are reasonable, then those people will be able to afford it. They will be able to go out and choose their insurer, and they will be able to then to get affordable health care. But we have to make
the recipient of the health care more responsible. We have to have outcome-based results for health care. We have to emphasize wellness and fitness. One of the most disturbing things in America is the increase in diabetes, obesity and high blood pressure
amongst younger Americans. So we have to award wellness and fitness. We'll have a healthier nation and we will have less health care costs. Some people here in New Hampshire have been to Canada. I don't think they want that system.
Supports tax-free medical savings accounts & tax credits
McCain supports the following principles regarding healthcare:
A Patient's Bill of Rights, including appeal mechanisms when claims are denied, & the right to sue when claims are denied.
Expanded eligibility for tax-free medical savings accounts
In favor of limits on the amount of punitive damages awarded in medical malpractice lawsuits.
Expanded prescription drug coverage under Medicare.
Tax credits to individuals and small businesses to offset the cost of insurance coverage.
Source: National Political Awareness Test (NPAT)
Nov 7, 2004
1989: No mandatory catastrophic Medicare coverage
In 1988, Congress had enacted the Medicare Catastrophic Coverage Act, which allowed senior citizens to get catastrophic health care coverage if they paid an income tax surcharge. Many senior citizens, concerned about living on a shoestring budget,
opposed the program because, they argued, they could not afford to pay the surcharge. In Arizona, a state known for its large senior citizen population, McCain had received more than his share of telephone calls. Many senior citizens felt they simply
couldn't afford the program. So, McCain attached an amendment to a supplemental appropriations bill and submitted it to the Senate. The legislation, if passed, would essentially kill the new catastrophic benefits---and the prohibitive surcharge.
An editorial by McCain about catastrophic health care coverage [said] mandatory participation in the program would cost some senior citizens as much as $800 a year for coverage. The Senate voted overwhelmingly against McCain: 58 to 40.
During the fall of 1993, a controversy erupted on Capitol Hill concerning the universal health care plan being advanced by the Clinton Administration under the direction of First Lady Hillary Rodham Clinton. McCain was opposed to the
Clinton plan, although, in a break with many members of his party, he did believe all Americans should have access to the health care system.
[But the Clinton plan, according to McCain], would destroy
America's health care system as it had come to be known---the best in the world. McCain was also worried about the Clinton plan's distribution of money. "All Americans deserve the opportunity to obtain health care coverage of their choice,"
McCain wrote
"I hope that we will never see the day in which the government tells us which health care plan we may enroll in or who will provide the care. To socialize our health care system, as the Clinton reform plan would, will be to ruin it.
By the summer of 2001, McCain had taken on the patients' bill of rights to regulate HMOs, a highly popular but for years unresolved issue in Congress. Though he joined the essentially Democratic side, led by Ted Kennedy and John Edwards, he had his own
impact on the drawing up of the bill and was instrumental in getting it through the Senate in the summer of 2001. He joined with Chuck Schumer on legislation to provide consumers with greater access to generic drugs.
McCain threw himself into the
struggle over the patients' bill of rights, applying some of the lessons he'd learned from the campaign finance fight, most especially the benefits of getting others invested in the bill by having them sponsor amendments that were adopted.
The bill passed by the Senate in late June by a vote of 59-36. When Bush threatened a veto, McCain issued a statement saying that he was "disappointed" but then he went on to take strong issue with some of the points in the President's veto threat.
Source: US News & World Report, p. 23
Jan 17, 2000
Matching funds for seniors citizens’ prescription drugs
We’re asking senior citizens now to make a choice between their health and their income. They make too much money to be on Medicare and not enough to pay for their prescription drugs. We’ve
got to devise a program that when a senior spends a certain part of their income on these prescription drugs that we’ll have a state and federal match for it. We can’t do that to our senior citizens.
Source: Des Moines Iowa GOP Debate
Dec 13, 1999
Expand health insurance to 11 million uninsured children
[We have] 11 million children without health insurance. We’ve got to expand the children’s health insurance program. And I’ll tell you what: I have the guts to take the money where it shouldn’t be
spent in Washington and put it where it should be spent, including 10 percent of the surplus.
Source: Des Moines Iowa GOP Debate
Dec 13, 1999
Keep health care promises to aging veterans
McCain fears the dying generation of WWII veterans is being shortchanged in health care at an age when the old soldiers’ medical needs are more expensive than ever. “Our WWII veterans, the greatest generation, they’re dying at 30,000 a month, & they’re
not getting the care they’ve been promised,” McCain said. “If you’ve got a flat budget, and millions of Americans who need expensive long-term and geriatric care, it doesn’t match up.” McCain said he plans to announce soon a “Contract with Veterans.”
Source: (X-ref Defense) The Sunday Enterprise (Brockton, MA), p. A7
Nov 21, 1999
Address powerlessness when faced with health care crises
Too many Americans feel powerless when faced with a health care crisis in their personal life [because]
Our complicated health care system intimidates and confuses many Americans.
Many of us fail to fully examine the coverage provided until we
become ill.
health care [has become] depersonalized, focused more on profits than on proper patient care.
While I appreciate the important contributions of managed care, we must protect the rights of patients in our nation’s health care system.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
“Patient rights” means value human life over dollars
I applaud the success of managed care in reining in skyrocketing health care costs, eradicating excessive health care expenditures, and reducing unnecessary overuse of the system. However, too many Americans feel trapped in a system which does not put
their health care needs first. They believe that HMOs value a paper dollar more than they do a human life. We cannot continue to ignore the rights of patients. We have allowed the health care reform debate to be determined by special interest groups.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
Expand medical savings; community health; & tax deductions
It is simply disgraceful that 43 million Americans can not afford health care coverage. We must expand medical savings accounts, offer flexible savings accounts, provide full tax deductibility for self-employed health insurance costs, and allow tax
deductibility for long-term care expenses. We should provide more funding for our nation’s community health centers, which have instituted a sliding fee schedule which allows people to contribute what they can afford and still receive health benefits.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
Patient Rights: access; MDs over HMOs; grievance process
Several principles must guide our health care debate:
Put patients and doctors in charge of their own health care, not HMO bureaucrats
Improve access to affordable health care
Choice of doctors to meet health care needs
Guaranteed access
to emergency care
Continuity of care when employers change
Doctors must be able to communicate openly and fully with their patients
A free and fair grievance process in the event an HMO denies medical care, including relief in the courts.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
Allow paying extra for choice of doctors & care
Americans should be free to choose their doctors, including specialists, if they are willing to bear the additional costs which may accompany this freedom. People should be able to enroll in a point-of-service plan with access to a multitude of
physicians, rather than be limited to an HMO which restricts freedom of choice in doctors.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
Full doctor-patient discussion even when it costs HMO
Today, some doctors are prevented by HMOs from openly discussing all medical treatments available to a patient. This is unconscionable. HMOs must not be allowed to stop doctors from openly discussing all possible care available, even if the procedures
are not covered by the HMO. A doctor’s loyalty must be to the patient and not an HMO’s bottom line.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
Supports patient rights; regulate nicotine as a drug
McCain supports the following principles regarding health issues:
Support legislation to define and enforce the rights of insured patients
Classify nicotine as a drug and cigarettes as drug delivery devices regulated by the FDA.
[McCain often works to] help raise money for one of McCain's favorite causes--cleft-palate surgery for children. The procedure saved the life of the McCains' teenage daughter
Bridget, who they adopted from Bangladesh, and Cindy McCain is very active in a global nonprofit called Operation Smile.
Source: The Myth of a Maverick, by Matt Welch, p. 40
Oct 9, 2007
John McCain on Voting Record
Allow appealing HMO decisions externally & in court
We can not support a system that leaves [patients] powerless against corporate health care. [We need] both internal and external appeals processes which are fair and readily available and which use neutral experts who are not selected, paid, or otherwise
beholden to the HMO. In life-threatening cases, there must be an expedited process. Finally, once all options to receive necessary medical care have been exhausted, every American should have the right to seek reasonable relief in the courts.
Source: Senate statement: “Health Care Reform”
Jul 15, 1999
Voted NO on expanding enrollment period for Medicare Part D.
To provide for necessary beneficiary protections in order to ensure access to coverage under the Medicare part D prescription drug program. Voting YES would extend the 6-month enrollment period for the Prescription Drug Benefit Program to the entire year of 2006 and allows beneficiaries to change plans once in that year, without penalty, after enrollment. Also would fully reimburse pharmacies, states and individuals for cost in 2006 for covered Medicare Part D drugs.
Voted YES on increasing Medicaid rebate for producing generics.
Vote on an amendment that removes an increase in the Medicaid deduction rebate for generic drugs from 11% to 17%. The effect of the amendment, according to its sponsor, is as follows: "This bill eliminates the ability of generic drugs to be sold using Medicaid. Over half the prescription drugs used in Medicaid are generic. Because we have raised the fees so dramatically on what a generic drug company must pay a pharmacy to handle the drug, pharmacies are not going to use the generic. In the long run, that will cost the Medicaid Program billions of dollars. My amendment corrects that situation." A Senator opposing the amendment said: "This bill has in it already very significant incentives for generic utilization through the way we reimburse generics. Brand drugs account for 67% of Medicaid prescriptions, but they also account for 81% of the Medicaid rebates. This is reasonable policy for us, then, to create parity between brand and generic rebates. This amendment would upset that parity."
Reference: Amendment for Medicaid rebates for generic drugs;
Bill S Amdt 2348 to S 1932
; vote number 2005-299
on Nov 3, 2005
Voted YES on negotiating bulk purchases for Medicare prescription drug.
Vote to adopt an amendment that would allow federal government negotiations with prescription drug manufactures for the best possible prescription drug prices. Amendment details: To ensure that any savings associated with legislation that provides the Secretary of Health and Human Services with the authority to participate in the negotiation of contracts with manufacturers of covered part D drugs to achieve the best possible prices for such drugs under Medicare Part D of the Social Security Act, that requires the Secretary to negotiate contracts with manufacturers of such drugs for each fallback prescription drug plan, and that requires the Secretary to participate in the negotiation for a contract for any such drug upon the request of a prescription drug plan or an MA-PD plan, is reserved for reducing expenditures under such part.
Voted NO on $40 billion per year for limited Medicare prescription drug benefit.
S. 1 As Amended; Prescription Drug and Medicare Improvement Act of 2003. Vote to pass a bill that would authorize $400 billion over 10 years to create a prescription drug benefit for Medicare recipients beginning in 2006. Seniors would be allowed to remain within the traditional fee-for-service program or seniors would have the option to switch to a Medicare Advantage program that includes prescription drug coverage. Private insurers would provide prescription drug coverage. Private Insurers would engage in competitive bidding to be awarded two-year regional contracts by the Center for Medicare Choices under the Department of Health and Human Services.Enrolled seniors would pay a $275 deductible and an average monthly premium of $35. Annual drug costs beyond the deductible and up to $4,500 would be divided equally between the beneficiary and the insurer. Beneficiaries with incomes below 160 percent of the poverty level would be eligible for added assistance.
Reference: Medicare Prescription Drug Benefit bill;
Bill S.1/H.R.1
; vote number 2003-262
on Jun 26, 2003
Voted YES on allowing reimportation of Rx drugs from Canada.
S. 812, as amended; Greater Access to Affordable Pharmaceuticals Act of 2002. Vote to pass a bill that would permit a single 30-month stay against Food and Drug Administration approval of a generic drug patent when a brand-name company's patent is challenged. The secretary of Health and Human Services would be authorized to announce regulations allowing pharmacists and wholesalers to import prescription drugs from Canada into the United States. Canadian pharmacies and wholesalers that provide drugs for importation would be required to register with Health and Human Services. Individuals would be allowed to import prescription drugs from Canada. The medication would have to be for an individual use and a supply of less than 90-days.
Reference:
Bill S.812
; vote number 2002-201
on Jul 31, 2002
Voted YES on allowing patients to sue HMOs & collect punitive damages.
Vote to provide federal protections, such as access to specialty and emergency room care, and allow patients to sue health insurers in state and federal courts. Economic damages would not be capped, and punitive damages would be capped at $5 million.
Reference:
Bill S1052
; vote number 2001-220
on Jun 29, 2001
Voted YES on funding GOP version of Medicare prescription drug benefit.
Vote to pass an amendment that would make up to $300 billion available for a Medicare prescription drug benefit for 2002 through 2011. The money would come from the budget's contingency fund. The amendment would also require a Medicare overhaul.
Voted NO on including prescription drugs under Medicare.
Vote to establish a prescription drug benefit program through the Medicare health insurance program. Among other provisions, Medicare would contribute at least 50% of the cost of prescription drugs and beneficiaries would pay a $250 deductible
Reference:
Bill HR.4690
; vote number 2000-144
on Jun 22, 2000
Voted YES on limiting self-employment health deduction.
The Santorum (R-PA) amdt would effectively kill the Kennedy Amdt (D-MA) which would have allowed self-employed individuals to fully deduct the cost of their health insurance on their federal taxes.
Status: Amdt Agreed to Y)53; N)47
Reference: Santorum Amdt #1234;
Bill S. 1344
; vote number 1999-202
on Jul 13, 1999
Voted YES on increasing tobacco restrictions.
This cloture motion was on a bill which would have increased tobacco restrictions. [YES is an anti-smoking vote].
Status: Cloture Motion Rejected Y)57; N)42; NV)1
Reference: Motion to invoke cloture on a modified committee substitute to S. 1415;
Bill S. 1415
; vote number 1998-161
on Jun 17, 1998
Voted NO on Medicare means-testing.
Approval of means-based testing for Medicare insurance premiums.
Status: Motion to Table Agreed to Y)70; N)20
Reference: Motion to table the Kennedy Amdt #440;
Bill S. 947
; vote number 1997-113
on Jun 24, 1997
Voted NO on blocking medical savings acounts.
Vote to block a plan which would allow tax-deductible medical savings accounts.
Status: Amdt Agreed to Y)52; N)46; NV)2
Reference: Kassebaum Amdt #3677;
Bill S. 1028
; vote number 1996-72
on Apr 18, 1996
Tax credits for those without employee health insurance.
McCain adopted the Republican Main Street Partnership agenda item:
H.R. 1181 the Health Insurance Affordability and Equity Act With 40 million Americans currently living without health insurance, Republican Main Street Partnership members have been leading the effort to find new and innovative ways to secure health care for our citizens. Easing the burden on businesses entering into insurance purchasing pools, and expanding the use of medical savings accounts (MSAs) have been included in previous economic stimulus packages. RMSP Congresswoman Nancy Johnson (CT) in conjunction with Representatives Jo Ann Emerson (MO), Melissa Hart (PA), Jim Kolbe (AZ), Connie Morella (MD), Doug Ose (CA), Marge Roukema (NJ), Rob Simmons (CT), Fred Upton (MI), and Jim Walsh (NY) introduced legislation that targets tax credits to those that are not offered employee provided health insurance, or are self employed.
Source: Republican Main Street Partnership Legislative Agenda 02-RMSP4 on May 24, 2002
Tax deduction for long-term care insurance.
McCain adopted the Republican Main Street Partnership agenda item:
H.R. 831/S. 621 the Long Term Care and Retirement Security Act. Republican Main Street Partnership Senators Lincoln Chafee (RI), Susan Collins (ME), and Gordon Smith (OR) joined House of Representatives sponsors Reps. Charlie Bass (NH), Dave Camp (MI), Tom Davis (VA), Greg Ganske (IA), Ben Gilman (NY), Dave Hobson (OH), Steve Horn (CA), Nancy Johnson (CT), Sue Kelly (NY), Ray LaHood (IL), Connie Morella (MD), Deborah Pryce (OH), Jim Ramstad (MN), and Rob Simmons (CT) in securing health insurance for seniors and those in long-term care facilities. As new medicines and healthier lifestyles are extending life, more and more Americans need to prepare for their long-term health needs. This legislation allows a tax deduction on long-term care insurance premiums for taxpayers, including accelerated deductions persons for people 55 years of age and up.
Source: Republican Main Street Partnership Legislative Agenda 02-RMSP5 on May 24, 2002
Support telemedicine for underserved areas.
McCain adopted the Republican Main Street Partnership agenda item:
H.R. 2706, The Medicare Telehealth Validation (MTV) Act. Republican Main Street Partnership members Congressman Doug Ose (CA) and Jo Ann Emerson (MO) have introduced this bill to increase the use of telehealth services under the Medicare program. Currently, telehealth services are restricted to use in certain geographically underserved areas. The MTV Act provides sufficient funding and regulatory relief to expand high technology medical diagnostic tools, across the Internet, to urban as well as rural underserved areas. The bill further provides for expansion of store-and-forward techniques, and for a study of the restrictions on telemedicine due to state licensing rules.
Source: Republican Main Street Partnership Legislative Agenda 02-RMSP6 on May 24, 2002
$350 billion for prescriptions for poor seniors.
McCain adopted the Republican Main Street Partnership agenda item:
Medicare Prescription Drug Benefit One of issues to be addressed this year by Congress is that of providing a prescription drug benefit to our nation's Medicare beneficiaries. Legislation currently being drafted [by Republican Main Street Partnership members] intends to authorize $350 billion over the next 10 years to provide purchasing assistance for prescription medications. The benefit reaches out to low and moderate income seniors by extending coverage to incomes up to 150% of the poverty level. The bill could also include provisions to correct reimbursement reductions for physicians, nurses, hospitals, technicians, home health care providers, and long-term care facilities.
Source: Republican Main Street Partnership Legislative Agenda 02-RMSP7 on May 24, 2002
Rated 25% by APHA, indicating a anti-public health voting record.
McCain scores 25% by APHA on health issues
The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.
The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.
