Health Care in the Final Debate, in Paraphrase

If you missed the debate last night, it was way more heated and engaging than the previous two, with Bob Schieffer asking these questions, among others:

On the current ($455 billion) and projected ($1 trillion possible by next year) budget deficit:
“Aren’t you both ignoring reality? Won’t some of the programs you are proposing have to be trimmed, postponed, even eliminated?”

On tough language during this campaign:
“Are each of you tonight willing to sit at this table and say to each other’s face what your campaigns and the people in your campaigns have said about each other?”

On the credentials of vice presidents:
“Why would the country be better off if your running mate became president rather than his running mate?”

On health care:
“Given the current economic situation, would either of you now favor controlling health care costs over expanding health care coverage?”

I loved that last question, especially, for bringing the very real problem of health care back to the stage. Rather than cut and paste relevant quotes from the debate, I’ll spare you all the Joe the plumber references because that got old, real quick.

Here’s the very-paraphrased, short version of how the candidates’ explanations of their health care plans sounded to me last night:

Obama: Lots of people don’t have insurance, and that’s sad. My plan means you keep your current insurance, but we’re going to make coverage cheaper for everyone. Annual premiums will be about $2,500 less for families. If you don’t have coverage, you can buy some under a government plan like the one McCain and I have as senators. We’ll stop insurance companies from discriminating over pre-existing conditions, and we’ll get cheaper prescription prices. We’ll use technology to streamline, and we’ll manage and prevent chronic diseases better. It’s going to be expensive, but it will make families healthier and save the budget by scaling down rising costs.

McCain: Lots of people don’t have insurance, and that’s painful. So are higher premiums and co-pays. But the higher costs are more painful, so we need online health records and more community health centers and walk-in clinics. Obesity in kids is a major problem, so we need school-based physical fitness and nutrition programs. For adults, companies should reward employees who go to gyms and are healthy. I’ll give every family a $5,000 tax credit, and you can go anywhere you like for health insurance. Obama will fine small businesses that don’t adopted his mandated plan. And what is that fine, Obama? His plan would create bureaucracies and turn American health care into a single-payer system like in Canada and England.

Schieffer: Is that right?

Obama: No. Small businesses are exempted but large businesses aren’t, as I said in the last debate. People end up on Medicaid or in the ER (where they can’t pay the bill) when the large companies they work for won’t provide insurance. The uninsured cost families $900 annually in higher premiums. Small companies that do provide insurance will get a 50% credit. In McCain’s plan, young/healthy people can find $5,000 insurance, but older, less healthy people can’t. With just older people left in employers plans, those companies won’t be able to afford the plans anymore. Also, McCain will be taxing company health care benefits. Also, health insurance costs around $12,000. Also, McCain’s plan would strip state restrictions, which would lead to insurance companies’ refusing coverage more often.

McCain: Obama wants to spread the wealth. So when people work hard and start businesses, and those those companies turn large and successful and make lots of money for their owners, Obama wants to take some of that money by fining owners who don’t provide the health care plan he requires. My plan will give 95% of Americans more money because they get their current benefits which will be taxed, and also $5,000. Health insurance costs around $5,800. Obama’s plan means Big Government will make the decision for you, and my plan means you get to make the decision yourself. Government is already too big and spending too much, and the Democrats have had control of Congress for the last two years.

Obama: Here’s the real choice. Under my plan, you keep your company health insurance. Under McCain’s, you’re at risk of losing that company-based insurance. Don’t believe me? The U.S. Chamber of Commerce says so, too. I’m just trying to make your health care cheaper if you’ve already got it.

(Read the actual debate transcript here.)

Confusing, right? What does it all mean, and who do you think is right? Head over to Fact Check: Health Care Spin, which won’t make any decisions for you but wades through the details of both health care plans and the claims of both candidates.