6/3/2008Candidates and Costs Two Distinct Approaches to Overall Reform John McCain Expanded coverage through individual insurance market with: Tax incentives Changes to tax exemptions for employer-sponsored insurance Deregulation of state markets The Democrats Universal coverage through: Mixed private-public group insurance Improved private group insurance markets Financing from government, employers, and individuals

6/3/2008Candidates and Costs Where the Candidates Agree (at least in title) Expansion of coverage Health IT Transparency Malpractice reform Prevention Payment reform for coordinated care Pay for performance Comparative effectiveness

6/3/2008Candidates and Costs Where the Candidates Differ McCainClintonObama Universal coverage XX Individual Mandate XChildren only Employer pay or play XX Changes to employer benefit tax exemption XX Regulation of insurance markets XX Financing Source XX

6/3/2008Candidates and Costs Cost Containment Tools McCainClintonObama Health IT XXX Direct government negotiation of drug prices XX Transparency Price, Quality XXX Insurance national exchange XX Nationwide sale of insurance X Promotion of alt. healthcare providers X Chronic Care Coordination XXX HSA Promotion X

6/3/2008Candidates and Costs Cost Containment Tools (contd) McCainClintonObama Comparative effectiveness ?XX Prevention XXX Payment reforms for value XXX Malpractice reform XXX Drug re-importation XXX Drug generics promotion XXX Direct Govt negotiation of drug prices XX

6/3/2008Candidates and Costs Polls: Health Care Important to Voters, Economy More Important Pew Research Center Poll, May 21-25, 2008

6/3/2008Candidates and Costs Top Economic Concerns Ms. Magazine LRP/Tarrance Group Battleground Survey, December