Republican presidential nominee-in-waiting John McCain has offered up his health care proposal, and as you might imagine, it pushes a market-based system.

“McCain’s health plan centers on eliminating the tax breaks for employers who provide health insurance for their workers—a marked departure from the current system—and giving $5,000 tax credits to families to buy their own insurance,” says The New York Times. “His goal in shifting from employer-based coverage to having people buy their own policies is to encourage competition and choice, and to drive down the costs of health insurance.” But, the Times story adds, “Democrats have argued that McCain’s plan, by not compelling insurance companies to cover people who have trouble getting coverage, would ignore the plight of people with health problems.”

Steve Smith, a spokesman for the AFL-CIO, told USA Today that McCain’s plan “would push employers to drop health care coverage they currently provide, put insurance companies in charge, increase costs, and force tens of millions of Americans to fend for coverage on their own with inadequate tax credits.”

McCain is spending a lot of time this week on health care, and it makes sense. This is a critical issue in the presidential campaign. And, McCain clearly seems to be getting out in front of this issue even though he knows that his health care proposal may need to be tweaked and changed as time goes on.

For example, the Times story indicated that “McCain’s speech here implicitly acknowledged some of the shortcomings in his free-market approach. But rather than force insurers to abandon cherry-picking the healthiest patients, McCain proposed that the federal government work with the states to cover those who cannot find insurance on the open market. With federal financial assistance, states would be encouraged to create high-risk pools that would contract with insurers to cover consumers who have been rejected on the open market.”

As I wrote in this blog last week, there is a lot of talk about health care these days, but not too many solutions. Although McCain’s proposal probably raises more questions than it answers, I applaud him for sticking his toe in the water on this one.

And by the way: the two Democratic candidates have very different thoughts on this subject. “Unlike McCain … both Senators Barack Obama and Hillary Rodham Clinton would both make it illegal for health insurance companies to deny an applicant because of age or health status,” the Times story says. “The two Democratic rivals argue that such regulation is needed to end discrimination against those with pre-existing medical conditions.”

This is just the beginning of the debate over health care by our presidential candidates, and my guess is that it will be a hot-button topic for both parties right down to Election Day.