That's not a bikini....lol.

Talk about a shock to the system. Has anyone bothered
to notice the radical changes that John McCain and
Sarah Palin are planning for the nation's health
insurance system?

These are changes that will set in motion nothing less
than the dismantling of the employer-based coverage
that protects most American families.

A study coming out Tuesday from scholars at Columbia,
Harvard, Purdue and Michigan projects that 20 million
Americans who have employment-based health insurance
would lose it under the McCain plan.

There is nothing secret about Senator McCain's far-
reaching proposals, but they haven't gotten much
attention because the chatter in this campaign has
mostly been about nonsense - lipstick, celebrities and
"Drill, baby, drill!"

For starters, the McCain health plan would treat
employer-paid health benefits as income that employees
would have to pay taxes on.

"It means your employer is going to have to make an
estimate on how much the employer is paying for health
insurance on your behalf, and you are going to have to
pay taxes on that money," said Sherry Glied, an
economist who chairs the Department of Health Policy
and Management at Columbia University's Mailman School
of Public Health.

Ms. Glied is one of the four scholars who have just
completed an independent joint study of the plan. Their
findings are being published on the Web site of the
policy journal, Health Affairs.

According to the study: "The McCain plan will force
millions of Americans into the weakest segment of the
private insurance system - the nongroup market - where
cost-sharing is high, covered services are limited and
people will lose access to benefits they have now."

The net effect of the plan, the study said, "almost
certainly will be to increase family costs for medical
care."

Under the McCain plan (now the McCain-Palin plan)
employees who continue to receive employer-paid health
benefits would look at their pay stubs each week or
each month and find that additional money had been
withheld to cover the taxes on the value of their
benefits.

While there might be less money in the paycheck, that
would not be anything to worry about, according to
Senator McCain. That's because the government would be
offering all taxpayers a refundable tax credit - $2,500
for a single worker and $5,000 per family - to be used
"to help pay for your health care."

You may think this is a good move or a bad one - but
it's a monumental change in the way health coverage
would be provided to scores of millions of Americans.
Why not more attention?

The whole idea of the McCain plan is to get families
out of employer-paid health coverage and into the
health insurance marketplace, where naked competition
is supposed to take care of all ills. (We're seeing in
the Bear Stearns, Fannie Mae, Freddie Mac, Lehman
Brothers and Merrill Lynch fiascos just how well the
unfettered marketplace has been working.)

Taxing employer-paid health benefits is the first step
in this transition, the equivalent of injecting poison
into the system. It's the beginning of the end.

When younger, healthier workers start seeing additional
taxes taken out of their paychecks, some (perhaps many)
will opt out of the employer-based plans - either to
buy cheaper insurance on their own or to go without
coverage.

That will leave employers with a pool of older, less
healthy workers to cover. That coverage will
necessarily be more expensive, which will encourage
more and more employers to give up on the idea of
providing coverage at all.

The upshot is that many more Americans - millions more
- will find themselves on their own in the bewildering
and often treacherous health insurance marketplace. As
Senator McCain has said: "I believe the key to real
reform is to restore control over our health care
system to the patients themselves."

Yet another radical element of McCain's plan is his
proposal to undermine state health insurance
regulations by allowing consumers to buy insurance from
sellers anywhere in the country. So a requirement in
one state that insurers cover, for example,
vaccinations, or annual physicals, or breast
examinations, would essentially be meaningless.

In a refrain we've heard many times in recent years,
Mr. McCain said he is committed to ridding the market
of these "needless and costly" insurance regulations.

This entire McCain health insurance transformation is
right out of the right-wing Republicans' ideological
playbook: fewer regulations; let the market decide; and
send unsophisticated consumers into the crucible alone.

You would think that with some of the most venerable
houses on Wall Street crumbling like sand castles right
before our eyes, we'd be a little wary about spreading
this toxic formula even further into the health care
system.

But we're not even paying much attention.