We all have stories like this:

My friend L. recently quit a high-pressure job after 20 years to help her husband out in his solo architecture practice. She had insurance for herself, her husband and the kids through her job, so after resigning she paid for COBRA while she waited for her family to be accepted into a stand-alone plan.

You know what happened next: she was diagnosed with a chronic condition while waiting for new insurance approval. So her husband and kids can get on the new plan, but she’s SOL unless she can get a doc to un-diagnose her (unlikely, since it’s a genetic condition that has plagued her brother for the last 30 years, and her grandmother before that). And her COBRA will run out December 31.

John McCain’s plan:

While still having the option of employer-based coverage, every family will also have the option of receiving a direct refundable tax credit – effectively cash – of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in expanded Health Savings Accounts.

I don’t know about you, but my employer-based healthcare plan costs $450/month – just for me. My husband’s runs about the same, and our son’s – which we have to purchase separately, costs about $300/month.

So that’s $14,400 a year, and would likely be at least 50% more if J. and I were buying our own coverage, since I have degenerative hip disease, migraines and a family history of melanoma.

John McCain’s plan, in practice, would mean a 25% loss to our annual disposable income after his puny tax credit if we had to buy coverage on our own.

And as for universal coverage, McCain can get you there, if you can afford it:

One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.

What’s a “reasonable limit on premiums” for a man who thinks $5,000 per family is enough to cover their health coverage costs? If my health insurance premiums are $20,000 a year for our family, and our after-tax joint income is $80k, I cannot afford health insurance. And I doubt our family will fall below the “certain income level” threshold McCain would set for whatever pittance of “assistance” that might be offered.

Neither Obama’s nor Hillary’s plans are perfect, but they move toward universal coverage and single payer – the only way to get profit out of the healthcare coverage equation*, and the only choice if we are to get anything like health equity in this country.

This does not mean that doctors can’t make a decent living. It just means you can’t profit by denying healthcare coverage, something that allowed the likes of CIGNA to pay its CEO a lavish bonus and stock options:

H. Edward Hanway received a salary of $1.11 million, a performance-based bonus of nearly $18 million, and other perks worth $32,021 including the use of company aircraft. He received $3.57 million worth of stock and option awards…

CIGNA reported a profit of $1.115 BILLION for 2007 – $1,115,000,000 that was not spent caring for the health of their customers last year.

$1,115,000,000 that could have paid for the coverage of almost 100,000 families. And they’re only 140th on Fortune’s list of the top 500 U.S. companies.

Rounding out the healthcare companies on the list:

25. UnitedHealth Group: profits of $4.654 billion, enough to cover 388,000 families for a year.

33. WellPoint: profits of $3.3454 billion, enough to cover 279,000 families.

85. Aetna: profits of $1.831 billion, enough to cover 152,000 families.

98. Humana: profits of $833.7 million, enough to cover 70,000 families.

179. Healthnet: profits of $193.7 million, enough to cover 16,000 families.

266. Coventry Health Care: profits of $626.1 million, enough to cover 51,800 families.

The remaining companies in the Forbes top 1000 had enough combines profits to cover another 43,000 families.

So those Forbes 1000 healthcare companies alone had sufficient combined profits to pay for healthcare for 2.4 million families.

And we have 40 million people uninsured in this country.

It’s shameful, isn’t it?