updated 10/11/2007 6:20:56 AM ET 2007-10-11T10:20:56

John McCain is proposing a sweeping health care system overhaul aimed at giving people more control and more choices while fostering greater industry competition in hopes of lowering costs and improving services.

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The Republican presidential candidate’s plan, to be outlined in a speech Thursday in Des Moines, Iowa, contrasts sharply with his Democratic rivals’ proposals.

He focuses on expanding access for individuals and families but does not require people to carry health insurance. To varying degrees, Democrats want to make health coverage mandatory.

“We are approaching a ’perfect storm’ of problems that if not addressed by the next president will cause our health care system to implode,” the Arizona senator said in remarks prepared for delivery and made available to The Associated Press.

“Democratic presidential candidates are not telling you these truths. They offer their usual default position: If the government would only pay for insurance everything would be fine. They promise universal coverage, whatever its cost, and the massive tax increases, mandates and government regulation that it imposes,” McCain said. “I offer a genuinely conservative vision for health care reform, which preserves the most essential value of American lives — freedom.”

Aides acknowledged the plan would take time to implement because of its scope, while billing it as a vision for changes he would work toward if elected.

They provided no estimated price tag. To help pay for it, they said McCain would end a provision in the tax code that lets employers deduct the cost of health care from their taxable earnings. Additionally, they said, passing tort reform to eliminate frivolous lawsuits and excessive damage awards would help reduce costs.

Among Democrats, front-runner Hillary Rodham Clinton has proposed universal health care and called for a requirement for businesses to obtain insurance for employees. Former North Carolina Sen. John Edwards is seeking to achieve mandatory universal coverage by 2012, while Illinois Sen. Barack Obama is pushing for employers to share costs of insuring workers and ensure that all children are covered.

Balking GOPers
Republicans have balked.

Mitt Romney wants the government to help states lower premiums by deregulating their insurance industries. He has distanced himself from a 2006 law he signed as Massachusetts governor that requires all residents to get coverage. He says states should be free to craft the specifics of their own programs.

Rudy Giuliani, the former New York mayor, proposes an income tax deduction of $7,500 per taxpayer to defray insurance costs and a tax credit for poorer workers to supplement Medicaid and employer contributions, as part of “market-driven” expansion of affordable coverage.

McCain calls for:

  • Allowing people to buy health insurance nationwide instead of limiting them to in-state companies.
  • Permitting people to buy insurance through any organization or association they choose as well as through their employers or buying direct from an insurance company.
  • Providing tax credits of $2,500 to individuals and $5,000 to families as an incentive to buy health coverage.
  • Allowing veterans to use whatever provider they want, wherever they want by giving them an electronic health care card or through another method.
  • Supporting different methods of delivering care, including walk-in clinics in retail outlets across the country.
  • Developing routes for cheaper generic versions of drugs to enter the U.S. market, including allowing for safe importation of drugs.
  • Revamping Medicare payment systems to pay providers for diagnosis, prevention and care coordination without paying them for preventable medical errors or mismanagement.

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