The journal Health Affairs had some economists take a look at the healthcare plans put out by by both McCain and Obama. The Washington Post summarized it nicely. McCain's plan, they feel, would add more people to the insurance rolls but would lose as many due to employers who stop paying for it. They also think that insurance companies would move to states, if cross-state insurance shopping is allowed, that allow them to game the system. This again would screw over patients. They feel Obama's plan is basically one big government subsidy (isn't half of our healthcare system today?) which would skyrocket the costs because the concept of rationing doesn't enter his mind. My state chapter of the Academy of Family Physicians put out their newsletter, and though they are supposed to remain nonpartisan (yeah, right!), they obviously dropped hints that they love Obama's plan because they want all patients covered. They forget the ripple effect of what happens when there is not enough cash to cover this. Anyway, I like the concept of personal responsibility and teaching someone how to fish versus letting them eat at the free buffet every day. My patients are working me daily to try cheaper meds and I comply because they are right. I love their ownership and it proves to me that when they have to pay out of their own pockets, they will bring costs down. My next editorial for the upcoming October issue of the Placebo Journal, coincidentally, takes a look at this election topic again. You should check it out.