Health Care Contrasts: It's All About The Risk

Ron Brownstein's column today is at once fascinating and counterintuitive:

The plans unveiled by Barack Obama and Hillary Rodham Clinton encourage the sharing of risk between the healthy and the sick, even at the cost of requiring the former to subsidize the latter. McCain's proposal would maximize individual choice in obtaining coverage, even at the cost of reducing risk-sharing. This contrast, which reflects the broader divide between the Democratic emphasis on community and the Republican focus on personal freedom, is the wellspring from which all of the major differences in the candidates' plans flow.

"...Some experts, including centrists such as prominent health economist Jonathan Gruber, would take the gamble of McCain's tax credit plan. They consider it fairer than the exclusion, which reduces taxes most for affluent workers and penalizes people who buy insurance as individuals rather than through their employers. The catch is that many credit supporters (Gruber included) say it can work only if it is joined with reforms that ensure more risk-sharing and equity in the individual marketplace.

Obama and Clinton are proposing such reforms, but McCain would move in the opposite direction by vastly deregulating all insurance markets to promote competition. Next week we'll explore that component of his agenda.