In fairness, whose plan is better?

When it comes to fixing our health care system, McCain got it half right, Obama got it more right

The election is less than a week away. Health care remains a key issue for most Americans, with the declining economy serving to underscore how important it is that the next president get health care right. Considerable ink and blog space have been devoted to explicating the details and expected outcomes of Sen. Barack Obama's and Sen. John McCain's health care plans. Armed with analyses from health economists, both campaigns are peppering last-minute speeches and ads with specific figures about how much money their health care plans would save you and how much their plans would cost.

Yet we would all be wise to take these figures with a large grain of salt. Health economists are the first to say that the assumptions they are using to generate the numbers are open to serious question.

Despite such uncertainties, Americans need to know whom to trust to meet the challenge of health care reform. There are real differences between the candidates, but in this case, it is far safer for voters to make decisions based on the candidates' values rather than the candidates' facts. Mr. McCain's and Mr. Obama's health plans are based on very different moral visions of what makes a health care system fair, and this difference offers voters a real basis for choice.

What Mr. McCain sees as unfair about our current system is how the costs of health care are financed. Some Americans pay the full freight of their health insurance and medical care, but many others do not. These include not only people eligible for Medicare or Medicaid but also those of us fortunate to get health insurance through our employers. Americans who have workplace health insurance get a tax break that subsidizes the costs of insurance, while other Americans without this workplace benefit get no federal help with these costs. Mr. McCain would change the tax code to ensure that all Americans enjoy the same package of tax incentives for health insurance. The centerpiece of his health plan eliminates tax breaks for workplace insurance and instead gives all Americans the same tax credit for health insurance: $2,500 for individuals and $5,000 for families.

Mr. McCain is right. There is no morally defensible reason why some Americans get federal assistance with health care costs and others, including many who are uninsured or underinsured, do not. The way we finance health care in this country is fundamentally unfair.