Figuring the ins and outs of both candidate's healthcare proposals makes my head hurt. Both of them have some good points, both have some glaring weaknesses. I'd really rather leave things alone but evidently that's not an option.

Obama:  how anyone can believe that the people responsible for the DMV, the Post Office, the IRS, and the government school system will be able to do a good job with healthcare is beyond me. Because of one child’s health problems and disabilities I’ve had a lot more contact with our state DORS (Department Of Rehabilitation Services) DHS (Department of Human Services) and the Social Security Administration that I ever would have wanted [although let me say that my experience with the “boots on the ground” caseworkers and clerical staff who actually work with the clients has been uniformly positive, when you finally can get past the damn phone system and get face-to-face with them. Once you get beyond those people and begin to work with supervisors and management, that is another story].

McCain:  Must not get out much if he thinks $5,000 is going to go very far toward purchasing medical insurance. Conventional medical insurance, like most people think of as medical insurance that you would get through an employer, costs in the vicinity of $18,000/yr. Where the typical family is supposed to come up with the $13,000/yr difference I don’t know. I just dropped a policy that was a $10,000 annual deductible that was costing me $7200/yr. I was paying $7200/yr for nothing since the likelihood of ever meeting the deductible was nil. I would have to spend $17200 out of pocket in a year (premium plus meeting the deductible) before I got back the first $1 in insurance reimbursement (plus if I got really sick on December 1, I’d have to spend 17200 in that year, then 10000 in January before seeing that first dollar). Then there’s the issue of preexisting conditions. I know from personal experience that unless you’re a single, 22-year-old in absolutely perfect health, it is very difficult to get past most companies’ underwriting without a collection of “rate-ups” for this, that, and the other. And the fine print, we would see an explosion of jack-leg “out of state” quick buck operators who’d take the money and run.

I don’t have an answer, but I know I don’t like either candidate’s proposals (although McCain’s would be a better stem to work off of). I do think a good start would be putting self-employed people on the same footing as people who get medical benefits through an employer by allowing the self-employed to deduct the first dollar of medical expenses, including insurance. Yes, yes, HSAs. I’m looking into one but there’s a cost to taking the time to sort out the details. Just let me deduct the expenses and be done with it.

Yes it’s true you’re a sharp comparison shopper when you’re paying 100% out of pocket. I schnorr bloodwork at the health fair where I do contract work. I self-diagnose by internet lookup. But I won’t be getting any colonoscopic screening for colon polyps or other reasonable screening procedures for someone my age. First time I’ll know I have colon cancer will be when the tumor pops out my navel. Comparison shopping and negotiating will really be a hoot if I have a stroke or heart attack. To copper my bets I’ve lost 130 lbs, and taken up distance bicycling. Since 1/1/08 I’ve cycled 2500 miles, spent maybe 200 hours on the elliptical, and walked maybe 1000 miles. More fun than paying insurance premiums.