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Republican presidential hopeful John McCain drew fire from healthcare providers Monday when he promised to balance the federal budget by the end of his first term, in part, through reductions in Medicare and Medicaid.

The presumptive GOP nominee said he would seek to continue the Bush tax cuts while at the same time eliminating the nation’s $410 billion deficit through significant funding cuts to Medicare, Medicaid and Social Security. One of the linchpins of his healthcare agenda is a deregulation of private health insurance plans and a “tax credit” for families to help them afford the insurance. The McCain camp says that deregulation would increase competition among healthcare providers, lowering the overall cost to the consumer, and a tax credit will help offset the cost of that insurance.

The plans are being met with skepticism and out-and-out criticism from many economists and healthcare providers. A recent Congressional Budget Office report finds that, if the Bush tax cuts are kept in place, the next president would need to cut $443 billion from the budget to make ends meet. Some analysts say this would require cutting all discretionary spending—including Medicare, Medicaid, Social Security and defense—by up to 33%.