The College released a statement applauding Sen. John McCain's efforts to tackle health system reform. Sen. McCain agrees with us that ensuring access to high-quality care for all Americans is essential. We can work with him on his desire to improve quality and promote health IT. But I have concerns about the finances behind the plan, which would eliminate employer tax subsidies for insurance coverage.

His promotion of a portable individual coverage concept with refundable tax credits ($2,500 for individuals; $5,000 for families) may make long-term sense, but to give employers a reason to drop coverage (by eliminating tax subsidies to them) is dangerous! That’s how most Americans currently get covered and pay for services. He doesn’t promote universal coverage, and favors a voluntary means of expanding access through tax subsidies and purchasing cooperatives for insurance.

Unless modified, his strategy could shift a lot of people from employer coverage to “self-coverage” using these tax credits, which would surely result in dropping coverage for a lot of the workforce. This would put more people on the public dole. I’d rather see him give the subsidy to whoever pays for coverage, such that uninsured individuals would have an incentive to buy coverage, but employers wouldn’t precipitously drop coverage. Hopefully we will be able to help advise his campaign about these concerns after the primary, including where he’s going to get the money for these subsidies.

The Dems on the other hand plan to require or mandate coverage, but they also need to look a bit more realistically into how they are going to pay for it in the current economic circumstance. Interestingly, all three candidates have great interest in improving quality, reducing unnecessary costs, and expanding the use of HIT, so our BRP ACC System Reform principles are right on target.