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Obama And McCain On Health Care

To help you make an informed decision in the presidential election, CBS News is devoting a large part of our broadcasts until Nov. 4 to telling you where the candidates stand on major issues - from the war in Iraq to health insurance to education … and a lot more. Each piece will be an in-depth look at the issues facing the 44th president. In this installment, CBS News correspondent Seth Doane reports on how the proposed health care policies of Barack Obama and John McCain would affect you and your community. Click here to see Where They Stand on more of the issues.



The Issue

It's the barbeque that draws customers to The Hickory House just outside Columbus, Ohio.

"Award-winning ribs, that's for sure!" said Randy Wolfe, the restaurant's general manager.

But the employees keep coming back, too. The staff has worked here an average of 15 years.

"Keeping these employees, keeping this consistency is important ... and health insurance is part of that?" Doane asked.

"Yes," Wolfe said.

But health-care benefits may soon be off the menu for Hickory House employees, and their boss.

In 1990, the restaurant picked up the check for the full cost of medical benefits for everyone. Now, the staff must pay half themselves, and only three of the 35 workers participate.

"What we do to make it affordable for us - is we keep raising our deductible," Wolfe said. "Which, again, means more out-of-pocket for the employees."

That's more out of 25-year-old bartender Lisa Martensen's pocket - when she's already feeling the pinch.

Making less than $17,000 a year, Martensen stretches to pay her $260 monthly premium. But she does it for one reason - so that her 3-year-old daughter, Madison, is covered.

Can she continue to pay for health care?

"Right now I'm saying yes … but if it continues to go up, then I say no," she said.

Lunchtime server Candy Cooper had to say no years ago.

She says she makes about $22,000 a year and can't afford the $400 a month the company health insurance would set her back.

"I've checked into this and I can't swing it - I can't do it," she said.

Doane asked: "Does that frustrate you? Does that worry you?"

"Very frustrating," she said.

Cooper is one of the 45 million Americans who simply go without insurance. When she recently got dizzy at work, an ambulance was called - but she didn't get in.

"I didn't want to go to the hospital due to the medical costs," she said.

And that worries her boss, who is counting on the next president to find a solution.

"I don't have the answers. That's why we're hoping they do," Wolfe said.

The Candidates

Both Sens. Barack Obama and John McCain agree that health care costs are out of control - but they have radically different ideas on how to fix them.

McCain's approach is all about driving down costs to make it more affordable.

Under his plan, individuals would pay taxes on the health insurance benefits they receive from their employer. To offset that new cost - or to encourage people to go buy insurance on their own, McCain would provide a tax credit that could only be used for health care: $2,500 for individuals - double that for families.

"I will give every family, every family in America, a $5,000 credit to buy their own health insurance policy and let them choose their own doctor," McCain said. "This will make insurance affordable to every American."

Though today, the average family plan is worth $12,000. But McCain thinks these tax credits would spur market competition - as insurance companies vie for their piece of the tax credit money, cheaper health insurance options would be created.

Obama's emphasis is on increasing access. He would give small businesses a tax credit to ease the burden of offering health insurance to their employees. And larger companies would be required to either provide insurance or pay into a national fund, called the "Health Insurance Exchange," which could offer more affordable options to those currently uninsured.

"I will finally keep the promise of affordable, accessible health care for every single American," Obama said. "You'll be able to get the same kind of coverage that members of Congress give themselves."

The Impact

So, what's the potential impact of these proposals?

CBS News checked in with a healthcare consultant at Towers Perrin to see how Martensen, Cooper and the Hickory House would fare under these plans.

"I think Candy and Lisa are more alike than they are different - both of them are lower-wage employees who are currently finding health care unaffordable in its current state," the consultant, Ron Fontanetta, said.

Though each candidate tackles the problem in different ways, both would give each of them a number of cheaper options.

Under Obama's proposal, they would be able to choose from an array of plans through the National Exchange, and may qualify for subsidies as lower-income workers.

Under McCain's proposal, both women could use their tax credit to buy healthcare on the open market.

"Does the idea of having a tax credit seem appealing to you, where you could go out and buy your own insurance?" Doane asked.

"It seems kind of scary, I think, really," Cooper said. "I just wouldn't know what I was choosing, what I was picking, whose policy I'm getting into."

But Martensen likes the idea of more choices.

"If you could have a scaled-down plan, which would cover you in case of emergency - but would cost a lot less each month, would you take that?" Doane asked.

"If there was a way I could pay less and have less coverage for me, but maybe pay a little more and have coverage for her, I would do it," she said.

But the biggest change may be for the Hickory House itself.

"Under either proposal it really begs the question - does the Hickory House need to provide coverage any more? Both proposals obviate the need for a small employer - like the Hickory House - to be in the health care business at all," Fontanetta said.

You'd think that'd be a relief to Wolfe.

"I would like to go ahead and to be able to help the employees through our business with health insurance," he said.

"Even though you spend a lot of time thinking, worrying about healthcare, you still want to be … part of offering it?" Doane asked.

"I would still like to - I would like to have that option," he said.

It's likely that larger employers, under both candidates' proposals, would stay in the health care game - to attract and retain good employees. But the only hope for the Hickory House is that a new president makes health care the first order of business.

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