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John McCain on Health Care

Republican nominee for President; Senior Senator (AZ)


Repeal and replace the massive federal health-care law

But in the end, McCain said the election is about a choice. While he said he'll fight to repeal and replace the massive federal health-care law and rein in pork-barrel spending, he predicted Glassman would push for another big-spending stimulus package, protect the unpopular health-care law and support the "corrupt practice of earmarks."

"He's clearly out of step with Arizona and with the people of this state," McCain said.

Source: Arizona Daily Star coverage of 2010 Arizona Senate debate , Sep 27, 2010

Healthcare reform requires cultural change over a generation

In Oct. 2007, AARP sponsored what was supposed to be a major health forum in Iowa. Only John McCain and I agreed to even show up. While it was a shame that the other candidates didn't come, it turned out to be one of the most interesting events of the entire campaign, as Senator McCain and I talked about the problems and possible solutions to the country's healthcare situation.

The kind of change we need--the kind that Senator McCain and I were talking about in Sioux City, isn't merely a programmatic switch, but a cultural change, one that will take a generation to accomplish, not just an election cycle. And here we run up against one of the dirty little secrets of politics. People who run for office like to champion issues that they can address during their term of office.

Source: Do The Right Thing, by Mike Huckabee, p.177-179 , Nov 18, 2008

Get healthcare records online to reduce costs

Q: Would either of you now favor controlling health care costs over expanding health care coverage?

McCAIN: It really is the escalating costs of health care that’s inflicting such pain on working families and people across this country. And I am convinced we need to do a lot of things. We need to put health care records online. The V.A. does that. That will reduce costs. We need to have more community health centers. We need to have walk-in clinics.

Source: 2008 third presidential debate against Barack Obama , Oct 15, 2008

Mandated heath insurance is Big Government at its best

McCAIN: Sen. Obama wants, if you’ve got [a small business with] employees, & you’ve got kids, if you don’t adopt the health care plan that Sen. Obama mandates, he’s going to fine you. Now, Sen. Obama, I’d still like to know what that fine is going to be. Sen. Obama wants to set up health care bureaucracies, take over the health care of America--as he said, his objective is a single payer system. You’ll have to pay a fine if you don’t provide health insurance that Sen. Obama mandates, not the kind that you think is best for your family, your children, your employees, but the kind that he mandates for you. That’s big government at its best.

OBAMA: Here’s your fine--zero.

McCAIN: Zero?

OBAMA: Zero, because as I said in our last debate and I’ll repeat, I exempt small businesses from the requirement for large businesses that can afford to provide health care to their employees, but are not doing it.

Source: 2008 third presidential debate against Barack Obama , Oct 15, 2008

50% credit for businesses who provide employees insurance

McCAIN: I want to give every family a $5,000 refundable tax credit. Take it and get anywhere in America the health care that you wish. For small businessmen like Joe the plumber, if you want to do the right thing with your employees and provide them health insurance, we’ll give you a 50% credit so that you will actually be able to afford it.

OBAMA: If you’ve got insurance through your employer, you can keep your insurance. We estimate we can cut the average family’s premium by about $2,500 per year. If you don’t have health insurance, then we’re going to provide you the option of buying into the same kind of federal pool that both Sen. McCain and I enjoy as federal employees. We’re going to make sure insurance companies can’t discriminate on the basis of pre-existing conditions. We’ll negotiate with the drug companies for the cheapest available prices. We are going to invest in information technology to eliminate bureaucracy and make the system more efficient.

Source: 2008 third presidential debate against Barack Obama , Oct 15, 2008

Put health records online, to reduce medical errors

Q: Do you believe health care should be treated as a commodity?

A: You really identified one of the really major challenges that America faces. Co-payments go up, which make people less & less able to afford health insurance. And we need to do all of the things that are necessary to make it more efficient. Let’s put health records online, that will reduce medical errors, as they call them. Let’s have community health centers. Let’s have walk-in clinics. Let’s do a lot of things to impose efficiencies

Source: 2008 second presidential debate against Barack Obama , Oct 7, 2008

Health care is a responsibility: just make it available

Q: Is health care in America a privilege, a right, or a responsibility?

McCAIN: I think it’s a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. And with the plan that I have, that will do that. But government mandates I’m always a little nervous about. But it is certainly my responsibility. It is certainly small-business people and others, and they understand that responsibility. American citizens understand that. Employers understand that.

OBAMA: Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can’t pay their medical bills--for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies--there’s something fundamentally wrong about that.

Source: 2008 second presidential debate against Barack Obama , Oct 7, 2008

FactCheck: Plan is $5,000 per family, not $5,000 per person

McCain misstated his own health care plan, saying he’d give a $5,000 tax credit to “every American” His plan actually would provide only $2,500 per individual, or $5,000 for couples and families. He also misstated Obama’s health care plan, claiming it would levy fines on “small businesses” that fail to provide health insurance. Actually, Obama’s plan exempts “small businesses.”
Source: FactCheck.org on 2008 second presidential debate , Oct 7, 2008

Bring together smart Americans to solve Medicare

Q: How should we fix Social Security and other entitlement programs?

McCAIN: What we have to do with Medicare is have the smartest people in America come together, come up with recommendations, and then, like the base-closing commission idea we had, then we should have Congress vote up or down.

OBAMA: If we get our tax policies right so that they’re good for the middle class, if we reverse the policies of the last eight years that got us into this fix in the first place and that Sen. McCain supported, then we are going to be in a position to deal with Social Security and deal with Medicare, because we will have a health care plan that actually works for you, reduces spending and costs over the long term, and Social Security that is stable and solvent for all Americans and not just some.

Source: 2008 second presidential debate against Barack Obama , Oct 7, 2008

$5,000 refundable tax credit for every family

McCAIN: I want every family to have a $5,000 refundable tax credit so they can go out and purchase their own health care. I want to double the dividend, from $3,500 to $7,000, for every dependent child in America. I know that the worst thing we could possibly do is to raise taxes on anybody.

OBAMA: I make sure that we have a health care system that allows for everyone to have basic coverage. McCain talked about providing a $5,000 health credit. Now, what he doesn’t tell you is that he intends to, for the first time in history, tax health benefits. So you may end up getting a $5,000 tax credit. Here’s the only problem: Your employer now has to pay taxes on the health care that you’re getting from your employer, and if you end up losing your health care from your employer, you’ve got to go out on the open market and try to buy it. It is not a good deal for the American people.

Source: 2008 first presidential debate, Obama vs. McCain , Sep 26, 2008

Family should make health decisions, not federal government

OBAMA: If you end up losing your health care from your employer, you’ve got to go out on the open market and try to buy it. It is not a good deal for the American people.

McCAIN: I want to make sure that we’re not handing the health care system over to the federal government which is basically what would ultimately happen with Obama’s health care plan. I want the families to make the decisions between themselves and their doctors, not the federal government.

Source: 2008 first presidential debate, Obama vs. McCain , Sep 26, 2008

FactCheck: Obama’s plan is voluntary for adults

Obama & McCain traded incorrect statements on each other’s health care plan.

Obama said, “Your employer now has to pay taxes on the health care that you’re getting from your employer.” McCain’s plan doesn’t call for taxing employers on health care benefits; it would instead tax employees. Employees don’t pay taxes on their health insurance benefits. Under McCain’s plan, they would.

McCain also misrepresented Obama’s plan when he said that his opponent favored “handing the health care system over to the federal government.“ McCain made a similar claim in his acceptance speech, when he said that Obama’s plans would ”force families into a government run health care system.“ We called it false then and we stand by that. Obama’s plan mandates coverag for children, but not for adults, and it does not require anyone to be covered by a nationalized system. Obama’s plan expands the insurance coverage offered by the government, but allows people to keep their own plans or choose from private plans as well

Source: FactCheck.org on 2008 first Presidential debate , Sep 26, 2008

Tax credits to address crisis of health insurance

Bush & McCain both proposed to address the crisis of health insurance with new programs of tax credits. This approach does nothing to reform the structural flaws in the current health insurance system--it merely subsidizes demand; and the credit is too low a level to allow the beneficiary to afford decent health insurance. So when they propose mainly tax credits, Democrats increasingly play on Republican turf: Government bad, tax cuts good. The game becomes a battle merely over which taxes to cut.
Source: Obama`s Challenge, by Robert Kuttner, p. 96 , Aug 25, 2008

FactCheck: McCain’s $5,000 health tax credit would be taxed

McCain made his tax plan sound way too generous to middle-income taxpayers, omitting a key feature of one proposal. McCain said, “Let’s give [families] a $5,000 refundable tax credit to go out and get the health insurance of their choice.”

But he failed to mention what he would also take away. Under his plan, workers would be taxed on the value of any health benefits paid for by their employers, which isn’t the case under current law.

McCain didn’t include that fact in an ad his campaign aired in May touting his health care plan, either. As we said at the time, the credit isn’t a $5,000 windfall--it’s designed to cover the increased taxes families with employer-sponsored insurance would have to pay.

[Our experts tell] us that there would be “a lot of winners and losers” under McCain’s plan. Those with lower incomes and employer-sponsored insurance might fare better, because they’d be taxed at a lower rate than those in higher tax brackets.

Source: FactCheck.org analysis of 2008 Saddleback joint appearance , Aug 16, 2008

Large tax credit for families to buy their health care

We will offer every individual and family a large tax credit to buy their health care, so that their health insurance is theirs to keep even when they move or change jobs.
Source: McCain-Obama speeches at 99th NAACP Convention , Jul 12, 2008

1997: Give FDA more regulatory powers over tobacco

In November 1997, McCain introduced a bill to provide the Food and Drug Administration with a number of new regulatory powers over tobacco products, in order to "reform and restructure the processes by which tobacco products are manufactured, marketed, and distributed." Giving the FDA the power to regulate tobacco would have been a significant change in policy--one that his Republican colleagues, who receive millions in contributions from tobacco companies, were none too eager to see enacted. After a long process of amendments to the bill, it was eventually killed by Senate Republicans in June 1998.

In the decade since McCain's bill died in 1998, he has done NOTHING to press the issue further. He did not introduce the bill, nor did he attempt to introduce a modified version.

Source: Free Ride, by David Brock and Paul Waldman, p. 64-65 , Mar 25, 2008

Harness market competition for comprehensive reform

Comprehensive Health Care Reform: John McCain believes health care reform should address the rising costs that threaten families’ budgets, business competitiveness, and government programs by making the entire system responsive to the needs of American families. Families should receive quality, accountable care at lower costs by harnessing market competition.
Source: Campaign plan: “Bold Solutions for Economic Prosperity” , Feb 3, 2008

Preserve quality of health care by individual responsibility

Q: What would you do to curb the high cost of medical health care & to help those who don’t have health insurance?

A: The real question is: How are we going to keep health care costs down, because we have the highest quality of health care in the world in America today? And unlike the Democrats, I’m going to preserve that quality of health care, and at the same time stop the inflation & the skyrocketing costs of health care. And there’s a couple of principles:

Ronald Reagan said nobody ever washed a rental car. And that’s true in health insurance. If they’re responsible for it, then they will take more care of it.
Source: 2007 Republican primary debate on Univision , Dec 9, 2007

Give individuals $2500 refundable tax credits for healthcare

Q: Your plan for lowering health care costs involves switching people from employer-provided health care to policies they buy on their own. There’s concern that could lead insurance companies to cherry-pick their clients. You also want to limit the amount doctors can charge for chronic diseases, which skeptics worry could make it difficult for people with diabetes, for example, to find doctors to take care of them. How would you deal with these two problems?

A: Last year, the Medicaid inflation was 10%. No program in the world can survive under that. So of course we want to remove the employer tax, and tax incentives, and move it to the individual. Give the individual a $2,500 refundable tax credit, a family a $5,000 tax credit. If you need to have people in special categories such as congenital diseases, we may have to set up a fund to care for those. But the key is, make health care in America affordable and available. Don’t destroy it, as the Democrats want to do.

Source: 2007 GOP primary debate in Orlando, Florida , Oct 21, 2007

Control health costs so manufacturers stay competitive

Q: Pres. Bush said that GM & Ford need to produce a product that’s relevant rather than looking to Washington for help. Do you agree?

A: I agree with that, but I think we in Washington have an absolute requirement to bring health care costs down. The differential between Toyota and General Motors [due to healthcare costs affects each cars’ cost by] $1,700. It’s our responsibility to stop the cost aspects of health care, which is endangering the profitability and the competitiveness of our Detroit workers. So of course they have to do it on their own. But it is our job to create a climate where we have both a safe and secure Social Security system but also health care costs under control so that they can be competitive with foreign products. By the way, there are automobile manufacturers moving in the southern part of this country, as you know, that are doing very well because American workers are the most productive in the world.

Source: 2007 Republican debate in Dearborn, Michigan , Oct 9, 2007

Stumped by whether contraceptives prevent spread of AIDS

In March 2007, McCain was asked a question any tenth grader knows the answer to. The full exchange:

Q: Do you think contraceptives help stop the spread of HIV?

McCain: (Long pause) You've stumped me.

Q: I mean, I think you'd probably agree it probably does help stop it?

McCain: I'm not informed enough on it. I've never gotten into these issues before.

McCain HAD gotten into those issues before, acknowledging the link between contraception and HIV prevention, and supporting federal money to purchase condoms. In 2004, as the Democratic National Committee has gleefully pointed out, McCain answered yes to a question posed by Project Vote Smart: "Should aid to African nations for AIDS prevention programs fund distribution of contraceptives?" And on Meet the Press in Feb. 2002, McCain said: "I think we need to use every means possible to try to eradicate this HIV/AIDS epidemic. But I do believe it's appropriate to emphasize abstinence and other ways, as well, and give them priority."

Source: The Myth of a Maverick, by Matt Welch, p.180-181 , Oct 9, 2007

No mandated universal system; no mandated insurance coverage

McCain says he thinks affordable health care can be made available to all Americans without a mandated universal system. McCain said that he doesn’t think government-run systems such as those in Canada and in Europe will succeed in the US. “I think it’s a warmed-over proposal that we rejected back in the early 1990s and I’m certainly not interested in raising people’s taxes,” McCain said, adding he also is opposed to requiring everyone to buy health insurance coverage. “We’ve got to make health care affordable and available. There’s plenty of ways to do that.“

He said he’s been working on a plan ”for a long time“ but ”it’s a very tough issue.“ One way, he said, would be to expand community health centers and the S-CHIP program, offer tax incentives for poor people, put health care online, medical malpractice reform and promote health savings accounts. However, he said, one problem getting everyone covered ”is there’s a lot of healthy Americans that say I just don’t want health insurance.

Source: United Press International, “McCain sees room” , Jun 10, 2006

We should be able to reimport drugs from Canada

There are no incentives in the system today. How could pharmaceutical companies be able to cover up the cost to the point where nobody knows? Why shouldn’t we be able to reimport drugs from Canada? It’s because of the power of the pharmaceutical companies. We should have pharmaceutical companies competing to take care of our Medicare and Medicaid patients.
Source: 2008 Facebook/WMUR-NH Republican primary debate , Jan 5, 2006

Include a health savings account in healthcare reform

There’s a choice of having outcome-based treatment. If someone has diabetes, we should give the health care provider a certain amount of money and say, “Care for that patient. If at the end of that period that patient is well, we’ll give you a reward.” We need walk-in clinics, community health care, and incentives for home health care. In Arizona, we adopted a proposal which incentivizes health care providers to keep people in home health care settings--dramatically less expensive than long-term care.
Source: 2008 Facebook/WMUR-NH Republican primary debate , Jan 5, 2006

The problem with health care in America is inflation

The problem with health care in America, it’s not the quality. It is the inflation. In all due respect to your expert that we just saw, he’s talking about the wrong aspect of this issue. The right aspect of this issue is inflation, if we could get it under control and get it reduced so that health care costs are reasonable, then those people will be able to afford it. They will be able to go out and choose their insurer, and they will be able to then to get affordable health care. But we have to make the recipient of the health care more responsible. We have to have outcome-based results for health care. We have to emphasize wellness and fitness. One of the most disturbing things in America is the increase in diabetes, obesity and high blood pressure amongst younger Americans. So we have to award wellness and fitness. We’ll have a healthier nation and we will have less health care costs. Some people here in New Hampshire have been to Canada. I don’t think they want that system.
Source: 2008 Facebook/WMUR-NH Republican primary debate , Jan 5, 2006

Supports tax-free medical savings accounts & tax credits

Source: 2004 Presidential National Political Awareness Test , Nov 7, 2004

1989: No mandatory catastrophic Medicare coverage

In 1988, Congress had enacted the Medicare Catastrophic Coverage Act, which allowed senior citizens to get catastrophic health care coverage if they paid an income tax surcharge. Many senior citizens, concerned about living on a shoestring budget, opposed the program because, they argued, they could not afford to pay the surcharge. In Arizona, a state known for its large senior citizen population, McCain had received more than his share of telephone calls. Many senior citizens felt they simply couldn’t afford the program. So, McCain attached an amendment to a supplemental appropriations bill and submitted it to the Senate. The legislation, if passed, would essentially kill the new catastrophic benefits---and the prohibitive surcharge.

An editorial by McCain about catastrophic health care coverage [said] mandatory participation in the program would cost some senior citizens as much as $800 a year for coverage. The Senate voted overwhelmingly against McCain: 58 to 40.

Source: Man of the People, by Paul Alexander, p.130-1 , Jan 19, 2004

1993: To socialize healthcare would be to ruin it

During the fall of 1993, a controversy erupted on Capitol Hill concerning the universal health care plan being advanced by the Clinton Administration under the direction of First Lady Hillary Rodham Clinton. McCain was opposed to the Clinton plan, although, in a break with many members of his party, he did believe all Americans should have access to the health care system.

[But the Clinton plan, according to McCain], would destroy America’s health care system as it had come to be known---the best in the world. McCain was also worried about the Clinton plan’s distribution of money. “All Americans deserve the opportunity to obtain health care coverage of their choice,” McCain wrote

“I hope that we will never see the day in which the government tells us which health care plan we may enroll in or who will provide the care. To socialize our health care system, as the Clinton reform plan would, will be to ruin it.

Source: Man of the People, by Paul Alexander, p.157 , Jan 19, 2004

Greater consumer access to generic drugs

By the summer of 2001, McCain had taken on the patients’ bill of rights to regulate HMOs, a highly popular but for years unresolved issue in Congress. Though he joined the essentially Democratic side, led by Ted Kennedy and John Edwards, he had his own impact on the drawing up of the bill and was instrumental in getting it through the Senate in the summer of 2001. He joined with Chuck Schumer on legislation to provide consumers with greater access to generic drugs.

McCain threw himself into the struggle over the patients’ bill of rights, applying some of the lessons he’d learned from the campaign finance fight, most especially the benefits of getting others invested in the bill by having them sponsor amendments that were adopted. The bill passed by the Senate in late June by a vote of 59-36. When Bush threatened a veto, McCain issued a statement saying that he was “disappointed” but then he went on to take strong issue with some of the points in the President’s veto threat.

Source: Citizen McCain, by Elizabeth Drew, p. 71-72 , May 7, 2002

1998 tobacco bill attempted regulation via $1.10/pack tax

Pres. Clinton, in a White House ceremony, endorsed the 1997 agreement to regulate tobacco--the deal that had been brokered between the tobacco companies and certain state attorneys general. The bill, christened the McCain bill, passed through the Commerc Committee by a vote of 19-1. The McCain bill had proposed a cigarette tax of $1.10 per pack.

Slowly but surely, however, things began to unravel, precipitated by the tobacco companies' media blitzkrieg against the McCain bill. Ultimately, the tobacco companies spent nearly $50 million in media spots.

The tobacco industry advertisements fixed on one subtle, though not insurmountable contraindication to the McCain bill. If tobacco was indeed addictive, then the addicted smoker was all but compelled to pay increased taxes. The fact that the majority of cigarette smokers were in lower income brackets made it an even more regressive tax. The McCain bill failed in the Senate.

Source: John McCain: An Essay, by John Karaagac, p.184-187 , Sep 20, 2000

Favorite cause: Cleft-palate surgery for children

[McCain often works to] help raise money for one of McCain’s favorite causes--cleft-palate surgery for children. The procedure saved the life of the McCains’ teenage daughter Bridget, who they adopted from Bangladesh, and Cindy McCain is very active in a global nonprofit called Operation Smile.
Source: The Myth of a Maverick, by Matt Welch, p. 40 , Oct 9, 2007

Higher taxes on cigarettes

McCain supports higher taxes on cigarettes.
Source: US News & World Report, p. 23 , Jan 17, 2000

Matching funds for seniors citizens’ prescription drugs

We’re asking senior citizens now to make a choice between their health and their income. They make too much money to be on Medicare and not enough to pay for their prescription drugs. We’ve got to devise a program that when a senior spends a certain part of their income on these prescription drugs that we’ll have a state and federal match for it. We can’t do that to our senior citizens.
Source: Des Moines Iowa GOP Debate , Dec 13, 1999

Expand health insurance to 11 million uninsured children

[We have] 11 million children without health insurance. We’ve got to expand the children’s health insurance program. And I’ll tell you what: I have the guts to take the money where it shouldn’t be spent in Washington and put it where it should be spent, including 10 percent of the surplus.
Source: Des Moines Iowa GOP Debate , Dec 13, 1999

Keep health care promises to aging veterans

McCain fears the dying generation of WWII veterans is being shortchanged in health care at an age when the old soldiers’ medical needs are more expensive than ever. “Our WWII veterans, the greatest generation, they’re dying at 30,000 a month, & they’re not getting the care they’ve been promised,” McCain said. “If you’ve got a flat budget, and millions of Americans who need expensive long-term and geriatric care, it doesn’t match up.” McCain said he plans to announce soon a “Contract with Veterans.”
Source: (X-ref Defense) The Sunday Enterprise (Brockton, MA), p. A7 , Nov 21, 1999

Address powerlessness when faced with health care crises

While I appreciate the important contributions of managed care, we must protect the rights of patients in our nation’s health care system.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

“Patient rights” means value human life over dollars

I applaud the success of managed care in reining in skyrocketing health care costs, eradicating excessive health care expenditures, and reducing unnecessary overuse of the system. However, too many Americans feel trapped in a system which does not put their health care needs first. They believe that HMOs value a paper dollar more than they do a human life. We cannot continue to ignore the rights of patients. We have allowed the health care reform debate to be determined by special interest groups.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

Expand medical savings; community health; & tax deductions

It is simply disgraceful that 43 million Americans can not afford health care coverage. We must expand medical savings accounts, offer flexible savings accounts, provide full tax deductibility for self-employed health insurance costs, and allow tax deductibility for long-term care expenses. We should provide more funding for our nation’s community health centers, which have instituted a sliding fee schedule which allows people to contribute what they can afford and still receive health benefits.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

Patient Rights: access; MDs over HMOs; grievance process

    Several principles must guide our health care debate:
  1. Put patients and doctors in charge of their own health care, not HMO bureaucrats
  2. Improve access to affordable health care
  3. Choice of doctors to meet health care needs
  4. Guaranteed access to emergency care
  5. Continuity of care when employers change
  6. Doctors must be able to communicate openly and fully with their patients
  7. A free and fair grievance process in the event an HMO denies medical care, including relief in the courts.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

Allow paying extra for choice of doctors & care

Americans should be free to choose their doctors, including specialists, if they are willing to bear the additional costs which may accompany this freedom. People should be able to enroll in a point-of-service plan with access to a multitude of physicians, rather than be limited to an HMO which restricts freedom of choice in doctors.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

Full doctor-patient discussion even when it costs HMO

Today, some doctors are prevented by HMOs from openly discussing all medical treatments available to a patient. This is unconscionable. HMOs must not be allowed to stop doctors from openly discussing all possible care available, even if the procedures are not covered by the HMO. A doctor’s loyalty must be to the patient and not an HMO’s bottom line.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

Supports patient rights; regulate nicotine as a drug

Source: 1998 National Political Awareness Test , Jul 2, 1998

More tax-deductible health costs; limits on malpractice

Source: (x-ref to Tax Reform) Project Vote Smart, 1998 , Jul 2, 1998


John McCain on Voting Record

Allow appealing HMO decisions externally & in court

We can not support a system that leaves [patients] powerless against corporate health care. [We need] both internal and external appeals processes which are fair and readily available and which use neutral experts who are not selected, paid, or otherwise beholden to the HMO. In life-threatening cases, there must be an expedited process. Finally, once all options to receive necessary medical care have been exhausted, every American should have the right to seek reasonable relief in the courts.
Source: Senate statement: “Health Care Reform” , Jul 15, 1999

Voted YES on the Ryan Budget: Medicare choice, tax & spending cuts.

Proponent's Arguments for voting Yes:

[Sen. DeMint, R-SC]: The Democrats have Medicare on a course of bankruptcy. Republicans are trying to save Medicare & make sure there are options for seniors in the future. Medicare will not be there 5 or 10 years from now. Doctors will not see Medicare patients at the rate [Congress will] pay.

[Sen. Ayotte, R-NH]: We have 3 choices when it comes to addressing rising health care costs in Medicare. We can do nothing & watch the program go bankrupt in 2024. We can go forward with the President's proposal to ration care through an unelected board of 15 bureaucrats. Or we can show real leadership & strengthen the program to make it solvent for current beneficiaries, and allow future beneficiaries to make choices.

Opponent's Arguments for voting No:

[Sen. Conrad, D-ND]: In the House Republican budget plan, the first thing they do is cut $4 trillion in revenue over the next 10 years. For the wealthiest among us, they give them an additional $1 trillion in tax reductions. To offset these massive new tax cuts, they have decided to shred the social safety net. They have decided to shred Medicare. They have decided to shred program after program so they can give more tax cuts to those who are the wealthiest among us.

[Sen. Merkley, D-TK]: The Republicans chose to end Medicare as we know it. The Republican plan reopens the doughnut hole. That is the hole into which seniors fall when, after they have some assistance with the first drugs they need, they get no assistance until they reach a catastrophic level. It is in that hole that seniors have had their finances devastated. We fixed it. Republicans want to unfix it and throw seniors back into the abyss. Then, instead of guaranteeing Medicare coverage for a fixed set of benefits for every senior--as Medicare does now--the Republican plan gives seniors a coupon and says: Good luck. Go buy your insurance. If the insurance goes up, too bad.
Status: Failed 40-57

Reference: Ryan Budget Plan; Bill HCR34&SCR21 ; vote number 11-SV077 on May 25, 2011

Voted YES on regulating tobacco as a drug.

Congressional Summary:Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to provide for the regulation of tobacco products by the Secretary of Health and Human Services through the Food and Drug Administration (FDA). Defines a tobacco product as any product made or derived from tobacco that is intended for human consumption. Excludes from FDA authority the tobacco leaf and tobacco farms.

Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.

Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.

Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.

Reference: Family Smoking Prevention and Tobacco Control Act; Bill HR1256&S982 ; vote number 2009-S207 on Jun 11, 2009

Voted NO on expanding the Children's Health Insurance Program.

Congressional Summary:

Proponent's argument to vote Yes:

Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.

Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.

Reference: SCHIP Reauthorization Act; Bill H.R.2 ; vote number 2009-S031 on Jan 29, 2009

Voted NO on expanding enrollment period for Medicare Part D.

To provide for necessary beneficiary protections in order to ensure access to coverage under the Medicare part D prescription drug program. Voting YES would extend the 6-month enrollment period for the Prescription Drug Benefit Program to the entire year of 2006 and allows beneficiaries to change plans once in that year, without penalty, after enrollment. Also would fully reimburse pharmacies, states and individuals for cost in 2006 for covered Medicare Part D drugs.
Reference: Medicare Part D Amendment; Bill S Amdt 2730 to HR 4297 ; vote number 2006-005 on Feb 2, 2006

Voted YES on increasing Medicaid rebate for producing generics.

Vote on an amendment that removes an increase in the Medicaid deduction rebate for generic drugs from 11% to 17%. The effect of the amendment, according to its sponsor, is as follows: "This bill eliminates the ability of generic drugs to be sold using Medicaid. Over half the prescription drugs used in Medicaid are generic. Because we have raised the fees so dramatically on what a generic drug company must pay a pharmacy to handle the drug, pharmacies are not going to use the generic. In the long run, that will cost the Medicaid Program billions of dollars. My amendment corrects that situation." A Senator opposing the amendment said: "This bill has in it already very significant incentives for generic utilization through the way we reimburse generics. Brand drugs account for 67% of Medicaid prescriptions, but they also account for 81% of the Medicaid rebates. This is reasonable policy for us, then, to create parity between brand and generic rebates. This amendment would upset that parity."
Reference: Amendment for Medicaid rebates for generic drugs; Bill S Amdt 2348 to S 1932 ; vote number 2005-299 on Nov 3, 2005

Voted YES on negotiating bulk purchases for Medicare prescription drug.

Vote to adopt an amendment that would allow federal government negotiations with prescription drug manufactures for the best possible prescription drug prices. Amendment details: To ensure that any savings associated with legislation that provides the Secretary of Health and Human Services with the authority to participate in the negotiation of contracts with manufacturers of covered part D drugs to achieve the best possible prices for such drugs under Medicare Part D of the Social Security Act, that requires the Secretary to negotiate contracts with manufacturers of such drugs for each fallback prescription drug plan, and that requires the Secretary to participate in the negotiation for a contract for any such drug upon the request of a prescription drug plan or an MA-PD plan, is reserved for reducing expenditures under such part.
Reference: Prescription Drug Amendment; Bill S.Amdt. 214 to S.Con.Res. 18 ; vote number 2005-60 on Mar 17, 2005

Voted NO on $40 billion per year for limited Medicare prescription drug benefit.

S. 1 As Amended; Prescription Drug and Medicare Improvement Act of 2003. Vote to pass a bill that would authorize $400 billion over 10 years to create a prescription drug benefit for Medicare recipients beginning in 2006. Seniors would be allowed to remain within the traditional fee-for-service program or seniors would have the option to switch to a Medicare Advantage program that includes prescription drug coverage. Private insurers would provide prescription drug coverage. Private Insurers would engage in competitive bidding to be awarded two-year regional contracts by the Center for Medicare Choices under the Department of Health and Human Services.Enrolled seniors would pay a $275 deductible and an average monthly premium of $35. Annual drug costs beyond the deductible and up to $4,500 would be divided equally between the beneficiary and the insurer. Beneficiaries with incomes below 160 percent of the poverty level would be eligible for added assistance.
Reference: Medicare Prescription Drug Benefit bill; Bill S.1/H.R.1 ; vote number 2003-262 on Jun 26, 2003

Voted YES on allowing reimportation of Rx drugs from Canada.

S. 812, as amended; Greater Access to Affordable Pharmaceuticals Act of 2002. Vote to pass a bill that would permit a single 30-month stay against Food and Drug Administration approval of a generic drug patent when a brand-name company's patent is challenged. The secretary of Health and Human Services would be authorized to announce regulations allowing pharmacists and wholesalers to import prescription drugs from Canada into the United States. Canadian pharmacies and wholesalers that provide drugs for importation would be required to register with Health and Human Services. Individuals would be allowed to import prescription drugs from Canada. The medication would have to be for an individual use and a supply of less than 90-days.
Reference: Bill S.812 ; vote number 2002-201 on Jul 31, 2002

Voted YES on allowing patients to sue HMOs & collect punitive damages.

Vote to provide federal protections, such as access to specialty and emergency room care, and allow patients to sue health insurers in state and federal courts. Economic damages would not be capped, and punitive damages would be capped at $5 million.
Reference: Bill S1052 ; vote number 2001-220 on Jun 29, 2001

Voted YES on funding GOP version of Medicare prescription drug benefit.

Vote to pass an amendment that would make up to $300 billion available for a Medicare prescription drug benefit for 2002 through 2011. The money would come from the budget's contingency fund. The amendment would also require a Medicare overhaul.
Reference: Bill H Con Res 83 ; vote number 2001-65 on Apr 3, 2001

Voted NO on including prescription drugs under Medicare.

Vote to establish a prescription drug benefit program through the Medicare health insurance program. Among other provisions, Medicare would contribute at least 50% of the cost of prescription drugs and beneficiaries would pay a $250 deductible
Reference: Bill HR.4690 ; vote number 2000-144 on Jun 22, 2000

Voted YES on limiting self-employment health deduction.

The Santorum (R-PA) amdt would effectively kill the Kennedy Amdt (D-MA) which would have allowed self-employed individuals to fully deduct the cost of their health insurance on their federal taxes.
Status: Amdt Agreed to Y)53; N)47
Reference: Santorum Amdt #1234; Bill S. 1344 ; vote number 1999-202 on Jul 13, 1999

Voted YES on increasing tobacco restrictions.

This cloture motion was on a bill which would have increased tobacco restrictions. [YES is an anti-smoking vote].
Status: Cloture Motion Rejected Y)57; N)42; NV)1
Reference: Motion to invoke cloture on a modified committee substitute to S. 1415; Bill S. 1415 ; vote number 1998-161 on Jun 17, 1998

Voted NO on Medicare means-testing.

Approval of means-based testing for Medicare insurance premiums.
Status: Motion to Table Agreed to Y)70; N)20
Reference: Motion to table the Kennedy Amdt #440; Bill S. 947 ; vote number 1997-113 on Jun 24, 1997

Voted NO on blocking medical savings acounts.

Vote to block a plan which would allow tax-deductible medical savings accounts.
Status: Amdt Agreed to Y)52; N)46; NV)2
Reference: Kassebaum Amdt #3677; Bill S. 1028 ; vote number 1996-72 on Apr 18, 1996

Tax credits for those without employee health insurance.

McCain adopted the Republican Main Street Partnership agenda item:

H.R. 1181 the Health Insurance Affordability and Equity Act
With 40 million Americans currently living without health insurance, Republican Main Street Partnership members have been leading the effort to find new and innovative ways to secure health care for our citizens. Easing the burden on businesses entering into insurance purchasing pools, and expanding the use of medical savings accounts (MSAs) have been included in previous economic stimulus packages. RMSP Congresswoman Nancy Johnson (CT) in conjunction with Representatives Jo Ann Emerson (MO), Melissa Hart (PA), Jim Kolbe (AZ), Connie Morella (MD), Doug Ose (CA), Marge Roukema (NJ), Rob Simmons (CT), Fred Upton (MI), and Jim Walsh (NY) introduced legislation that targets tax credits to those that are not offered employee provided health insurance, or are self employed.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP4 on May 24, 2002

Tax deduction for long-term care insurance.

McCain adopted the Republican Main Street Partnership agenda item:

H.R. 831/S. 621 the Long Term Care and Retirement Security Act.
Republican Main Street Partnership Senators Lincoln Chafee (RI), Susan Collins (ME), and Gordon Smith (OR) joined House of Representatives sponsors Reps. Charlie Bass (NH), Dave Camp (MI), Tom Davis (VA), Greg Ganske (IA), Ben Gilman (NY), Dave Hobson (OH), Steve Horn (CA), Nancy Johnson (CT), Sue Kelly (NY), Ray LaHood (IL), Connie Morella (MD), Deborah Pryce (OH), Jim Ramstad (MN), and Rob Simmons (CT) in securing health insurance for seniors and those in long-term care facilities. As new medicines and healthier lifestyles are extending life, more and more Americans need to prepare for their long-term health needs. This legislation allows a tax deduction on long-term care insurance premiums for taxpayers, including accelerated deductions persons for people 55 years of age and up.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP5 on May 24, 2002

Support telemedicine for underserved areas.

McCain adopted the Republican Main Street Partnership agenda item:

H.R. 2706, The Medicare Telehealth Validation (MTV) Act.
Republican Main Street Partnership members Congressman Doug Ose (CA) and Jo Ann Emerson (MO) have introduced this bill to increase the use of telehealth services under the Medicare program. Currently, telehealth services are restricted to use in certain geographically underserved areas. The MTV Act provides sufficient funding and regulatory relief to expand high technology medical diagnostic tools, across the Internet, to urban as well as rural underserved areas. The bill further provides for expansion of store-and-forward techniques, and for a study of the restrictions on telemedicine due to state licensing rules.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP6 on May 24, 2002

$350 billion for prescriptions for poor seniors.

McCain adopted the Republican Main Street Partnership agenda item:

Medicare Prescription Drug Benefit
One of issues to be addressed this year by Congress is that of providing a prescription drug benefit to our nation's Medicare beneficiaries. Legislation currently being drafted [by Republican Main Street Partnership members] intends to authorize $350 billion over the next 10 years to provide purchasing assistance for prescription medications. The benefit reaches out to low and moderate income seniors by extending coverage to incomes up to 150% of the poverty level. The bill could also include provisions to correct reimbursement reductions for physicians, nurses, hospitals, technicians, home health care providers, and long-term care facilities.

Source: Republican Main Street Partnership Legislative Agenda 02-RMSP7 on May 24, 2002

Rated 25% by APHA, indicating a anti-public health voting record.

McCain scores 25% by APHA on health issues

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Source: APHA website 03n-APHA on Dec 31, 2003

Other candidates on Health Care: John McCain on other issues:
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