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John McCain on Health Care

Republican Sr Senator (AZ


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

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

Supports tax-free medical savings accounts & tax credits

Source: National Political Awareness Test (NPAT) Nov 7, 2004

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: Project Vote Smart, 1998, www.vote-smart.org 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 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:
AZ Gubernatorial:
Janet Napolitano
AZ Senatorial:
Jim Pederson
Jon Kyl

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Chmn.John Cox
Rep.Newt Gingrich
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