07.29.08
Barack Obama’s Plan for a Healthy America
I wanted to devote some time to my thoughts on the presidential candidates' healthcare plans as they are currently written. I will start today with a review of the Obama plan and then in a subsequent entry the McCain plan.
To quote the Obama plan:
"...the Obama plan will save a typical American family up to $2500 every year on medical expenditures by:
- Providing affordable , comprehensive and portable health coverage for every American;
- Modernizing the US health care system to contain spiraling health care costs and improve the quality of patient care; and
- Promoting prevention and strengthening public health, to prevent disease and protect against natural and man-made disasters."
Wow, that sounds great, this is certainly something every American would want, but let's look at this a little more closely.
So how will every family save $2500 dollars per year? The Obama plan tells us how:
- Health IT investment, which will reduce unnecessary spending in the system that results from preventable errors and inefficient paper billing systems.
- Improving prevention and management of chronic conditions.
- Increasing insurance industry competition and reducing underwriting costs and profits, which will reduce insurance overhead;
- Providing reinsurance for catastrophic coverage, which will reduce insurance premiums; and
- Making health insurance universal, which will reduce spending on uncompensated care.
I certainly agree with investing in IT and all of its benefits, but its upfront costs are huge. He says he would invest $10 billion a year over 5 years to cover this, he ventures this would save $77 billion per year once implemented. Not sure where the $10 billion dollar per year number comes from, but this seems low to me. Improving prevention and management of chronic condition will be done by mandating coverage of smoking cessation programs and cancer screenings and by emphasizing to Americans that they should live in a "healthy environment that includes sidewalks, biking paths, and walking trails; local grocery stores with fruits and vegetables;" and "Obama will increase funding to expand community based preventative interventions to help Americans make better choices to improve their health." Whoooo, that is a whole lot of fluff.
The 3rd way was to lower overhead for insurers. Last time I checked the insurers were making record profits, do you really think that lowering their overhead will make them pass that savings on to the working man.
It is not clear from the plan how providing reinsurance for catastrophic coverage will reduce premiums for all of healthcare. If an American only has catastrophic coverage then aren't they missing out on all the great preventive measures in the plan that are going to save so much?
Finally, making insurance universal, my favorite. This will reduce spending on uncompensated care. This will be a new plan like the one Senator Obama has called the Federal Employee Health Benefits Program (FEHBP, needs a fancier sounding abbreviation). This sounds like Medicaid to me, which as you know, very few physicians and other medical providers participate in. So where will patients go for their care? Your emergency department.
Another issue is "Reforming medical malpractice while preserving patient rights...Barack Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance." Funny how he does not seem to understand that the price of malpractice is not the issue, the number of wasteful lawsuits against hospitals and physicians is the issue. The plan also will work to reduce physician error. Unfortunately, error is not why patients enter litigation; bad outcomes whether the doctor did anything wrong or not is the reason.
And finally, the most important part of how the plan will be paid for, besides on the backs of the small business owner, is "by allowing the Bush tax cuts to expire for people making more than $250,000 per year, as they are scheduled to."
Any takers....
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