Breaking Down John McCain and Barack Obama's Health Care Plans

This is a rush transcript from "America's Election HQ," October 8, 2008. This copy may not be in its final form and may be updated.

MARTHA MACCALLUM, HOST: Another hot button issue that is now getting more played these days on the campaign trail, especially with all the financial worries. People are concerned about their health care, of course.

Today, Barack Obama and McCain slammed each other's plans. Take a listen:


SEN. JOHN MCCAIN, PRESIDENTIAL CANDIDATE: Under the plan he has proposed, he will fine employers who don't offer health insurance and put their employees in government healthcare. He never did tell you what the fine was, did he? What he doesn't say, and what nobody has asked is how big that fine will be.

SEN. BARACK OBAMA, PRESIDENTIAL CANDIDATE: He talks about giving every family a $5,000 credit to buy healthcare. But he didn't mention last night that he will also tax your benefits for the first time in history. It's an old Washington game.


MACCALLUM: All right. So what's the truth here? What are the pros and cons of each of these plans? And what do really mean for us?

Video: Watch Martha MacCallum's interview

Joining me now is Dr. John Abramson. He is on the clinical faculty of Harvard Medical School. He is also the author of the book "Overdosed America: The Broken Promise of American Medicine."

Doctor, good to have you today.


MACCALLUM: Let's take a look at a couple sound bites from last night so you can kind of break down and tell with us what you think of these two plans. Let's play those first.



OBAMA: Here's what I would do. If you've got healthcare already, and probably the majority of you do, then you can keep your plan if you are satisfied with it. You can keep your choice of doctor. We're going to work with your employer to lower the costs of your premiums, by up to $2,500 a year. If you don't have health insurance, you're going to be able to buy the same kind of insurance that Sen. McCain and I enjoy as federal employees.

MCCAIN: If you're a small businessperson and you don't insure your employees, Sen. Obama will fine you. That's remarkable. If you're a parent, and you're struggling to get health insurance for your children, Sen. Obama will fine you. I want to give every American a $5,000 refundable tax credit they can take anywhere, across state lines.


MACCALLUM: All right. So the big question here, Doctor, is what works better, when the government decides, you know, you're going to provide healthcare insurance. You're going to provide healthcare insurance and this is what you are going to do. Or when you give people back some of their own money and say, here is, you know, some money. We'd like you to figure out where you're going to get your own health insurance and make your own choice.

ABRAMSON: You know, Martha, the American people are fundamentally decent. And their decency is really brought out in their attitudes about healthcare. Americans believe that everybody should be covered. Everybody should have access to care when they're sick and access to preventive care.

Now, the question is how do we best get there? Sen. Obama's plan builds on the current system, though it promises that we will decrease costs by $2,500. That's hard to do.

Sen. McCain's plan will change the system that we have now. It will make it a market-based system, allow for competition. But the real problem, Martha, is that our healthcare system is so disordered that neither plan can work. We are wasting in America. We are wasting $700 billion a year on healthcare that is either unnecessary or harmful.

MACCALLUM: Well, Doctor, let me ask you then. Wouldn't it then, you know, make some sense perhaps, and you tell me if I'm wrong, to put more competition into the medical sector so that, you know, companies get rid of some of that waste, because they have to be lean and mean and they have to provide care and they're competing against each other?

ABRAMSON: Martha, I think it's a great question. And the problem is that the knowledge that consumers have about healthcare largely comes from the drug companies and the providers of healthcare. And it's biased because the drug companies and the other medical industries have a fundamental responsibility to maximize their profits.

In a better system where there was better information for consumers, and I'm sorry to say, but for doctors as well, then either approach would work. But in this system where we don't have oversight of the integrity of our medical knowledge, because there's so much money to be made in healthcare, neither system is going to be able to work.

MACCALLUM: All right. Well, that's encouraging. Before I let you go, can you give us one sort of, you know, a very specific idea that you think both of these people should consider in their plans?

ABRAMSON: I sure will, and they both do. It's so important for Americans to understand that most of our health is determined by how we live our lives, whether our lifestyle is healthy, whether we exercise routinely and eat a healthy diet. And we've been taught to rely upon medical care and to think that medical care can protect us. Really, it is individual responsibility primarily.


ABRAMSON: We need to help ourselves.

MACCALLUM: All right. So start with yourself and individual responsibility is a good theme all across the board. Thank you very much, Doctor. Good to talk to you tonight.

ABRAMSON: Pleasure, Martha. Thanks. Good to be with you.

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