If you listened to last week's presidential debate in Nashville, you heard a little bit about the candidate's health care plans. In the nine minutes devoted to the topic, both men laid out the basic elements of their proposals.
Democratic Senator Barack Obama said under his plan Americans who like their health coverage can keep it. The only thing they'll notice is a lower health care bill, assuming his cost-saving ideas are implemented. And for the nearly 46 million Americans who don't have coverage, Obama said he would create a new insurance option. "If you don't have health insurance you're going to be able to buy the same kind of insurance that Senator McCain and I enjoy as federal employees," Obama said. "Because there's a huge pool we can drop the cost. And nobody will be excluded for pre-existing conditions which is a huge problem."
Obama's plan would also add more dollars to existing government insurance programs like Medicaid and would require all children to have health insurance.
In contrast, Republican Senator John McCain said he would focus on reducing burdensome government regulations that add cost to health care. He believes the private insurance market would respond by lowering their prices. McCain's proposal would also change the way most Americans purchase their health insurance.
"I want to give every American a $5,000 refundable tax credit they can take anywhere across state lines," McCain said. "Why not? Don't we go across state lines when we purchase other things in America?"
Actually, according to the McCain campaign, he would offer the $5,000 tax credit to families. Individuals would get half that amount.
"The McCain one would be a more dramatic change in how health care markets work and how health care is purchased by a lot of people in the country," said Linda Blumberg, an economist with the non-partisan Urban Institute's Health Policy Center. "So it's pretty bold."
She said McCain's health reform plan is a significant departure from what Americans are used to, particularly those with employer-sponsored health insurance. That's because to pay for his reform plan, McCain wants to eliminate the favorable tax treatment employers receive for providing insurance benefits.
Blumberg said that could cause some employers to drop their coverage altogether. And, while employees would still have a tax credit they could use to buy insurance on the private market, she said insurers wouldn't be obligated to sell their products to everyone.
"Those who aren't in perfect health are going to have a much more difficult time accessing care that they need in a system that's really grounded in the non-group market, instead of the group," Blumberg said.
But healthy patients might see better prices on their health coverage and Blumberg said the plan would also give more federal subsidies for health insurance to low income workers than currently exist.
While McCain's plan represents a dramatic change, Blumberg said Obama's plan feels more familiar.
"The Obama one tends to be taking the system that we've got and saying, 'okay well let's expand upon it and try to fill in the gaps that we know are there,'" Blumberg said.
Rather than placing the responsibility on consumers to find their own insurance, Blumberg said Obama would expand government-sponsored insurance pools and put more regulations on insurers.
"The Obama plan would prohibit insurers from denying coverage to individuals based on their health status and would really broaden the way that risk is shared across the healthy and the sick," Blumberg said.
To pay for his plan, Obama would require large employers who don't offer health insurance to contribute a percentage of their payroll toward the cost of a federal insurance plan. Blumberg said the campaign hasn't revealed the cost of the tax. If it's high, she said Obama could encounter a lot of resistance to his plan from employers.
But it's not clear if health care reform will be a major priority for the next president. A new poll showed that only 7 percent of respondents care about health care more than the economy.