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Debate: Obama, McCain Talk Health Care

Experts Analyze the Candidates' Comments for Accuracy

Charges, Countercharges

Obama criticized McCain's plan to give $5,000 tax credits to families to help them purchase health insurance in exchange for taxing their employer-provided health benefits as income.

"So what one hand giveth, the other hand taketh away," he said.

The Democratic nominee repeated several familiar themes from campaign speeches, noting that people who are happy with their employer-provided health plans will be able to keep them under his proposal and that people without health insurance "will be able to buy the same kind of insurance that Sen. McCain and I enjoy as federal employees."

McCain said under his plan "95% of the American people will have increased funds to go out and buy the insurance of their choice and shop around."

The exceptions, he said, are people who have what he called "gold-plated Cadillac plans" that cover things like hair transplants.

Health Policy Experts Weigh In

What did insiders think of Tuesday night's exchanges between Obama and McCain on health care?

WebMD asked two of them for their thoughts: Karen Davis, who is president of the nonprofit Commonwealth Fund, which supports research on health care policy, and Robert Laszewski, who writes the health policy blog Health Care Policy and Marketplace Review.

Davis tells WebMD that the candidates provided far more details about their respective health plans than they had in the first debate.

She was also pleased to hear McCain call access to affordable health care "a government responsibility."

"I had never heard him say that before," she says.

Davis was also gratified that both candidates considered health care reform to be a major priority.

But she says both were guilty of misrepresenting at least some aspects of the other's plan.

She called McCain's contention that Obama's plan will lead to fines for small businesses misleading.

"Sen. Obama made it clear that his plan doesn't fine small business," she says. "In fact, it pays half their premiums."

Also misleading, she says, was Obama's charge that families would pay more under McCain's plan to provide individual tax credits while taxing benefits from employer plans.

"That probably wouldn't be true in the initial years when the tax credit for most people would be more than the tax they would have to pay."

Obama's ads also claim that the tax credits would go straight to insurance companies, suggesting that families would not benefit if the credit is more than the cost of the insurance policy.

That is also misleading, Laszewski tells WebMD.

Laszewski agrees with Obama's contention that deregulation of health insurance providers will result in a more stratified market where healthy people end up in one pool and sick people in another.

Health Reform and the Economic Crisis

Both experts say the current economic crisis will change the outlook for major health care reform, no matter who is elected.

If reform does happen, Davis says, it is likely that it will be phased in over time.

"Obama could start with children," she says. "The Children's Health Insurance Plan (SCHIP) is up for renewal in March and expansion is certainly possible. And McCain could start by allowing people to buy insurance across state lines."

Laszewski agrees that this might happen. But he says the chance of seeing major health care reform in 2009 or even 2010 is now "exactly zero."

He faults both candidates for their failure to acknowledge this economic reality.

"They were asked about it last night and they were asked at the first debate, and neither one would admit that major reform is off the table," he says. "They need to be made to answer the question, 'If you can't have major reform, what will you do?' By letting them off the hook, we have no idea what the answer is."

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