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Barack Obama's Health Plan

Barack Obama’s Health Plan is not a complete healthcare system as is Edwards’ Plan. To avoid drastic unintended consequences, Obama recommends two plans: one private that essentially boosts competition among current players in order to decrease costs; and the other public that brings portability, quality and fairness to all. This way, he encourages experimentation leading to a broad healthcare system most of us would like.

The private plan consists of current providers, hospitals, insurers, employers and others, plus a National Health Insurance Exchange. The Exchange sets standards. All plans must allow anybody to apply and to not penalize a person for being sick. All plans must be at least as generous as the public plan (discussed below). The Exchange acts as a watchdog. It evaluates health plans, compares them and makes differences transparent to the public so it may make better healthcare choices.

The public plan supplies benefits similar to those offered by the Federal Employee Health Benefits Program that serves members of Congress. Emphasis is on quality. Providers and hospitals in the system report data on procedures, medicines and outcomes to a special institute that analyzes the data and makes quality-improvement recommendations. Everybody is eligible to apply. If a person is not getting healthcare from an employer or is transferring to a job that does not have an associated health plan, he or she may join the public plan.

The poor are subsidized whether they join the private plan or the public plan.

Employers who do not participate in a private plan must contribute toward the cost of the public plan.

Here is how the Obama approach stacks up against my criteria:

  1. A NATIONAL SYSTEM - It is not a coordinated national system. However, means are provided through the institute and through information technology to improve healthcare with time. Eventually the private and public parts may be folded into a complete system.

  2. EVERYBODY IS INCLUDED - Everybody may apply for coverage. However nobody is forced to apply, which means that coverage will not be 100%.

  3. NOT EMPLOYER DEPENDENT - This is true. Employers may have plans or not. A worker may join either the employer's plan or the public plan. Employee insurance is portable from job to job.

  4. GUARANTED HELP WITH CATACLYSMIC EVENTS - Obama calls for federal reinsurance to reduce insurance costs accompanying catastrophic health events. It's not clear how far this will go.

  5. INSURERS MUST USE COMMUNITY RATING - This is true. The Exchange polices this.

  6. INSURERS MAY NOT INTERFERE WITH DOCTOR DECISIONS - It's not clear whether this is so, though I think it may be.

  7. HOSPITALS MUST SUBMIT TO QUALITY CONTROL - Those that are part of the public system must. I'm not sure about those who want to remain in the private system.

  8. DOCTORS HAVE THE LAST WORD - I hope so. It's not clear to me.

  9. PATIENTS MAY CHOOSE ANY DOCTOR - This is not clear.
Though this is not a complete universal healthcare system, Obama's Healthcare Plan may be a good way to start building a system through universal paticipation.

Posted by Paul Siegel at June 1, 2007 10:00 AM
Comments
Comment #221892

paul


“The private plan consists of current providers, hospitals, insurers, employers and others, plus a National Health Insurance Exchange. The Exchange sets standards. All plans must allow anybody to apply and to not penalize a person for being sick. All plans must be at least as generous as the public plan (discussed below). “

if the private providers are forced to insure anyone regaurdless of prior med. history, and conform to the gov’t opperated heath system. where is the competition in the market ? seems one or the other would become obsolete, and i’m guessing it won’t be the gov’t run plan.

insurance is a business, and without the ability to assign risk, in order to insure reasonable profitablity, most will just quit offering it. this will leave the gov’t in control of health care, and ultimately limit choice to consumers. if the gov’t decides not pay for somthing who are you going to sue them ?

Posted by: dbs at June 1, 2007 1:27 PM
Comment #221898

A survey study group I watched on C-Span yesterday, conducted in the previous week, demonstrates Obama is making inroads to some Republican and Independent voters, with his moderate middle road proposals. Many voters still don’t think they know enough about him to commit their vote, but, they are interested in learning more, and are impressed with Obama’s potential to work with both parties be a good diplomat. His trust factor is growing while Clinton’s is not moving at all.

Posted by: David R. Remer at June 1, 2007 3:20 PM
Comment #221903
where is the competition in the market?

Healthcare is not a market.

The general public is not qualified to choose between different treatments and so must trust the doctors and insurance salespeople.

Currently, you can’t find out if your doctor has been sued for malpractice, so consumers don’t even know if their doctor is one of the 5% who are the subjects of 90% of lawsuits.

Most importantly, healthcare is like food. Sick people will pay anything for it until they just can’t afford any more, and then they die.

That’s not a marketplace. That’s extortion.

Posted by: American Pundit at June 1, 2007 5:15 PM
Comment #221910

AP, exactly.

This is why the industry must be opened up. I do not trust my doctor, and most especially not an insurance salesman. They have other vested interests. Whenever my doctor tells me something, I go home get on the internet and read. I also review the PDR, Merck Manual and try to educate myself as to options. I go back and ask my doctor questions. If I’m not satisfied, I go find another doctor.

I was recently prescribed a blood pressure pill.
I went home and read. The pill is not considered a first line BP pill in England because it mey trigger diabetes. I have a family history of diabetes. I went back to my doctor. My blood pressure was normal, and he said don’t take the pill. He was unaware of the UK protocol. The story is longer than that, but that’s the gist.

If the information is public there will be many groups that assimilate and evaluate the info. There will be tons of websites that teach you how to evaluate a treatment/doctor.

Then you can have a free market. Then you can stop wasting your money on pill pushers and surgery fanatics who want to buy that new yacht. You will be able to put insurance companies and healthcare agencies with super executive perks out of business, by spending wisely.

Posted by: barneygoogle at June 1, 2007 5:58 PM
Comment #221912

Ap


“Healthcare is not a market.”

i disagree. people become doctors not only to help people, but also to make a good living. if you attempt to control pricing of services through gov’t regulation many will choose not go down that path because of the lack of opportunity. you will only limit the supply of high quality doctors. people may pay less for services, but they will also wait longer for those services because of backlogs.


“The general public is not qualified to choose between different treatments and so must trust the doctors and insurance salespeople.”


of course they’re not, they’re physicians. they need to do thier homework as barney pointed out. how many do you actually think do that now ? you don’t want to trust doctors, so you’de rather trust the gov’t. in my opinion this is even a worse option. if people don’t take the time research thier doctors advice now, why would they do it later ? there’s a lot to be said about getting more than one opinion. wonder how many do that now.


any service people pay for is going to be controlled by some type of market force. the only way to keep the cost down is to insure adequate supply, and competition between providers. if you tell the insurance industry what they can or cant charge, you’ll find fewer and fewer providers to choose from.

Posted by: dbs at June 1, 2007 6:34 PM
Comment #221913

barneygoogle

“If the information is public there will be many groups that assimilate and evaluate the info. There will be tons of websites that teach you how to evaluate a treatment/doctor.”

information is a good thing if you are willing to do the research. those that won’t take the time now, probably won’t later.


the doctor i have now no longer participates in group plans because they limit his ability to treat his patients as he feels is nessesary. he works with people on charges for services, and in many cases will waive his fee altogether. ie he’s willing to charge according to ability to pay, but that is his decision not an insurance companies, or the gov’ts. people wanted cheap health care, insurance cos. said we can do it but we have to be able to control the costs. it’s a business with a bottom line like anything else. if people were willing to pay the doctor for a visit on a cash basis you’de probably find more doctors and more flexability, but everybody feels entitled and wants someone else to pay.

Posted by: dbs at June 1, 2007 6:48 PM
Comment #221914

Ap

they’re physicians

whoops should read ( they’re NOT physicians )

Posted by: dbs at June 1, 2007 6:51 PM
Comment #221927

Any system that keeps private insurance carriers as part of the system is handicapped at best. Insurance and healthcare are two different things. Obamas plan I surmise sets up two tacks,public and private. Edwarsd plan does the same. If the private plan cannot compete then people will have the public plan to rely on. Both plans are doing this for purely political reasons.Its an easier sell and a vain hope to keep the insurance industry lobbyist and front pressure groups from the savage fear attacks against H.Clintons attempt at reform.It won’t work.They will attack both plans with their sef serving spin machines.It appears that both plans,although I have not studied Obamas yet,will eventually lead to a single payer plan as private carriers realize they will no longer be able to suck the blood of the unfortunate and extort the rest of us.. That is where we should be starting .

As for a cuatious approach,we have the plans of the entire western world to study. All work better than ours and all cost signicantly less. Most provide better care.We do not have the best care,the French do,but we pay the most.I am sure we hear the shrieks from the right about this along with anecdotal horror stories. Lets agree not to take anything seriously from people with connections to the insurance industry ,the mis-informed,or downright selfish.One favorite is complaints about long waits in other countries. I guess they have not been to Kaiser(HMO) recently or the county hospital. Thats where many of us get care.

Posted by: BillS at June 1, 2007 8:37 PM
Comment #221933

My wife was involved in an auto accident almost two months ago. I rushed her to the hospital emergency room as the pain she was suffering in her chest and neck were increasing by the minute. We arrived at 7:05. She saw a doctor about 9:10 PM. Xrays were taken at about 10PM. The doctor returned to discuss them with her close to midnight. We finally left the hospital at close to 1AM.

Now, the kicker is, when we arrived, there were only to other people in the emergency waiting room. Thankfully, it wasn’t a Saturday or Friday night.

Total amount billed to our insurance company, $3,440. Total allowed by our insurance company, $1575. Had we not had insurance, we would have been legally obligated to pay the $3,440.

So, two things are obvious. The Medical community is way overcharging the uninsured. And, the insurance companies are engaged in a form of collective bargaining with health care providers while still making handsome profits for themselves and the medical community.

So, isn’t it obvious that billions would be saved by cutting the insurance companies out of the loop and allow the government to collective bargain with the medical community directly, while insuring everyone for basic, preventive, and emergency care?

Seems obvious to me. That would leave insurance companies to provide additional coverage for catastrophic, non-essential, and specialized non-emergency services to those who can afford it and desire it and they would suddenly be thrown into the heat of competition for that market share. A good thing for the wealthier folks as well.

Posted by: David R. Remer at June 1, 2007 9:08 PM
Comment #221935

dbs,
You can lead a horse to water, but you can’t make them drink. There are still those in our society who believe God will take care of everything for them, and refuse medical treatment all together. These people are not a good basis for healthcare.

If you aren’t a little knowledgable about mechanics and willing to shop around, you are also likely to pay more for auto repairs and recieve shoddy workmansip.

The point is that you censure , sue and remove licenses of bad mechanics and doctors. You publicize mechanics who rip people off as well as doctors. Think 20/20.

No system will be perfect.

Bill S.

By opening up Insurance to national markets you offer them the chance to beat their rivals and set them upon one another. By allowing national pools of associations (like engineers, office workers, etc.)to bargain for deals you diffuse risk, and increase bargaining power. Use the greed of Insurers against themselves instead of a lobby for prefered position and some collective bargain with government. Allow health savings accounts, taking the money out of Insurers hands all together. Competition is the key to driving prices down. Some creative uses of pooling for bargaining power can be used to avoid the skimming of risk groups.

Make no mistake, some will commit fraud, malpractice and even murder. A bright light and active justice system will kill these cockroaches.

Doctors and Insurers as a group hate these ideas and will try to marginalize Dr. Ron Paul because of it. The Banks don’t want his ideas out there either. Ask yourself, why?

Posted by: barneygoogle at June 1, 2007 9:10 PM
Comment #221944

barnygoogle
Why keep insurance involved at all. They do NOT provide healthcare.To the contrary,they are a major reason our system is broken.Keeping them involved is like hiring the local burgler to gard your house. The amount of paperwork they require and the amount of paperwork the healthcare providers have to produce in response including appeals cost enough to cover the uninsured with actual healthcare.
I am in a large pool already,the Carpenters Union,and we get socked with outrageous medical cost just like everyone else.The ideas you express are better than nothing but still switching deck chairs on the Titanic.
I repeat. There are very good systems all over the western world to model.In Canada you may purchase insurance to cover things not in the government formulary,like braces and cosmetic surgery if you choose. Most Canadians are happy with their system. The average Frenchman gets better healthcare than even rich Americans(NYT).Norwegions have the longest life expectancy in the west even though they complain all the time and drink like fish.Good healthcare.We on the other hand have a higher infant mortality rate than Cuba and Croatia and many predict our life expectancy to start decresing soon. We can do better.

Posted by: BillS at June 1, 2007 10:12 PM
Comment #222016
the doctor i have now no longer participates in group plans because they limit his ability to treat his patients as he feels is nessesary

dbs, why do you think your doctor is any good? If you say you trust him then you’re making my point.

How do you know this guy doesn’t have a dozen malpractice suits under his belt? Tell you what, Why don’t you go find out. I’ll wait…

Let me save you some time. A while back, Congress and the AMA decided the public didn’t need that information, so you won’t be able to find it.

I’m not trying to scare you, I’m just making my point. If healthcare is a market (it’s not), then you should know your doctor’s malpractice history. Maybe there’s a different reason your doctor no longer participates in group plans…

Posted by: American Pundit at June 2, 2007 4:54 PM
Comment #222077

Enough with the hero worship, great leader has the plan bull crap.

Hillary tried to dictate a socialist left wing failure of a plan to the country and even the democrats laughed at her and told her she had failed miserably.

The health care plan for the US should be drawn up by both sides of congress, it should take a hard look at what works overseas and what DOESN’T work. For example, the long lines that have people who need operations coming over here to get them…etc.

Then we should take a hard look at what works over here, why the US Capitalist system works and what it can bring to the table, and for god sakes, bring in the insurance companies, the hospitals, the doctors, the nurses…lets put it all on the table. Lets see what EVERYONE has to say and make a plan that worthwhile.

Bull crap with pretty boy politicians DICTATING our national health care and arbitrarily screwing around with such a huge portion of our economy. Lets let congress actually work on in for a year or two and come up with the worlds GREATEST, MOST WORKABLE plan instead of some piece of election year crap.

Why aren’t democrats working on fixing social security in congress? Why aren’t democrats working on fixing Medicare in congress? Why aren’t democrats killing earmarks and corruption? Why aren’t democrats working on a national health care plan? Why aren’t democrats making gas cheap as they promised? Why aren’t democrats balancing the budget? Why are democrats promising to spend more when they told us Bush spends too much?

This is just MORE OF THE SAME. This Democrat congress has become another corrupt, Do-Nothing congress.

Posted by: Stephen at June 3, 2007 9:46 AM
Comment #222079

Are their SEATS WARM YET?

Someone here once told me that the Reason democrats hadn’t accomplished anything is because they were “new to the job” and needed to “warm their seats”.

Well, the earmarks, the corruption, the lies….their seats seem pretty much WARM to me. 6 months in and they have not even STARTED to fix any of our major domestic problems AND they are now starting to fixate on what the “message” should be for the 08 election.

The MESSAGE?!!!! For craps sake dems……do something….fix something. FIX SOCIAL SECURITY…..GET TO WORK.

Oh they said they would work more….and work they are….passing those pork barrel spending projects. Spending more than republicans.

DOESN’T that mean….in the democrat parties own words…..they are spending our children’s future? Whatever happened to that line? Whoe’s spending our children’s future now! STOP WITH THE PORK AND GET TO WORK.

Posted by: Stephen at June 3, 2007 9:58 AM
Comment #222097

Stephen
“Pork barrel is infrastucture spelled backwords”…Tip O’Neal

It is a legitimate task of congresspeople to attempt to get projects in their respective districts funded. When it is time for re-election their constitiunts demand it.Projects like highway funding,sewer plants etc.
In my area our two congress people have managed to get some financial help for the salmon fishermen,hurt by fedearal decisions regarding water policies. Was it a good thing?Yes.Are the fishermen a special interest,certainly. Our people in congress were doing their job. This is very different than the Rep policy of sneaking items in to reward contributers ,sometimes in the middle of the night,with no way to even find out who put the measures in.

Posted by: BillS at June 3, 2007 1:35 PM
Comment #222100
The health care plan for the US should be drawn up by both sides of congress, it should take a hard look at what works overseas and what DOESN’T work.

Duh. The first step is for Republicans to actually admit there is a problem. What is the Republican plan for healthcare, Stephen?

I’ll save you some time: Republicans do not have a coherent plan. Go look at the GOP candidate’s web sites. Zip. Nada. Nothing about healthcare.

I take it back. Where healthcare IS mentioned, it’s in the category of something that must be done away with.

Posted by: American Pundit at June 3, 2007 1:47 PM
Comment #222260

BillS, There is NO EXCUSE for politicans who told us that Bush was spending our childrens future to now go in and spend like crazy.

There is no excuse for democrats who told us they would end corruption, to embark on a massive program of corruption. They are now working on attaching PORK SPENDING at the last moment so no one can spot it in advance and defeat it. Before the election democrats told us that Pork = Corruption and that they would deal with it. After the election brain dead liberals are preaching to us that pork is good and we need it. WHAT? What utter crap and nonsense.

END THE PORK. Good bills that are needed can be introduced and passed on their own. It’s time to stop attaching 20 billion in pork to defense bills. Where is all that wonder responsiblity democrats told us they had.

It’s their corruption now and all you can do is defend it, totally incapable of getting mad and demanding they stop it and get busy. Today we learned that charges are being filed against a corrupt democrat in congress who stuffed his freezer full of bribe money. Pelosi tried to put him on important committees. When will democrat corruption end?

This is the same old corrupt, big spending, do nothing, arrogant democrat congress we voted out years ago and replaced with Republicans. And the dems are still up to their same old corrupt tricks.

When will they fix social security? When will they fix medicare? When will they balance the budget? When will they keep their promise and end the corruption of ear marks? When will they secure our nations boarders? 6 months in and all they can do is attack Bush and spend massively.

Where is the great new world the democrats were supposed to give us? Where is the fiscal responsibility they promised us? Where is the end to corruption they promised us?

We don’t need Obama’s health care plan or Bush’s health care plan or Hillary’s health care plan. We need a health care plan that both parties hammer out largely behind closed doors where they can actually work instead of pose for cameras. We need a health care plan that looks at all the other health care plans around the world and REJECTS what doesn’t work and pulls in what does work, then it looks at our existing health care system and it rejects what doesn’t work and pulls in what does. We need to give Doctors, lawyers, Nurses, Unions, Hosptials, etc all a place at the table where they can help to keep us on track. And we need to take care of Social Security and take care of Medicare and balance the budget before we add yet another huge, broken, social program like health care to it.

No, I can’t get excited about “Obama’s” health care plan because it’s not the plan we deserve. It’s not the plan that both parties hammerd out after taking a painful and time consuming look at all that’s out there and taking in all the best advice we can get then carefully plotting our way forward.

So an irresponsible do-nothing democrat congress wants me to accept whatever health care plan their present leader enforces? That’s silly. None of us should do that, we deserve better. Forget Socialism and Socialist goals of take over and lets create an AMERICAN plan that is the best in the world because it can work and not bankrupt as.

Posted by: Stephen at June 4, 2007 3:55 PM
Comment #281946

My husband worked for a dealership that closed the doors may 15th and we are loseing our kaiser.we cant afford the high price they want us to pay,the parts dept that had the union will get cobra they should have help for the people didnt ask to lose there jobs and medical,we need medical i take medicines but do they care h??? no. so what do we do? someone tell me.

Posted by: lisa cox at May 23, 2009 1:55 PM
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