Where Do the Candidates Stand on Health Care? Barack Obama

Corinne Ramey

Where Do the Candidates Stand on Health Care? Barack Obama

Hillary Clinton and Barack Obama have been sparring over health care during the past few days, throwing insults left and right and prompting plenty of controversy on their respective health care plans.

Even the famed Obamagirl music video has something to say about Obama's health care plan. "You're into border security, let's break this border between you and me," she sings in the video, which has now been viewed on YouTube over four million times and spawned various spoofs. "Universal health care reform, it makes me warm."

So Obamagirl likes Obama's health care plan, but how does the plan fare for the rest of us? First, a few details:

Obama's plan, similar to the Edwards plan that I wrote about recently, seeks to provide health insurance that is affordable, comprehensive and universal. Obama's website claims that "Through partnerships among federal and state governments, employers, providers and individuals, the Obama plan will save a typical American family up to $2,500 every year on medical expenditures." Despite the ambiguous language -- "a typical American family" and "up to" $2,500 -- there's a lot in Obama's plan that makes sense.

According to the Obama campaign website, the plan establishes a new public insurance program, which will be available to people who are not covered under Medicaid, SCHIP, or through their employers. The new public insurance program would also be available to the self-employed and for small businesses to provide health insurance to their employees. The program would offer comprehensive benefits similar to those offered by the Federal Employees Health Benefits Program -- the plan that currently insures members of Congress -- and nobody would be turned away from the plan based on pre-existing conditions.

Obama's plan would also create a National Health Insurance Exchange, which would "act as a watchdog 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." The Exchange, based on Mitt Romney's Massachusetts plan, would insure that income-based subsidies are available and force insurers to justify premium increases. Insurers would also be forced to offer every applicant a policy, regardless of pre-existing health conditions. Although the Exchange is somewhat similar to the regional Health Care Markets in Edwards' plan --although it's national instead of regional -- it doesn't create competition between private and public plans in the way that Edwards' plan does.

The plan also contains a grab-bag of additional policies designed to improve efficiency and lower costs. A disease management program, better integrative care for people with chronic conditions and more preventative medicine will be included in the plan. There are also measures to improve data collection and transparency through adopting electronic health information systems. According to the plan,

"Most medical records are still stored on paper, which makes them difficult to use to coordinate care, measure quality, or reduce medical errors. Processing paper claims also costs twice as much as processing 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."

According to the Rand Corporation, electronic health records could save an estimated $77 billion each year.

Sounds good so far, but what's the bill? Obama, similar to John Edwards, plans to roll back Bush's tax cuts on wealthy Americans, although Obama sets the bar at $250,000 instead of Edwards' $200,000 (Might Obama have wealthier campaign supporters?) When introducing his health care plan in Iowa, Obama said, "To help pay for all this, we will ask all but the smallest businesses who don't make a meaningful contribution today to the health care coverage of their employees to do so by supporting this new plan. And we'll also allow the temporary Bush tax cuts for the wealthiest Americans to expire." Obama puts the cost of his plan at $50-$65 billion annually.

Much of the argument among both the Democratic candidates themselves and within the progressive community has come down to universality and mandates. Just how "universal" is the Obama plan, and what does universality really mean, anyhow? Universal health care is commonly defined as a system where every American -- young, old, employed, unemployed -- has health insurance. In the end, this comes down to enforcing health insurance through individual mandates and forcing to people to buy insurance whether they want it or not. Enforcement can be carried out through a variety of different ways. Insurance coverage can be checked at schools, public agencies, doctors' offices, or even through the IRS. Americans are "forced" to have car insurance, so why not health insurance, too?

Obama, unlike other candidates, only forces all children to be covered in his plan. Clinton, whose plan does include individual mandates, charges that Obama's plan would leave about 15 million Americans without coverage. "Among the Democrats, all of us except Sen. Obama have universal health care," she said. Although Obama's plan makes universal coverage a possibility in the future, it certainly doesn't create one hundred percent coverage.

Perhaps the question of "to mandate or not to mandate" comes down to the actual measures in the plan that make insurance affordable. Mandates don't necessarily make a health care plan a good one -- after all, you can't just force people to buy overpriced insurance -- but if used in conjunction with low-cost, subsidized, or sliding scale public plans they have the potential for success. Mandates work if good, affordable plans are available to all, and the existence of mandates can actually force governments to create affordable plans because of increased consumer demand. Mandates, writes Paul Krugman in Friday's Times, could actually make insurance cheaper for everyone:

"And it’s not just a matter of principle. As a practical matter, letting people opt out if they don’t feel like buying insurance would make insurance substantially more expensive for everyone else. Here’s why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance — then sign up for it if they developed health problems later. Insurance companies couldn’t turn them away, because Mr. Obama’s plan, like those of his rivals, requires that insurers offer the same policy to everyone."

So when it comes down to it, is Obama's plan good for the middle class? The basic answer is yes -- increased preventative care, the electronic health records system, and mandatory insurance for children are all a big step in improving the current health care system. The creation of the National Health Insurance Exchange sounds promising, as does expansion of current federal programs like Medicare and SCHIP. But as Ezra Klein writes in the American Prospect, Obama's plan is still a sort of baby step towards the health care system that the middle class really needs. As Klein says,

"Its failing, somewhat ironically, is a lack of audacity. It accepts the sectioning off of the market into the employed, the unemployed, the old, the young, and the poor. It does not consolidate the system into a coherent whole, preferring instead to preserve the patchwork quilt of programs and insurers that make health care so difficult to navigate. It does not sever the link between employment and health insurance, nor take a firm step towards single-payer, despite Obama's professed preference for such a system."

Is the middle class ready for a plan with the kind of "audacity" that Klein suggests? If carried out well, I'm inclined to say yes.

Posted at 7:07 AM, Dec 01, 2007 in The Candidates on Health Care | Permalink | Comments (1)

Comments

The #1 cause of injury, disability, and DEATH in America is, Health Care. More people die now from contact with the American Medical Health Care system than from any other cause of death. More than from Cancer, Heart disease, or Stroke. More than any other country in the world. Many times more than any other people in the world. This fact is a catastrophic indictment of the entire US Health Care System.

Driven by greed. And a rush to profit. Thousands of Americans are killed, and injured daily in America. By compromised health care. Cutting corners. Over, and under treatments. And poisonings with all manor of toxic, poisonous pharmaceuticals. Especially the children. America only makes up 2-4% of the world population. But Americans buy, and consume 50% of all pharmaceuticals world wide.

But the tide has turned. I can see it. Hear it. And feel it. The message is getting out. And taking hold about the fact that we have a very serious, and major health care crisis going on in America. Hurting everyone. Especially our precious little children. Rich, and poor alike. And most all Americans seem to understand now that "HR 676 Not For Profit Single Payer Universal National Health Care For All (Medicare For All)" is the way to go. Like all the other developed countries have done. I have seen numbers as high as 90% of Americans want government managed health care Now. Medicare for all. Like other developed countries have. And like older Americans have now.

BRAVO!!! America. YOU GET IT! YOU REALLY GET IT! See sickocure.org.

It's NOW TIME to bring out the BIG GUNS!! The BIG GUNS!! are you. The American people. And anyone else that wants to help. From now until HR 676 is passed into law. I want every person to reach out and touch their fellow Americans every day if you can. I want you to take a phone book. And call at least one of your fellow Americans every day. And ask them to pickup the sword of HR 676 Single Payer Not For Profit Universal Health Care For All (Medicare For All).

Call more than one each day if you can. And ask them to do the same as you are doing if they can. And also to put maximum pressure on their politicians to get HR 676 done. And to make sure their politicians support HR 676. Accept no substitute. HR 676 is a no-brainer. It's the best way to go on health care. It's the only moral, and ethical way to go. That is why every other developed country has done it. Most did it years ago.

I know that many of you have been doing a fabulous job of spreading the word by talking it up with family, friends, and co-workers. And putting pressure on the politicians to get HR 676 done ASAP. The phone calls to your fellow Americans will increase the pressure. And grow the movement at an astonishing, and exponential rate. And I know many of you have been wanting to do something more to help. The phone calls to your fellow Americans is something you can do every day to help.

Trust me. It will be something to see. But you have to keep the focus, and pressure on getting HR 676 passed pronto. They will try to distract you. With all manor of other crises, and catastrophes. And other plans. Don't be distracted. HR 676 Single Payer Not For Profit Universal Health Care is the #1 concern of the American people. Thousands of Americans are dieing daily now. And you or your loved ones could be next.

There is no good reason HR 676 cannot be passed into law well before the coming elections. Do not tolerate delays. If it is not passed before the coming elections. All America will know which politicians are on the side of the American people. And which are not when they vote. Well before the elections.

Everyone can do this. Most of you are well informed about HR 676. This truly is one of those no-brainers. Be considerate of your fellow Americans when you call. But be comfortable about calling. These are your fellow Americans. Some will be receptive. And some will not be. Some maybe rude, and mean. Just thank them, and move on to the next. Most will be with you. And if you get a call from one of your fellow Americans about HR 676. Let them know you are already on board. And thank them for calling. Build them up. And keep them strong. They are fighting for all of us.

I will try to make a second post with just a few of the reasons everyone with 2 working brain cells agrees HR 676 is the best way to go. But you can also look them up for your-self. And read some of the positive informed post on many of the message boards too.

Lastly, I am sick and tired of hearing how the candidates, and politicians health care plans are going to protect, and preserve the private for profit health insurance companies that have been killing, and ripping off the American people. And now the politicians want to mandate (require) that every American has to support the private for profit insurance company's that have been killing, and ripping you off. Or you will be fined, and PENALIZED. Thats right. PENALIZED. Ridiculous! The politicians really think you are all detached idiots. CASH COWS! To lead to the slaughter. Don't put up with that.

So get on it America. Get those phones going. Chat it up! Save some lives. You want all of America talking about HR 676 becoming law, Now! Before more die needlessly. Make it happen. And to my fellow cyber warriors. You have been doing great! I see it! Keep it up. 1 of 2 post...

Below are a few reasons why "HR 676 Single Payer Not For Profit Universal Health Care For All (Medicare For All) is a no-brainer. And some reasons why private for profit health insurance is a stupid idea, and injuring, and killing you and your loved ones.

Medicare cost 2-3% to administer. Private insurance cost 30% to administer.

Under HR 676 everyone would be covered from birth to death. No co-pays. No-deductible. No out of pocket cost. Plus Dental. And Vision. For less cost than we pay now under private health insurance.

With private insurance. You have 47 million Americans with no insurance.

And 89 million Americans that had no insurance part of the time from 2006-2007.

And over a 100 million that are under insured.

18-30 thousand Americans that die each year from lack of health care.

Health Care bills as the #1 cause of personal bankruptcy. And loss of homes.

Under HR 676 health care is moral, and ethical.

Private for profit insurance is immoral. And unethical.

Profit is the primary motive of the private insurance companies.

They make profit by charging needy, vulnerable, sick Americans as much as they can charge them.

Then they make more profit by denying them care when they most need it. And are most vulnerable and unable to fight back. When they are sick. Or trying to recover from major illness.

Yep! I know you are getting angry. I'm sorry. But I have to continue.

Under HR 676: we will save 300 billion dollars in administrative cost each year.

With private insurance: we spent more per capita on health care than any other country in the world. Over twice as much as most other developed country's. Yet we have 47 million with no health care.

We rank at the bottom in quality of health care #37.

Americans have a shorter life expectancy than people from all other developed countries. We rank # 42 in life expectancy. Down from #1.

For the first time in American history. The life expectancy of American children is less than that of their parents. American children are dieing at a record rate. And are in terrible health generally.

People from other country's enjoy a much higher level of general health than the best privately insured Americans.

Americans are also shrinking. We used to be the tallest people in the world. Now we are down to # 10.

People from other country's never have to worry about going bankrupt, or loosing their homes over medical bills if they get sick.

Maybe you should go take a break for a while before I go on. I know this must be upsetting. But this is just a small part of the sad truth about private health insurance that HR 676 can fix.

Under HR 676: Health care will be based on need. Not on profit. And high standards, and quality will be enforced, and patients protected by the Government through a dedicated civil service. With the power, and resources to rain in abuses of patient care. Like they do with Medicare now.

With private insurance: Medical care is base on ability to pay. And profit. Tens of thousands of patient are killed, and millions are injure, crippled, and mutilated each year under private for profit health care, and insurance.

By insurance companies denying needed care to increase their profits.

By hospitals cutting corners. And using the cheapest least experienced personnel, equipment, and standards they can get away with.

By doctors that over treat, and under treat. Who injure, mutilate, and kill patients with unnecessary test, procedures, surgery, and invasive diagnostic test for profit. Who poison, kill, and injure millions of Americans with all manor of unnecessary pharmaceuticals for profit. Men, Women, Children, and babies.

Americans makeup 2-4 % of the world population. But Americans buy, and consume 50% of all pharmaceuticals world wide. This is a monstrous evil. And immorality.

And lastly, by politicians that take blood money from all these despicable groups and turn blind eye's to this slaughter of the American people. And the slaughter of their own loved ones. And them-self.

Well I could go on. And on. But I think this is enough to get you started making your daily phone calls to your fellow Americans to support HR 676. And to help them understand how important it is that each of them join the fight. And bring the MAXIMUM pressure to bear on all individuals, parties, and especially your politicians, and Representatives. To get HR 676 passed into law immediately.

This is an emergency. America is in a crisis. More Americans have died from this health care crisis than have died in all the wars in US history. Do your best. Millions of Americans lives are counting on each of you. Including your own life. Remember, you are Americans. You know how to fight for your country when you have too. The whole world is in your blood. I'm with you.

All the best... 2 of 2