USA election 08, debate da Saúde de volta
Depois da eclosão da crise de Wall Street todos recearam que o tema da Saúde permanecesse esquecido na derradeira fase da campanha.
Mas este fim de semana Obama trouxe o tema de novo à primeira linha do debate através de um ataque ao plano de saúde de John McCain, que propõe trocar as isenções fiscais dadas aos empregadores sobre os benefícios de saúde dos trabalhadores por créditos fiscais a atribuir directamente aos cidadãos americanos - $2,500 (individual) e $5,000 para as famílias. link
Se um plano familiar de saúde custa em média $12,680 ano, link o crédito de $5,000 só pode significar endividamento inevitável das famílias.
Segundo Obama, o plano de McCain, ao transferir o seguro de benefícios fiscais dos empregadores para os indivíduos, determinará inevitavelmente o fim do actual sistema de cobertura assegurada pelas entidades empregadoras no qual o encargo das famílias é em média de $3,354 ano.
Mas este fim de semana Obama trouxe o tema de novo à primeira linha do debate através de um ataque ao plano de saúde de John McCain, que propõe trocar as isenções fiscais dadas aos empregadores sobre os benefícios de saúde dos trabalhadores por créditos fiscais a atribuir directamente aos cidadãos americanos - $2,500 (individual) e $5,000 para as famílias. link
Se um plano familiar de saúde custa em média $12,680 ano, link o crédito de $5,000 só pode significar endividamento inevitável das famílias.
Segundo Obama, o plano de McCain, ao transferir o seguro de benefícios fiscais dos empregadores para os indivíduos, determinará inevitavelmente o fim do actual sistema de cobertura assegurada pelas entidades empregadoras no qual o encargo das famílias é em média de $3,354 ano.
Etiquetas: USA election 08
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At the heart of Mr McCain’s strategy is the elimination of the tax advantage enjoyed by employer provided health insurance over the sort obtained by individuals directly with an insurer. This tax break has been a politically popular feature of America’s corporate landscape since the second world war.
But most economists hate this giveaway, which costs the Treasury over $200 billion a year, arguing that it distorts the market in two ways. It biases the market against individual plans, which receive no such tax break. And it ties employees to firrms, thus diminishing labour market flexibility.
Mr McCain’s reforms would replace that corporate subsidy with a refundable tax credit, worth up to $5,000 per family, for people to buy their own insurance from anyone they like. He would allow them to purchase insurance across state lines and through such organisations as churches. Unlike Mr Obama, he will not force insurers to accept everyone, but he will offer federal funding for state-run “high risk pools” which (he claims) will defray the cost of covering the sickest.
Will it work? Mr McCain certainly deserves applause for proposing an end to the employer subsidy. That is worth doing, but it could make it less attractive for firms to offer health insurance. Mr McCain insists that very few big firms will actually drop coverage.
But the boffins at the TPC are unconvinced. They calculate that Mr Obama’s plan will reduce the number of uninsured quickly (by about 18m in 2009, and by 34m in 2018), but that Mr McCain’s plan would lower the number by only 1m-5m by 2013.
Mr McCain’s advisers reject that analysis, arguing that the tax credit given to individuals to buy insurance on their own will allow millions of Americans to get coverage, far offsetting any decline in corporate cover. But given that a typical health plan for a family costs $12,000 or so, it is unclear how many of the working poor will be motivated by a $5,000 refundable credit. The highrisk pools proposed by Mr McCain also raise doubts. States that have experimented with this timid approach to reform have mostly failed.
In the end, both plans have their virtues. With Mr Obama’s, the big unknown is how much it will really cost to reach nearuniversal coverage, while the uncertainty about Mr McCain’s strategy to tackle costs is whether it will do much to expand coverage. Given the growing ranks of the underinsured and an increasingly common view that this is a scandal for a country as rich as America-never mind the 46m with no health insurance at all - voters may prefer the plan that promises to cover everyone quickly, and let future voters worry about the cost.
suplemento "The economist" 04.10.08
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