McCain's healthcare plan is a disaster

Health Affairs, the health policy journal, has published their analysis of John McCain's health insurance plan. In short, it's a terrible idea. You should really read the whole thing, but here's some tidbits:

Their one sentence summary:

Achieving John McCain's vision would radically transform the U.S. health insurance landscape, with negligible gains in numbers of covered Americans, and an expected decline within five years.

Their abstract:

Senator John McCain's (R-AZ) health plan would eliminate the current tax exclusion of employer payments for health coverage, replace the exclusion with a refundable tax credit for those who purchase coverage, and encourage Americans to move to a national market for nongroup insurance. Middle-range estimates suggest that initially this change will have little impact on the number of uninsured people, although within five years this number will likely grow as the value of the tax credit falls relative to rising health care costs. Moving toward a relatively unregulated nongroup market will tend to raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections.

A couple of key quotes:

The main effect of establishing a national market would be to undo state laws designed to establish minimum levels of coverage and protect consumers. In a national market where state licenses are not required, insurers will charter in places where regulations are scarce--much like credit card companies do today. As a result, people guaranteed basic benefits today would find those benefits eliminated under the McCain plan. People in most states would lose access to procedural protections, such as requirements that disputed decisions by managed care plans be subject to external review. People also would lose access to many benefit protections. For example, forty-seven states now require mental health parity, forty-nine states require coverage of breast cancer reconstructive surgery, and twenty-nine require coverage of cervical cancer screening. All of these requirements--as well as regulations in several states that limit the rates that can be charged to higher-cost consumers and that limit who can be excluded from a health plan--would be eliminated under the McCain plan. Without legal requirements in place, plans would no longer offer these benefits at all in many markets, even if many consumers want them.

[I]nitially there would be no real change in the number of people covered as a result of the McCain plan. However, people are likely to have far less generous policies than those they have today.

His plan would see deregulation of health care and make it harder for people with pre-existing conditions to get coverage. His plan would make employer-provided health care a taxable expense. His plan would mean less people with health insurance. His plan would mean that people who do have coverage would receive worse coverage. I'm struggling to find anything good with his idea...