The McCain health care plan represents a philosophical advance over many proposals, principally in its commitment to redistributing the current tax exemption for employer-based health insurance. However, the plan raises more concerns than it addresses.McCains proposal would dramatically change how many obtain insurance, make coverage less accessible for those with health problems, have a high budget cost, but have little effect on the number uninsured.These problems could be addressed by providing a guaranteed source of adequate, affordable coverage; phasing-out the tax exemption slowly; larger subsidies to the low-income; spreading health risk broadly; and a significant commitment to cost-containment.