The Doctor Behind McCain's Health Care Plan

By David Nather | April 30, 2008 8:45 AM | | Comments (0)

When John McCain outlined his health care plan in Florida yesterday, it had the imprints of a House Republican who has been looking for a chance to bring his own experiences with the health care system to the national stage.

Back when there was still a crowded field of Republican presidential candidates, Rep. Michael C. Burgess of Texas, an obstetrician-gynecologist from the Dallas-Fort Worth suburbs, approached Rudolph Giuliani and Mitt Romney to offer his advice on health care policy. “I didn’t get a lot of interest,” he recalls.

So over Christmas, Burgess called Douglas Holtz-Eakin, McCain’s economic adviser. The two had gotten to know each other during Holtz-Eakin’s days as director of the Congressional Budget Office, when he had testified before the House Energy and Commerce Committee (Burgess is a member). They kept talking, and Burgess got credit for helping to shape the ideas in McCain’s health care speech.

His input is an example of the kind of outreach McCain has done to build stronger ties with the conservatives in his party, particularly the House Republicans he has sometimes clashed with as a senator. Until now, the most prominent role McCain has played in the health care debate was his co-sponsorship of the “Patients’ Bill of Rights” in 2001 with Democratic Sen. Edward M. Kennedy of Massachusetts and then-Sen. John Edwards of North Carolina – not exactly mainstream Republican fare.

Now, though, McCain is in safer Republican territory – particularly with his embrace of consumer-driven health care, the main idea Burgess says he discussed with the McCain team. It’s the notion that consumers would seek more appropriate, and often cheaper, medical services if they had more control over their health coverage.

In McCain’s version, that would mean letting people opt out of employer-based health coverage and use a tax credit to get their own health coverage. His Democratic rivals, Hillary Rodham Clinton and Barack Obama, said such a change would leave millions of people without guarantees of health coverage. Clinton called the plan fundamentally flawed. Another critic, Roger Hickey, co-director of the liberal group Campaign for America’s Future, said in a conference call that McCain’s plan would “radically disrupt the functioning part of our health care system.”

Burgess, however, said it’s a logical step away from a system in which corporate employee benefits managers make all the decisions about what kind of health coverage most people get. “The reality is, we would never say, could you go out and buy my next car for me, because you’re pretty good at it,” Burgess said. “Perhaps we need to start looking at health insurance in the same way.”

He knows, however, that health care providers will have to get better about disclosing what they charge for their services before consumers would be able to make informed decisions about where to go for their care. That’s a “big hurdle,” Burgess says, which is why he has introduced a bill to promote better information on hospital charges at the state level.

“Even absent a national plan, this is something people need,” Burgess said. “There’s a new mindset out there. People are a lot more willing to do research.”

Between now and November, McCain and Burgess will be trying to convince the voters that they’ll be able to get that kind of information – and that the tradeoff in the security of their health coverage will be worth it.

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