Doug Holtz-Eakin, senior policy advisor, and Carly Fiorina, RNC Victory 2008 Chair and former Hewlett-Packard CEO, held a conference call today as part of John McCain’s healthcare rollout.
There’s good in the McCain plan. Both advisors stressed that McCain’s plan puts “patients in charge,” and they both emphasized that under the McCain plan drug importation would be permitted. McCain has broken with many Republicans and drug industry interests in pushing to allow drug imports from places like Canada.
But there are real problems with the plan as well. Skeptical questioners on the call asked how McCain is going to compete with Democratic plans that guarantee health insurance universally. This is an intractable problem. McCain will need to convince people that the Democratic plan is either unrealistic (see the Massachusetts example), too expensive, or will impair the good things in the American health care system (e.g. doctor choice innovation). And we have yet to see McCain get fired up on a domestic issue to the extent he can sell something like this, which is not at first glance better than what the Democrats are offering.
There is also a fair amount of fudging going on. Where are all the cost savings going to come from? In large part, says the McCain team, from innovation. But, as they revealed in response to a question, these are things that private companies (e.g. insurers or employers) do. So where is government going to get money to cover or subsidize all those hard-to-insure people in the GAP plan? Not clear.
And isn’t GAP really another entitlement? The McCain campaign said in response to my follow-up question after the call that the GAP plan is “an effort to work with states to develop approaches to establishing a market to assure coverage for higher-risk folks who find it hard to get insurance.” That is thin gruel for those advocating universal coverage, and ominous for fiscal conservatives concerned this will be a drain on taxpayers. So the McCain team has its work cut out for it. But it is best to start practicing healthcare salesmanship now, on a day when the media is consumed with Obama-Wright coverage.