Health Care Plans (Election '08)

[Cambist]

Both candidates for the Democratic nomination have health care proposals that aim to cover a majority if not all Americans.

What are your thoughts on each?

[Champs Elysees]

Just in case you don't know the particulars:

Barack Obama's Plan

• Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.
  
  
• Comprehensive benefits. The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have. The plan will cover all essential medical services, including preventive, maternity and mental health care.
  Affordable premiums, co-pays and deductibles.
  
  
• Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
  
  
• Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.
  Portability and choice. Participants in the new public plan and the National Health Insurance Exchange (see below) will be able to move from job to job without changing or jeopardizing their health care coverage.
  
  
• Quality and efficiency. Participating insurance companies in the new public program will be required to report data to ensure that standards for quality, health information technology and administration are being met.
  
  
• National Health Insurance Exchange: The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public.
  
  
• Employer Contribution: Employers that do not offer or make a meaningful contribution to the cost of quality health coverage for their employees will be required to contribute a percentage of payroll toward the costs of the national plan. Small employers that meet certain revenue thresholds will be exempt.
  
  
• Mandatory Coverage of Children: Obama will require that all children have health care coverage. Obama will expand the number of options for young adults to get coverage, including allowing young people up to age 25 to continue coverage through their parents' plans.
  Expansion Of Medicaid and SCHIP: Obama will expand eligibility for the Medicaid and SCHIP programs and ensure that these programs continue to serve their critical safety net function.
  
  
• Flexibility for State Plans: Due to federal inaction, some states have taken the lead in health care reform. The Obama plan builds on these efforts and does not replace what states are doing. States can continue to experiment, provided they meet the minimum standards of the national plan.
  
  
• Reducing Costs of Catastrophic Illnesses for Employers and Their Employees: Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums.
  
  
• Helping Patients:
  Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. This will improve quality of care, give doctors better information and lower costs.
  
  
• Coordinate and integrate care. Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. Obama will support implementation of programs and encourage team care that will improve coordination and integration of care of those with chronic conditions.
  Require full transparency about quality and costs. Obama will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care. Health plans will also be required to disclose the percentage of premiums that go to patient care as opposed to administrative costs.
  
  
• Promote patient safety. Obama will require providers to report preventable medical errors and support hospital and physician practice improvement to prevent future occurrences.
  
  
• Align incentives for excellence. Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded for achieving performance thresholds on outcome measures.
  
  
• Comparative effectiveness research. Obama will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.
  
  
• Tackle disparities in health care. Obama will tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. He will also challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.
  
  
• Insurance reform. Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and will promote new models for addressing errors that improve patient safety, strengthen the doctor-patient relationship and reduce the need for malpractice suits.
  
  
• Lowering Costs Through Investment in Electronic Health Information Technology Systems: Most medical records are still stored on paper, which makes it hard to coordinate care, measure quality or reduce medical errors and which costs twice as much as electronic claims. Obama will invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems, including electronic health records, and will phase in requirements for full implementation of health IT. Obama will ensure that patients' privacy is protected.
  
  
• Lowering Costs by Increasing Competition in the Insurance and Drug Markets: The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. There have been over 400 health care mergers in the last 10 years, and just two companies dominate a full third of the national market. These changes were supposed to make the industry more efficient, but instead premiums have skyrocketed by over 87 percent.
  
  
• Lower prescription drug costs. The second-fastest growing type of health expenses is prescription drugs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Obama will allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama will also repeal the ban that prevents the government from negotiating with drug companies, which could result in savings as high as $30 billion. Finally, Obama will work to increase the use of generic drugs in Medicare, Medicaid, and FEHBP and prohibit big name drug companies from keeping generics out of markets.
  
  
• Fight for New Initiatives
  Advance the Biomedical Research Field: As a result of biomedical research the prevention, early detection and treatment of diseases such as cancer and heart disease is better today than any other time in history. Barack Obama has consistently supported funding for the national institutes of health and the national science foundation. Obama strongly supports investments in biomedical research, as well as medical education and training in health-related fields, because it provides the foundation for new therapies and diagnostics. Obama has been a champion of research in cancer, mental health, health disparities, global health, women and children's health, and veterans' health. As president, Obama will strengthen funding for biomedical research, and better improve the efficiency of that research by improving coordination both within government and across government/private/non-profit partnerships. An Obama administration will ensure that we translate scientific progress into improved approaches to disease prevention, early detection and therapy that is available for all Americans.
  
  
• Fight AIDS Worldwide. There are 40 million people across the planet infected with HIV/AIDS. As president, Obama will continue to be a global leader in the fight against AIDS. Obama believes in working across party lines to combat this epidemic and recently joined Senator Sam Brownback (R-KS) at a large California evangelical church to promote greater investment in the global AIDS battle.
  
  
• Support Americans with Disabilities: As a former civil rights lawyer, Barack Obama knows firsthand the importance of strong protections for minority communities in our society. Obama is committed to strengthening and better enforcing the Americans with Disabilities Act (ADA) so that future generations of Americans with disabilities have equal rights and opportunities. Obama believes we must restore the original legislative intent of the ADA in the wake of court decisions that have restricted the interpretation of this landmark legislation.
  
  
• Improve Mental Health Care. Mental illness affects approximately one in five American families. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As president, Obama will support mental health parity so that coverage for serious mental illnesses are provided on the same terms and conditions as other illnesses and diseases.
  
  
• Reduce Risks of Mercury Pollution. More than five million women of childbearing age have high levels of toxic mercury in their blood, and approximately 630,000 newborns are born at risk every year. Barack Obama has a plan to significantly reduce the amount of mercury that is deposited in oceans, lakes, and rivers, which in turn would reduce the amount of mercury in fish.
  
  
• Support Americans with Autism. More than one million Americans have autism, a complex neurobiological condition that has a range of impacts on thinking, feeling, language, and the ability to relate to others. As diagnostic criteria broaden and awareness increases, more cases of autism have been recognized across the country. Barack Obama believes that we can do more to help autistic Americans and their families understand and live with autism. He has been a strong supporter of more than $1 billion in federal funding for autism research on the root causes and treatments, and he believes that we should increase funding for the Individuals with Disabilities Education Act to truly ensure that no child is left behind.

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[Champs Elysees]

Hillary's Plan (Paraphrased):

The American Health Choices Plan gives Americans the choice to preserve their existing coverage, while offering new choices to those with insurance, to the 47 million people in the United States without insurance, and the tens of millions more at risk of losing coverage.

• The Same Choice of Health Plan Options that Members of Congress Receive: Americans can keep their existing coverage or access the same menu of quality private insurance options that their Members of Congress receive through a new Health Choices Menu, established without any new bureaucracy as part of the Federal Employee Health Benefit Program (FEHBP). In addition to the broad array of private options that Americans can choose from, they will be offered the choice of a public plan option similar to Medicare.
  
  
• A Guarantee of Quality Coverage: The new array of choices offered in the Menu will provide benefits at least as good as the typical plan offered to Members of Congress, which includes mental health parity and usually dental coverage.
  
  Americans who are satisfied with the coverage they have today can keep it, while benefiting from lower premiums and higher quality.
  
  
• Reducing Costs: By removing hidden taxes, stressing prevention and a focus on efficiency and modernization, the plan will improve quality and lower costs.
  
  
• Strengthening Security: The plan ensures that job loss or family illnesses will never lead to a loss of coverage or exorbitant costs.
  
  
• End to Unfair Health Insurance Discrimination: By creating a level-playing field of insurance rules across states and markets, the plan ensures that no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums.
  
  Relying on consumers or the government alone to fix the system has unintended consequences, like scaled-back coverage or limited choices. This plan ensures that all who benefit from the system share in the responsibility to fix its shortcomings.
  
  
• Insurance and Drug Companies: insurance companies will end discrimination based on pre-existing conditions or expectations of illness and ensure high value for every premium dollar; while drug companies will offer fair prices and accurate information.
  
  Individuals: will be required to get and keep insurance in a system where insurance is affordable and accessible.
  
  
• Providers: will work collaboratively with patients and businesses to deliver high-quality, affordable care.
  
  
• Employers: will help financing the system; large employers will be expected to provide health insurance or contribute to the cost of coverage: small businesses will receive a tax credit to continue or begin to offer coverage.
  
  
• Government: will ensure that health insurance is always affordable and never a crushing burden on any family and will implement reforms to improve quality and lower cost.
  
  Senator Clinton’s plan will:
  
  
• Provide Tax Relief to Ensure Affordability: Working families will receive a refundable tax credit to help them afford high-quality health coverage.
  
  
• Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans.
  
  
• Create a New Small Business Tax Credit: To make it easier-not harder-for small businesses to create new jobs with health coverage, a new health care tax credit for small businesses will provide an incentive for job-based coverage.
  
  
• Strengthen Medicaid and CHIP: The Plan will fix the holes in the safety net to ensure that the most vulnerable populations receive affordable, quality care.
  
  
• Launch a Retiree Health Legacy Initiative: A new tax credit for qualifying private and public retiree health plans will offset a significant portion of catastrophic expenditures, so long as savings are dedicated to workers and competitiveness.
  
  
• Most Savings Come Through Lowering Spending Due to Quality and Modernization: Over half the savings come from the public savings generated from Senator Clinton’s broader agenda to modernize the heath systems and reduce wasteful health spending.
  
  
• A Net Tax Cut for American Taxpayers: The plan offers tens of millions of Americans a new tax credit to make premiums affordable-which more than offsets the increased revenues from the Plan’s provisions to limit the employer tax exclusion for health care and discontinue portions of the Bush tax cuts for those making over $250,000. Thus, the plan provides a net tax cut for American taxpayers.
  
  
• Making the Employer Tax Exclusion for Health Care Fairer: The plan protects the current exclusion from taxes of employer-provided health premiums, but limits the exclusion for the high-end portion of very generous plans for those making over $250,000.

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Now I got to read all this shit . . . [/color]

[QUIET As Kept]

lol @ lady

[DamieQue™]

I understand their difference being that Obama's is voluntary for adults but not for children and it's mandatory under Clinton's plan.

I understand both positions but I think Obama has the edge. 1. People like to have choice. Few people enjoy having a choice foisted upon them and it will be a particular hard sale to Conservatives and State's Righters... they don't like being told to do anything by governemnt.

Another reason why Obama has the edge is that while Clinton made a good point that programs like Social Security would not have worked if they weren't mandated but just a few years ago - we discovered that the systems weren't solvent, and what was the first thing that people suggested they should do? Allow people the choice to invest some of their Social Security in the market.

Given the solvency issues of Social Security I don't think that those were particular good examples for Clinton to use.

[Cambist]

To piggyback on what Damie said, Clintons Plan will eventually become Obamas plan. Just watch. For the reasons mentioned above, Clintons plan is entirely too "Socialist" in the eyes of most small government advocates.

Obamas plan, while still too liberal for most, still gives people a choice and Wall Street will be warmer to that concept.

[Cambist]

**NOTE**
Damie...check the siggy. I saw a post where you referenced a movie I really enjoyed. Decided to use one of the quotes.

[Champs Elysees]

I read all that shit.

What appeals to me most about Obama's plan is that young people up to age 25 can be covered.

I had to get my own once I turned 23 cause I was not in skewl. Me no like that.

I also like that he wants insurers to stop overcharging physicians for malpractice insurance. Maybe then they will carry it.

He also advocated buying prescription drugs from Europe and Canada, which are sold here for twice the price.

He wants to increase competition for insurance and drug companies to lower prices for us.
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I like that Clinton wants to limit premium payments to a percentage of your income.

She also wants to stress prevention, which I think is key (although many people are going to do what they want regardless).

I also like her focus on retirees. There are so many boomers and they are getting old. They need to be taken care of on the front end of the health care train.

[Cambist]

Doesn't Obama's plan also place an emphasis on prevention and preventative medicine?

Also, being able to purchase meds from other countries is one thing. The problem is, we would be buying the drugs from AMERICAN COMPANIES! Why is it that we have to pay more money for drugs that OUR TAX DOLLARS went to help develop?

[Champs Elysees]

Good point Cam. Maybe with increased competion, we won't even have to look outside the country for affordable meds.

[Cambist]

I also say that Cuba should become a medical haven! Set up lots of hospitals and training hospitals for specialty, elective surgeries. I'm sure Cuban doctors would be able to perform the surgery cheaper.

This could be a way for Cuba and the US to normalize relations. Also, the climate of Cuba would be good for people recovering from serious surgery. The plane ride isn't long and shouldn't be that expensive. Cuba could become an island full of qualified doctors and some of the best medical schools..it's right off of our coast and that way, it can keep it's tourism but also have function that helps keep it relevant to the US.

Just a thought.

[Champs Elysees]

I'm waiting for Cuba to come up after the Castro regime is gone.

[CrimsonENDvy]

Clearly both of their plans are essentially flawed, but the simple difference is Barack's plans don't constitute as many tax dollars as Hillary's. Anyway, like I said, I'm disppointed at both of their plans. Neither of them address the fact that the typical American doesn't have much money and that if it were that simple, everyone would be covered in the first place.

[Champs Elysees]

I wonder if either plan is modeled on Canada's or Europe's plans?

Problem is, America is too fucking free and there are too many damn people! Not to mention the illegals who WE pay for!

[CrimsonENDvy]

Well you know that France covers everyone under their universal healthcare system, but unfortunately these people have to wait so long if they want something simple. Like, if they need a biopsy that have to wait in line. So even though its covered, you might be dead by the time they get to you. I think Hillary's plan is KIND of like that, but the big companies would never let that happen.

[Champs Elysees]

You know, I do remember hearing about it being like that in Canada, too.

I live in Florida, the land of old people! I could just imagine all them old fogies waiting forever to see a doctor for somethng simple.

[CrimsonENDvy]

Its a good idea! Its just that everyone would have to work for IT to work, and as you know unfortunately, everybody isn't willing to work. They just want to reap the benefits.

[Cambist]

Cuba yall....Cuba...

Island Hospitals. Cheaper hospital stays.

Or not even Cuba...let's plug in another island like Grenada (a bit far away but walk with me on this) These economies operate on a much smaller scale than ours. Spending 1/4 or 1/3 of the funds that you would pay (in cash..not insurance) to get excellent care.

It can happen. Especially for speciality surgery. If I were a doctor or healthcare administration or policy professional i'd be looking into that.

Just a thought. Maybe I just need a vacation.