2008 Presidential Candidate Questionnaire Responses

Senator Barack Obama

Senator John McCain

More than 19 million women are uninsured in this country, and women are more likely than men to delay or not get medical care because of high costs. I am committed to signing health legislation by the end of my first term in office that ensures all Americans have high-quality, affordable health care coverage. My health care plan will save a typical American family up to $2,500 every year on medical expenditures by providing affordable, accessible health coverage for every American; modernizing the U.S. health care system to contain spiraling health care costs and improve the quality of patient care; and promoting prevention and strengthening public health to prevent disease and protect against natural and man-made disasters. And my health plan will require all federally-supported plans to cover essential clinical preventive services, including breast cancer screenings.

I will ensure that the United States remains a leader in combating cancer by doubling federal funding for cancer research. I will also strengthen partnerships between federal, state, and local public health authorities to expand access to proven community-based prevention programs, extend prevention efforts into workplaces and schools, and support federal initiatives, including the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) that serves as a safety net for millions of women who would otherwise have no access to these screenings.

I will direct the Centers for Disease Control and Prevention (CDC) to develop and carry out an epidemiologic study on cancer survivors to understand their long-term health needs. My plan will also foster efforts to expand psychosocial supports to cancer survivors, including directing the CDC to identify and replicate successful support group programs for cancer survivors. Finally, my plan will provide the CDC $50 million in new funding to determine the most effective approaches that assist not only navigation of cancer patients through diagnosis and treatment processes, but also provide easy-to-understand information on the necessary follow-up steps to ensure lifelong health.

John McCain believes that cancer screenings, early detection, and timely treatment are crucial tools in winning the fight against cancer. He cosponsored and fought for implementation of mammography standards and for expanding mammography and colorectal screenings under Medicare. He strongly supports programs such as the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides a vital, life-saving service to uninsured women who may otherwise go without these screenings and potentially risk their health.

John McCain's health care reform plan will also work to ensure that all American have access to quality and affordable health plans that offer health prevention and maintenance benefits to ensure they are detecting and treating illness including cancer as early as possible.

I am committed to addressing the pervasive and persistent inequalities in health status, educational attainment, and economic opportunity in the U.S. As president, I will undertake a number of initiatives to tackle these disparities.

I will work to eliminate health care disparities for women. Heart disease is the leading cause of death among women, accounting for nearly 39 percent of all female deaths. Studies show that after a first heart attack, women are less likely than men to receive diagnostic, therapeutic, and cardiac rehabilitation procedures, and are more likely to die or have a second heart attack. I have fought to maintain funding for the Centers of Excellence in Women's Health at the Department of Health and Human Services. I am also a cosponsor of the Women's Health Offices Act to permanently authorize women's health offices in all Department of Health and Human Services agencies and the HEART for Women Act to improve research and education on women and heart disease.

I will also tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. I will challenge the medical system to eliminate inequities in health care by requiring hospitals and health plans to collect, analyze, and report health care quality for underserved populations and holding them accountable for any differences found; diversifying the workforce to ensure culturally effective care; implementing and funding evidence-based interventions, such as patient navigator programs; and supporting and expanding the capacity of safety-net institutions, which provide a disproportionate amount of care for underserved populations with inadequate funding and technical resources. I also support disease management programs to fight chronic conditions like diabetes and will require that plans that participate in the new public plan, Medicare, or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. In the U.S. Senate, I helped write and cosponsored the Minority Health Improvement and Health Disparity Elimination Act to understand and tackle the root causes of health disparities.

To help our most at-risk children succeed in school, I will provide incentives to attract our best teachers and principals to the schools that need them most, especially schools serving large concentrations of students in poverty and students of color. I will enhance learning opportunities for struggling students, including high-quality afterschool and summer learning opportunities, invest in middle school and high school reform to reduce the high school dropout rate, and enable teachers to analyze student data and modify practices to increase student achievement.

I will also expand access to quality jobs for all Americans and make work pay by raising the minimum wage to $9.50 by 2011 and providing tax relief to offset the payroll tax for all low- and middle-income workers. As president, I will reward work by increasing the number of working parents eligible for EITC benefits, increasing the benefit available to parents who support their children through child support payments, increasing the benefit for families with three or more children, and reducing the EITC marriage penalty, which hurts low-income families. Finally, I will invest $1 billion over five years in transitional jobs and career pathways programs that implement proven methods of helping low-income Americans succeed in the workforce. This investment will be coupled with other measures to encourage the private sector and state and local governments to increase their support of these effective employment programs.

John McCain's plan ends the discrimination against individuals without access to employer-based health care – an important issue for several racial and ethnic groups. While maintaining the system of employer-provided system that is the dominant source of health insurance, his plan will level the playing field by permitting the same tax benefit received by those who get their health coverage from their employer to be received by those who wish to buy their own insurance or are uninsured. Today, the government does nothing to support individuals who don't get health insurance from an employer. The McCain plan would provide them with equal financial support to purchase their own health care coverage, and would promote greater competition and consumer choice in the health policies available.

John McCain has been a leader in supporting and strengthening community health centers throughout our country as a way to improve access to affordable and quality health care. He has long been an advocate of these facilities, including their use of bilingual tools and diverse staff to ensure they are reaching effectively into the community and truly helping everyone get access to quality health care. He is also committed to ensuring that our health care workforce is diverse and equipped to provide quality care and outreach in a culturally sensitive manner.

A quality education is the fastest way to eliminate persistent social and economic disparities. John McCain is committed to addressing these disparities and his education reform plan is a key step. He will provide parents and their children with the enhanced means and opportunity to help their children succeed, will invest in teachers by providing them incentives and rewards for excellence, and empower school principals with more authority to cut through bureaucracy and improve their schools' performance.

John McCain will also make it easier for people to go to college by simplifying federal financial aid and higher education tax benefits. Senator McCain also proposes to reform our antiquated unemployment compensation program to make it easier for workers who lose their job to get funds to get new training in a new career.

The U.S. remains the world's leader in conducting new and innovative research in the life sciences. Yet, to realize the promise of better preventive and diagnostic tools and treatments, we must address a number of serious challenges related to funding, workforce, clinical trial participation, and regulatory barriers that hamper innovation. I will address these challenges by:

Doubling Funding for Cancer Research: The National Institutes of Health (NIH), National Cancer Institute (NCI), and Centers for Disease Control and Prevention (CDC) have made significant advances in understanding cancer biology and translating that knowledge into effective prevention programs, diagnostics, treatments, and cures. Notably, this knowledge has also benefited individuals with other diseases, such as autoimmune disorders. Despite these advances, cancer funding has stagnated in recent federal budgets. I am committed to reversing this trend and providing our nation's scientists with the resources they need to expand and accelerate bench-to-bedside research that will lead to enhanced prevention, diagnostic tools, and innovative treatments. The Obama-Biden plan will double federal funding for cancer research within 5 years, focusing on NIH. I will also increase funding for other NIH research activities, and work with Congress to increase funding for the Food and Drug Administration (FDA), an under-resourced agency that plays a critical role in ensuring that advances in cancer research make a difference in the care of the millions of Americans who struggle with cancer.

My plan will provide additional funding for research on rare cancers and those without effective treatment options, for the study of health disparities and evaluation of possible interventions, and for efforts to better understand genetic factors that can impact cancer onset and outcomes.

Supporting Advances in Personalized Medicine: I have been a congressional leader in bringing attention to the potential of genomics to improve treatment and develop cures for Americans with cancer. Genomics is the study of gene structure and function, and researchers have started using genomics to increase understanding of diseases and develop better diagnostic tools and treatments. As a U.S. senator, I introduced the Genomics and Personalized Medicine Act to create an interagency task force on genomics research, to modernize FDA review of genomics tests and to expand support to genomics researchers, including the creation of a mechanism to allow researchers across the country to access and analyze genomics research. As president, I will continue to support advances in personalized medicine to help ensure early detection and treatment of cancer and other diseases.

John McCain has been a strong supporter of research programs both in public and private sectors. He sees a coordinated and strong research effort as a foundation for defeating chronic care diseases like cancer.

My health care plan will provide affordable, accessible health care to all Americans. My plan achieves thisgoal in two ways: it expands quality coverage for all Americans, and brings down healthcare costs to make insurance more affordable. My plan will save a typical American family up to $2,500 every year on medical expenditures.

My plan maintains patient choice, and establishes a National Health Insurance Exchange with a range of private insurance options as well as a new public health plan to allow individuals and small businesses to buy affordable and accessible health coverage similar to that available to federal employees. We will provide tax credits to people so they can afford health care and will reduce the typical family's medical expenditures by $2,500 per year while providing them with more health care options and greater security.

Inefficient and poor quality care costs the nation between $50-$100 billion every year. Billions more are wasted on administration and overhead because of inefficiencies in the health care system. America has the best health care technology in the world, but it is often not used well, and due to varying practices, it is often wasted.

I believe we must dramatically redesign our health system to reduce inefficiency and waste and improve health care quality, which will drive down costs for families and individuals. My plan will improve efficiency and lower costs in the health care system by: (1) offering federal reinsurance to employers to help ensure that unexpected or catastrophic illnesses do not make health insurance unaffordable or out of reach for businesses and their employees; (2) ensuring that patients receive and providers deliver the best possible care; (3) adopting state-of-the-art health information technology systems; and (4) reforming our market structure to increase competition.

Throughout our health care system, the great goal is to make the best care available to everyone. Underlying the many things that trouble our health-care system are the fundamental problems of cost and access. And these rising costs are by no means always accompanied by better quality in care or coverage.

The key to real reform is to restore control over our health-care to the patients themselves. John McCain will build on the employer-based coverage, by offering generous tax credits directly to individuals and families for the purchase of health insurance of their choice, including keeping their current coverage. While fully protecting employer provided health care benefits, this plan will offer additional assistance to those without employer provided coverage and to those who move in and out of the work force and don't want their health coverage tied to an employer's plan. These health plans would be yours, and yours to keep.

Most importantly, John McCain believes that no American, simply because of a pre-existing condition like cancer, should be denied access to quality and affordable coverage. This is a very important priority in his health care plan. And to make sure they get the high-quality coverage they need, John McCain has proposed a Guaranteed Access Plan (GAP) that will combine industry, state, and federal resources to help in the purchase of coverage for those hardest to insure, including patients with pre-existing conditions like cancer. There would be limits on premiums, and lower-income Americans would get additional financial assistance.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. John McCain will break down these barriers to competition, creativity, and excellence, with the goal of establishing a national market to make innovative policies and lowest prices available to every person in every state.

Finally, John McCain will continue to be a leader in pushing for greater competition in the drug and biotechnology industry through faster introduction of generic drugs and by allowing safe and effective follow-on biologics (FOBs) to enter the marketplace while ensuring that future research and development is not hindered. This will ensure that all patients, including cancer patients, have access to more affordable life-saving medications.