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Candidates’ healthcare fixes: tax credits vs. more federal spending

The US spends twice as much on healthcare per capita than other nations but still trails in access to care.

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But opponents say such a system would encourage insurers to locate in states with the fewest restrictions, so they could continue to deny coverage to people who need it most, simply “cherry-picking” the profitable, healthy ones. That, they contend, would ultimately undermine remaining state regulations.

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That argument doesn’t sway Gary Cox.

He and his wife own a small construction company in Delaware, Ohio, that builds custom homes. As the only employees, they are essentially self-insured. They buy their health plan through the chamber of commerce. That ensures they have access to care when they need it.

“But they are still pretty high rates and we have a high deductible to even get to the rates we’ve got,” Mr. Cox says.

He favors McCain’s $5,000 tax credit plan. He also likes the idea that he could go anywhere in the country to look for the best options available because it introduces what he believes is “much-needed competition” into the healthcare market.

But Cox is wary of McCain’s proposal to pay for the program by taxing the health benefits people currently receive.

“I’ve never been a believer that taxing people on their income is a fair and equitable way to work the tax code,” he says.

Still, Mr. Cox is even more opposed to the Obama plan, which is designed to expand the current employer-based and public sector insurance programs. He believes the way they are currently structured creates disincentives to individuals to spend their money wisely.

‘It’s morphed into a monstrosity’

“It’s morphed into a monstrosity where the insurance company is paying every time I go to the doctor, so I don’t bother to shop for the best rates because somebody else is going to pay,” Cox says. “We need to reintroduce competition into the healthcare industry, or we’re going to be faced with ever-increasing high healthcare costs.”

Cox is also opposed to Obama’s plan to subsidize some individuals or small businesses so they can afford to buy into a national insurance pool.

“My firm belief is that it never should be the government’s responsibility – and therefore us, the citizens and taxpayers – to pay for somebody’s health insurance premium anymore than I would expect the government to pay my car insurance premium or my homeowner’s insurance premium,” he says. “We’ve continually been on an ever-increasing slippery slope where we citizens think it’s everybody else’s responsibility to pay [our] bills.”

Margaret Demko of Albany, Ohio, agrees everyone should be responsible for themselves.

But she also believes the free market has failed the healthcare system miserably. That’s left too many people, like her family and every other family that lives on her rural road in Appalachia, without healthcare coverage.

“It’s a basic human need to be able to know that if you get sick or break your leg or get into a car accident that you’ll be able to have coverage,” she says. “At some level it becomes a moral issue as well, because it’s all about taking care of people and each other.”

Ensuring that everyone has access to care has become a full-time cause for Ms. Demko. She and her family have been without insurance since her daughter was born four years ago with what doctors say is Down syndrome. Her husband is a self-employed contractor so the family had relied on her job as a substance abuse counselor for their health insurance.