Sen. John McCain toured a cancer research center Tuesday in Tampa, Fla., where he peered through a microscope at some colon cancer cells. But as the Republican presidential hopeful travels the country this week to tout the benefits of a more competitive individual market for health insurance, it's his health care plan that's under the microscope.
At Tampa's Moffitt Cancer Center, McCain praised the doctors and researchers, saying they're a reminder of all that's good in American health care. The challenge, he noted, is making that kind of life-saving care available to all Americans, no matter where they work or how much money they have.
"We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need, and the peace of mind that comes with knowing they are covered," the Arizona senator said.
The current system falls short of that goal. An estimated 47 million Americans have no health insurance, and those who are covered face spiraling costs.
"Rising health care costs hurt employers and the self-employed alike. And in the end, they threaten serious and lasting harm to the entire American economy," McCain said.
McCain differs sharply from Democratic rival Sens. Barack Obama and Hillary Clinton on how to fix the problem. He criticized them for pushing a combination of tax subsidies and regulation in an effort to provide universal health care coverage.
"We will replace the inefficiency, irrationality and uncontrolled costs of the current system with the inefficiency, irrationality and uncontrolled costs of a government monopoly," McCain said.
In fact, neither Clinton nor Obama is proposing a government monopoly on health care.
Clinton's plan mandates that everyone should have insurance, and calls for a mix of individual, government and employer financing, with subsidies for those with low incomes. Obama's proposal, which mandates coverage for children but not adults, uses a combination of credits and subsidies.
McCain's plan also uses tax credits to subsidize insurance. But instead of building on the current system of employer-based coverage, as the Democrats' plans do, McCain wants a system that would encourage more people to buy their own insurance. That way, they wouldn't lose coverage when they change jobs, he says. And a more competitive market could lower costs.
"It would help change the whole dynamic of the current system, putting individuals and families back in charge and forcing companies to respond with better service at lower cost," McCain said.
The senator's proposal expands on President Bush's push for individual health savings accounts. And it reflects the idea that consumers are in the best position to make health care decisions.
"We shop for our houses. We shop for our cars. We shop for our computers. And generally, we get good value for the money," said Harvard Business School professor Regina Hertzlinger, a leader in the consumer-driven health care movement.
"I may consider in the automobile market that a stripped-down Toyota is just fine for me," Hertzlinger said. "But if my employer were buying my car, he'd have no idea what I want. And he may wind up buying much more of a car than I actually want or much less of a car than I actually want."
Critics of McCain's plan say older, sicker people often can't afford to buy health insurance on the individual market. And the presumptive Republican nominee's proposed tax credit of $2,500 for individuals or $5,000 for families might not be enough to make up the difference.
"McCain's plan is fine for healthy, richer people. But it's a very bad plan for the poor and the sick," said Jon Gruber, an MIT economist who helped shape Clinton's and Obama's plans, as well as Mitt Romney's health care program in Massachusetts.
McCain acknowledged Tuesday that the individual insurance market doesn't work well for those with serious health problems. He promised to work "tirelessly" to address that, possibly through some form of subsidized, high-risk pool.
He noted with approval that some states already limit the premiums that insurance companies can charge sick people. But Gruber warned that McCain's plan would undermine that protection. McCain wants to let customers buy insurance from companies anywhere in the country, so insurance companies might gravitate to those states with the least regulation.
"By allowing people to buy insurance anywhere in the country, he would essentially fully deregulate the non-group insurance market," Gruber said. "Healthy people get great deals, but sick people get no deals at all or incredibly expensive insurance."
One of the doctors who showed McCain around the lab Tuesday said there are few breakthroughs in cancer research, just a lot of hard work. The same apparently goes for fixing the nation's health care system.