By Sally K. Richardson

If you think the Bush trickle-down economic theories have been good for the economy in West Virginia and the rest of the country, then you may think that John McCain's healthcare plan for America is OK, too. But for my money, I'd like to have a little healthier approach that serves everyone equal to their needs.

The facts are undeniable: more than 47 million uninsured Americans in 2007 and over 235,000 of them were working age West Virginians. That's over one out of every five of us. So for our families and neighbors, it's essential that the next president do something about the health care system that -- compared with the rest of the world -- is dysfunctional. And in this area, there are stark differences in the way the two presidential candidates would address this ongoing crisis.

In a recent Commonwealth Foundation analysis of the candidates and their proposals, a comparison was made based on 22 elements needed for a consumer-friendly and affordable health care system. John McCain's proposal does not even address 10 of those elements -- including issues such as employer contributions, or public program expansions, or patient safety, or financing, and his proposals leave the regulation of the health insurance market where it is now -- up to the individual states.

McCain's "every man for himself" approach would put a couple thousand dollars in the hands of consumers via tax breaks ($2,500 for individuals or $5,000 for families) and leave them to purchase their own private insurance. McCain lauds his plan as "competition" that will put "families in charge of their own healthcare dollars".

Just for the record, here in West Virginia, Blue Cross and Blue Shield warned us in the mid-1990s that the health care system's costs were rising at a rate that would double average business premiums to over $16,000 a year. That's also why more and more businesses, particularly those that are smaller or less robust are reducing their health insurance benefits.

What's more, it is beginning to put American business and industry at a competitive disadvantage in the new global economic world in which we must compete.

Sen. Barack Obama has a much different approach, one that will make the healthcare system work for American families and workers. Recognizing that America is not yet ready to provide universal health care as that rest of the world's industrialized nations are doing, Sen. Obama offers our country a better plan for now that combines the best of our private employer-based system supplemented by a strengthening of the federal and state governments role in ensuring everyone's access to quality care. This comprehensive approach will reduce the enormous weight of uncompensated care -- a primary driver of the costs across the board in America's health care system. In sum, the Obama plan will bring down costs for average consumers, strengthen the employer-based coverage that most Americans have come to rely upon, and ensure that every American -- low-income to the wealthiest -- has access to the doctors and other providers they need.

Under the Obama plan, if you like your current health insurance, nothing changes, except your costs will be lower -- not higher. If you don't like your current health insurance, or don't have it, you will have a choice of new, affordable health insurance options through a new "National Health Insurance Exchange". This option will provide a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.

Of course, meaningful healthcare reform will come at a cost, perhaps as much as $50-65 billion over the next 10 years. In order to help meet this expense, Sen. Obama proposes rolling back the Bush tax cuts for people who are in the top 15 percent of income earners, namely, those making over $250,000 per year.

When the discussion turns to such intractable challenges as health care reform, it is easy to become dispirited. But it doesn't have to be that way. As West Virginians head to the polls and fill out absentee ballots, I suggest asking yourselves: Do I trust the risky McCain privatization approach? Or, will the more balanced Obama approach that focuses on universal access to healthcare through a sensible public-private partnership, be best for West Virginia and my family?

For me, the choice for change is clear: Barack Obama.

Richardson, of Charleston, is the executive director of the Institute for Health Policy Research and associate vice president of the Robert C. Byrd Health Sciences Center. From 1993 to 1999, she was a senior executive in the federal Health Care Financing Administration (now the Center for Medicare and Medicaid Services).

By Sally K. Richardson

If you think the Bush trickle-down economic theories have been good for the economy in West Virginia and the rest of the country, then you may think that John McCain's healthcare plan for America is OK, too. But for my money, I'd like to have a little healthier approach that serves everyone equal to their needs.

The facts are undeniable: more than 47 million uninsured Americans in 2007 and over 235,000 of them were working age West Virginians. That's over one out of every five of us. So for our families and neighbors, it's essential that the next president do something about the health care system that -- compared with the rest of the world -- is dysfunctional. And in this area, there are stark differences in the way the two presidential candidates would address this ongoing crisis.

In a recent Commonwealth Foundation analysis of the candidates and their proposals, a comparison was made based on 22 elements needed for a consumer-friendly and affordable health care system. John McCain's proposal does not even address 10 of those elements -- including issues such as employer contributions, or public program expansions, or patient safety, or financing, and his proposals leave the regulation of the health insurance market where it is now -- up to the individual states.

McCain's "every man for himself" approach would put a couple thousand dollars in the hands of consumers via tax breaks ($2,500 for individuals or $5,000 for families) and leave them to purchase their own private insurance. McCain lauds his plan as "competition" that will put "families in charge of their own healthcare dollars".

Just for the record, here in West Virginia, Blue Cross and Blue Shield warned us in the mid-1990s that the health care system's costs were rising at a rate that would double average business premiums to over $16,000 a year. That's also why more and more businesses, particularly those that are smaller or less robust are reducing their health insurance benefits.

What's more, it is beginning to put American business and industry at a competitive disadvantage in the new global economic world in which we must compete.

Sen. Barack Obama has a much different approach, one that will make the healthcare system work for American families and workers. Recognizing that America is not yet ready to provide universal health care as that rest of the world's industrialized nations are doing, Sen. Obama offers our country a better plan for now that combines the best of our private employer-based system supplemented by a strengthening of the federal and state governments role in ensuring everyone's access to quality care. This comprehensive approach will reduce the enormous weight of uncompensated care -- a primary driver of the costs across the board in America's health care system. In sum, the Obama plan will bring down costs for average consumers, strengthen the employer-based coverage that most Americans have come to rely upon, and ensure that every American -- low-income to the wealthiest -- has access to the doctors and other providers they need.

Under the Obama plan, if you like your current health insurance, nothing changes, except your costs will be lower -- not higher. If you don't like your current health insurance, or don't have it, you will have a choice of new, affordable health insurance options through a new "National Health Insurance Exchange". This option will provide a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.

Of course, meaningful healthcare reform will come at a cost, perhaps as much as $50-65 billion over the next 10 years. In order to help meet this expense, Sen. Obama proposes rolling back the Bush tax cuts for people who are in the top 15 percent of income earners, namely, those making over $250,000 per year.

When the discussion turns to such intractable challenges as health care reform, it is easy to become dispirited. But it doesn't have to be that way. As West Virginians head to the polls and fill out absentee ballots, I suggest asking yourselves: Do I trust the risky McCain privatization approach? Or, will the more balanced Obama approach that focuses on universal access to healthcare through a sensible public-private partnership, be best for West Virginia and my family?

For me, the choice for change is clear: Barack Obama.

Richardson, of Charleston, is the executive director of the Institute for Health Policy Research and associate vice president of the Robert C. Byrd Health Sciences Center. From 1993 to 1999, she was a senior executive in the federal Health Care Financing Administration (now the Center for Medicare and Medicaid Services).