The US banking and economic crisis has taken centre stage. Many Americans are worried about whether they’ll be able to get a car loan next year, much less pay for health care.

But they have good reason to worry about the latter. There was some stark news this week from the Henry J Kaiser Family Foundation, which tracks the cost of employer-paid health coverage. That’s the bedrock of the American health-delivery system, which more than 160 million Americans getting their insurance through their workplace or a family member’s workplace.

The hard facts: private health coverage for the average family of four now costs US$12 680 per year. Workers’ share of that staggering costs is $3354, which Kaiser described as only a “modest” rise of 5% from last year.

It’s true, a 5% rise in premiums is relatively small compared to the double-digit rises in some years over the last decade. But the figure is more than double what workers paid in premiums in 1999. Over the same time period, wages are up 34% and inflation 29%.

Kaiser’s data shows that it’s not just consumers who are clamoring for some cost relief in the health system. Employers are buckling under the weight of rising costs, leading more and more of them to opt for high-deductible insurance plans that let them limit their financial liability when it comes to workers’ health care. (more…)

Both Presidential candidates’ health-care plans come under scrutiny in the Sept 16 issue of Health Affairs, and both are found to have serious flaws.

Right now, people who receive employer-subsidised health insurance do not have to pay taxes on it. In their analysis of John McCain’s proposals, authors Thomas Buchmueller, Sherry A. Glied, Anne Royalty, and Katherine Swartz state that this not only lowers each employee’s tax burden; it also strengthens risk pools by including younger, healthier people who take advantage of the tax break to obtain coverage. Under McCain’s plan, employer-subsidised health insurance would be considered income and become subject to federal income taxes. However, families would receive tax rebates of US $2500 to $5000 to offset the cost of those policies. 

On the assumption that, stripped of the tax benefit of employer-based coverage, many people would then buy policies on the open market, the McCain plan would eliminate current restrictions against crossing state lines when shopping for policies. Many states now require insurance companies to cover certain services, such as mammograms, even in their barest-bones policies; under the McCain programme, people in one state could buy a less-expensive policy in another state that required less generous coverage.

All in all, the authors estimate that 20 million of the 160 million Americans now covered through employer health plans would lose that insurance under the McCain plan in its current form. His proposal to deregulate the market ultimately would raise prices for consumers and leave them with fewer protections and more limited coverage. (more…)

Much has been made of the fact that the Republican Vice-Presidential candidate, Alaska Governor Sarah Palin, has a 5-month-old baby boy with Down syndrome. While a good deal of the discussion has generated far more heat than light, Palin’s personal situation does raise the question of whether she will be a disability-rights advocate if elected.

During her acceptance speech at the Republican National Convention, Palin underscored her connection to families with special-needs children. They would, she said, have “a friend and advocate in the White House”.

But Palin’s-and the Republicans’-stand on some issues could complicate her ability to advocate for the disabled. She is opposed (unlike her running mate) to embryonic stem-cell research, a position highlighted by her Democratic counterpart, Senator Joe Biden. On Sept 9, Biden asked why, if Palin plans to help parents of disabled children, she doesn’t support stem-cell research. The McCain campaign called Biden’s remarks part of “an offensive debate over who cares more about special-needs children”. Neither campaign appears to have addressed the issue of whether stem-cell research holds any promise for conditions like Down syndrome.

Like John McCain, Palin also supports a voucher system that would enable parents to choose which schools their children attend. School choice is usually appealing to voters in principle, since it gives parents the right to remove children from failing or dangerous public (ie, state-supported, free) schools, and vouchers theoretically broaden the availability of educational venues beyond the public system to private or charter (fee-supported) schools. In practice, though, US schools are basically run by state, local, and private authorities, not by the federal government. Those local policies may dictate which children can enroll in specific schools, and not all schools (in particular, private ones) will accommodate special-needs children. (more…)

If the US presidential race can be described as theatre, last week’s Democratic National Convention would have been a Broadway hit, with its star candidate Barack Obama and his adorable family in the leading role, and a supporting cast that included the veteran politician and vice-presidential pick Senator Joe Biden. The performance went off without a hitch.With his own nominating convention this week, Republican candidate John McCain hoped to capture at least some of the fanfare from the Obama Show. Instead, he has had to overcome distractions that threatened to spoil the opening act. First, McCain surprised everyone by announcing his vice presidential running mate is Sarah Palin, a previously unknown Alaska governor with little political experience. Then Hurricane Gustav took the stage, narrowly missing an evacuated New Orleans and causing Republicans to delay the start of their convention by a day.

That should have been enough drama for one convention. But the McCain-Palin ticket hit another bump in the political road. And it stems not from the merits of either candidate, but rather from a situation involving Palin’s pregnant and unmarried teenage daughter.

The story dominated the airwaves for the first two days of the convention, although both candidates and a cast of experts pointed out that such personal issues have no place in politics.

Nevertheless, the announcement of Palin’s soon-to-be grandchild is politically relevant, and here’s why: Palin is touted by Republican insiders for her socially conservative credentials, including a strong anti-abortion record. In addition to opposing abortion, on a 2006 questionnaire submitted to gubernatorial candidates, Palin refused support for “explicit sex-education programs”, according to CNN. (more…)

All eyes this week were on Denver and the glitz and glamour of the Democratic National Convention, which many commentators likened to a Hollywood production with an emphasis on personalities rather than issues.

Media coverage made a political soap opera out of Bill and Hillary Clinton supposedly vying for the limelight one last time before the party formally throws its support behind its nominee Barack Obama, who will address the convention today.

In a speech on Tuesday night, Hillary Clinton urged her backers to get behind Obama to prevent a John McCain presidency, the Chicago Sun-Times reported. “I can’t wait to watch Barack Obama sign a health-care plan into law that covers every single American”, she said, reminding the convention floor that health reform was a key issue for her supporters.

Clinton also attacked McCain, who will be formally endorsed as the Republican nominee at his party’s convention next week. “John McCain says the economy is fundamentally sound. John McCain doesn’t think that 47 million people without health insurance is a crisis.” She repeated the Democratic message that a McCain presidency would be a continuation of George W Bush’s policies. (more…)