MELISSA BLOCK, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

John McCain is on a health care tour this week, traveling to Florida, Ohio, Iowa and Colorado. The Republican presidential candidate is talking up the benefits of greater competition in the market for insurance. Today, he visited a cancer research center in Tampa. He peered through a microscope at some colon cancer cells.

NPR's Scott Horsley puts McCain's health care plan under the microscope.

SCOTT HORSLEY: John McCain praised the doctors and researchers at Tampa's Moffitt Cancer Center, saying they're a reminder of all that's good in American health care. He says the challenge is making that kind of life-saving care available to all Americans no matter where they work or how much money they have.

Senator JOHN McCAIN (Republican, Arizona; Presidential Candidate): 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.

HORSLEY: McCain acknowledged the current system falls short of that. Forty seven million Americans have no health insurance, and even those who are insured are threatened by spiraling costs.

Sen. McCAIN: 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.

HORSLEY: On that much, all the presidential candidates agree, but McCain differs sharply from rivals Barack Obama and Hillary Clinton in how to fix the problem. Today, he criticized the Democrats for pushing universal health care coverage through a combination of tax subsidies and regulation.

Sen. McCAIN: We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality and uncontrolled costs of a government monopoly.

HORSLEY: In fact, neither Obama nor Clinton is proposing a government monopoly on health care. Instead, they're calling for bigger government subsidies for private insurance.

McCain's plan would also use tax credits to subsidize insurance. But instead of building on the current system of employer-based coverage, like the Democrats, McCain wants a complete overhaul that would encourage more people to buy their own insurance. He says that way, they wouldn't lose coverage when they changed jobs. And a more competitive market could lower costs.

Sen. McCAIN: 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.

(Soundbite of applause)

HORSLEY: McCain's proposal expands on President Bush's push for individual health savings accounts. And it's founded on the belief that consumers are in the best position to make health care decisions.

Harvard Business School professor Regina Herzlinger is a leader in the consumer-driven health movement. She says McCain's plan would let consumers shop for health care the same way they shop for computers, houses or cars.

Professor REGINA HERZLINGER (Business Administration, Harvard Business School): I may consider in the automobile market that a stripped-down Toyota is just fine for me. But if my employer were buying my car, he would have no idea what I want. And he might wind up buying much more of the car than I actually want or much less of a car than I actually want.

HORSLEY: MIT economist, Jon Gruber, who's helped shape the Democratic plans, as well as Mitt Romney's health care program in Massachusetts, warns that older, sicker people often can't buy insurance on the individual market. And he says McCain's $2,500 tax credit doesn't go far enough to overcome that.

Dr. JON GRUBER (Professor of Economics, Massachusetts Institute of Technology): McCain's plan is a fine plan for healthy, richer people. But it's not - it's a very bad plan for the poor and the sick. And I think that that's, you know, a major problem.

HORSLEY: McCain acknowledged today 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 warns McCain's own 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.

Dr. GRUBER: By allowing people to buy insurance anywhere in the country, he would essentially fully deregulate the nongroup insurance market. And thereby allowing healthy people to get great deals, but sick people to be left with no deal at all or incredibly expensive insurance.

HORSLEY: One of the doctors who showed McCain around the lab today 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.

Scoot Horsley, NPR News, Fort Myers, Florida.

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