McCain wants to give people a tax credit -- $2,500 for individuals and $5,000 for families -- to buy their own insurance. They can keep their insurance through their employer if they like, but the credit would make it easier for individuals to buy -- and keep -- insurance on their own. "The key to real reform," McCain said, "is to restore control over our health-care system to the patients themselves."
If individuals are shopping for health care, insurance companies would have an incentive to provide better plans at lower cost. If they purchase their own plans, their insurance wouldn't be dependent on their jobs. This change therefore mitigates two of the besetting problems of the current system -- affordability and access. One economist estimates that some 20 million more people would get insurance.
To be sure, the individual health-insurance market -- barely existent now -- has glaring failures. As Elizabeth Edwards has pointed out, both she and McCain, as cancer survivors, would have trouble buying new insurance because of their "pre-existing conditions." McCain promises to find ways to get such "uninsurables" coverage, but it will surely require more government involvement than free-market purists will like.
McCain's proposal is just the start of what has to be a broader conservative reformation. The sole Republican response to the public's economic anxieties can't be trying to talk the public out of them. If it is, the GOP will have a long time out of power to think more creatively. Better to do it now. John McCain, too, must be a candidate of change.