[Schneed10]

John McCain's is by far the best. Though for my employer, the biggest provider of free and underreimbursed care in Pennsylvania, a Democrat would be the best for our financials. But John McCain is the only candidate who addresses the root causes for why healthcare is so expensive.

All of the Democrats are simply trying to find a way to get everybody in the US coverage. A noble cause, but it does nothing to address the factors driving the high growth in health care costs.

First, making plans portable across state lines increases competition amongst hospitals. All of a sudden Cooper University Hospital in South Jersey has to compete with places like the Hospital of University of Pennsylvania, and Jefferson University Hospital for patients. Plus, HMOs now have increased competition from each other as consumers can opt for plans from other states.

Compensating providers based on quality is a movement already taking place in the commercial insurance world. Independence Blue Cross and Aetna here in Philadelphia are already driving pay-for-performance. In other words, if your hospital shows above average mortality rates, rates of unplanned-return-to-surgery, and other quality metrics, then you get a bigger rate increase from the insurers. McCain is the ONLY CANDIDATE that wants to put this in place for government payers Medicare and Medicaid. Keep in mind, Medicare and Medicaid are responsible for a huge portion of payments to providers, so until they begin using pay-for-performance, the healthcare industry will not take quality seriously.

And one of the biggest reasons why healthcare costs have been increasing so rapidly in this counrty is the increase in pharmaceuticals. There are more drugs than ever before, and they all come with patents. McCain is suggesting to make it easier for generics to compete with patented drugs, and increasing price competition through importation. Without these moves, there will be no market factors in place to stop the momentum behind the unstoppable growth in drug prices.

I work in the Financial Planning department of a major metropolitan academic healthcare center. We treat a TON of medicaid patients. A democrat would definitely be best for my employer (they'd essentially just boost payments to us), McCain is by far the best for the country. He's the only candidate who truly rolls up his sleeves, gets his hands dirty, and digs into the issues to truly understand them.