Barack Obama vs John McCain on Health Care

[Shayna]

In this thread, JXJohns is trying to understand Barack Obama’s healt care plan, and how he intends to pay for it. I said I’d start a new thread for debate, so here it is. However, I’ve got to leave for a while, so this will not be an entirely researched OP, so I’ll leave it to you guys to fill in blanks, and, as always, discuss. . .

Barack Obama’s Health Care Plan

John McCain’s Health Care Plan

From what I read on McCain’s site, it seems like he doesn’t want to change the basic model of how health care policies are offered and procured. He believes that “competition” will help keep costs down.

He says he’ll work with state Governors to establish “guaranteed access”, based on the experiences of those states.

He’s also going to modify the tax code so individuals get a $2,500 credit, and families get a $5,000 credit, to offset out of pocket health insurance costs.

Barack Obama’s plan includes offering individuals (and families) to buy into the group plan that members of Congress have, offering subsidies to those who can’t afford it. While on the face, this sounds like easy pickin’s for anti-liberals, there’s nothing to indicate that this methodology would be more costly to the American taxpayer than across-the-board tax credits to the tune McCain is offering to everyone in the country, not just those in need.

If you buy into one of the programs outlined in Obama’s plan, it is, by its nature, fully portable and not dependent on what job you hold.

Large employers would be mandated to provide group health coverage, and pay a portion of the premiums, as a portion of payroll expense. Small businesses are exempt, and will be offered a tax credit of up to 50% if they provide health care to their employees.

Obama also expects costs to be lowered through competition, as well as streamlining operations and other innovations, and will cover some of the cost of his plan through increased taxes in some sectors, including the top 1% of wage earners and corporations.

And I’m now out of time. I turn it over to you. . .

[JXJohns]

Thanks for the thread. Anyone have an idea of what constitutes a “small business?” Would that be 10, 100, 1000 employees? I looked and cannot find where that is spelled out.

Secondly, as asked in the other thread.Who will be paying for the guaranteed health care for those who either choose not to have HC today, the unemployed, the unemployable, or who cannot afford it themselves? Would I as a taxpayer have to kick into a national pool to cover their insurance as well as pay my own premiums to cover my family? As a small business owner, would I be forced to insure my own employees, pay my own premiums, and then kick up to cover those mentioned earlier?

In some of the recent "Would you emigrate/immigrate should X candidate win or lose, it seems that there are several internationals that would move here should Obama be able to get a UHC plan going. In reading his plan, I saw nothing about coverage for non citizens. Did I miss that too?

I’m not sure if there is a real debate here, and I certainly am not trying to shill for either candidate.

[A_shameful_cracka]

@JXJohns

Thanks for the thread. Anyone have an idea of what constitutes a “small business?” Would that be 10, 100, 1000 employees? I looked and cannot find where that is spelled out.

Secondly, as asked in the other thread.Who will be paying for the guaranteed health care for those who either choose not to have HC today, the unemployed, the unemployable, or who cannot afford it themselves? Would I as a taxpayer have to kick into a national pool to cover their insurance as well as pay my own premiums to cover my family? As a small business owner, would I be forced to insure my own employees, pay my own premiums, and then kick up to cover those mentioned earlier?

In some of the recent "Would you emigrate/immigrate should X candidate win or lose, it seems that there are several internationals that would move here should Obama be able to get a UHC plan going. In reading his plan, I saw nothing about coverage for non citizens. Did I miss that too?

I’m not sure if there is a real debate here, and I certainly am not trying to shill for either candidate.

I would guess that it would work like most government programs to help the needy - if you don’t apply for it, you don’t get it. A lot of poor people or even just working class people qualify for all kinds of government assistance - as an example, my househould income is between 35K and 40K a year, and I qualify for food stamps and my children aged 6 and under qualify for Medicaid, as would my wife if she got pregnant again (she actually considered having a 4th child so she could get some medical issues looked at until they cleared up on their own). There’s other assistance programs I qualify for that I haven’t applied for because they are a lot of trouble (requiring regular multi-hour waits at the DHS incompatible with having a strict temp-to-hire employer). I’ve known a lot of people who make less than me who receive no government assistane at all, and I’m sure there are a lot of people who could qualify for subsidized health insurance under Obama’s plan who wouldn’t bother applying for it, either out of pride, ignorance, laziness, or insanity.

I think that a national health care program could end up saving taxpayers money in the long run. Now, if I am sick and can’t scrape up enough money to pay for a doctor, I have to go to the emergency room. This can be much more expensive than a doctors visit, and often the care they provide is incomplete and result in the person having to come back repeatedly. I’ve only gone to the ER for something I could have handled with a regular doctor’s visit once (an infected spider bite), but it ended up costing over $80K that I haven’t paid a cent towards. I’m sure that if I had insurance paid by the government, this would have cost them less.

Another advantage to a national health care program would be the tracking of illegal aliens and wanted criminals. If almost everyone has an insurance card, people who do not have one or do not want to provide one will be much more noteworth. Today, there are thousands of clinics that have a large number of cash customers, some guy trying to stay under the radar who pays cash for his medical bill is not going to stand out. When uninsured people are a small minority, law enforcement will have an easier time of tracking these people down.

[UnwrittenNocturne]

I think both are fundamentally flawed - mostly because they rely on the current model to a greater or lesser extent. having said that Obama has a much better plan than McCain. Note: I support an NHS style healthcare system so neither is wildly appealing to me.

I notice they both seem to believe that competition will reduce prices. Except it won’t. It sure as hell hasn’t managed to do so yet. Costs for healthcare are, as you’re no doubt aware, skyrocketing. The insurance industry somehow manages to have massive overhead costs that don’t seem to exist in a state-run system. And of course they pass those costs on. Then they aim for profits, which have to come from somewhere. Once again they come from the consumer. A fully state-run system doesn’t have that problem.

I realise this is something of a hijack as you really wanted to compare the two plans they have, but since neither of them seem to have hit the mark I thought it relevant.

[Cyberhwk]

@Shayna

From what I read on McCain’s site, it seems like he doesn’t want to change the basic model of how health care policies are offered and procured. He believes that “competition” will help keep costs down.

He says he’ll work with state Governors to establish “guaranteed access”, based on the experiences of those states.

He’s also going to modify the tax code so individuals get a $2,500 credit, and families get a $5,000 credit, to offset out of pocket health insurance costs.

My biggest problem with this, is isn’t the goal to get people INSURED? You get the average American $2500 cash and they’ll pay credit card bills and you’ve accomplished nothing towards increasing the level of US health care.

[sugar_and_spice]

@Cyberhwk

My biggest problem with this, is isn’t the goal to get people INSURED? You get the average American $2500 cash and they’ll pay credit card bills and you’ve accomplished nothing towards increasing the level of US health care.

Per link:

Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in expanded Health Savings Accounts.

[Critical1]

@Shayna

From what I read on McCain’s site, it seems like he doesn’t want to change the basic model of how health care policies are offered and procured. He believes that “competition” will help keep costs down.

Obama also expects costs to be lowered through competition,

if nothing else this shows me both of them have no clue how Competition can and does increase costs while decreasing quality.

health care is a big issue for me, I havent been to a dentist in over 20 years and the only doctor visits have been the ones where I really had no other choice. I have RSS issues in my right wrist, I have crazy dietary issues, my back is STILL fucked up after a car crash back in feb 01, and I aint getting any younger. even though I have a decent job and I am considered an excellent employee I havent had health care in I dont know how long. its ridiculous.

McCains plan looks like the usual republican BS where the only people who will come out ahead are the big businesses in the industry to me.

[Sage_Rat]

@UnwrittenNocturne

Costs for healthcare are, as you’re no doubt aware, skyrocketing. The insurance industry somehow manages to have massive overhead costs that don’t seem to exist in a state-run system. And of course they pass those costs on. Then they aim for profits, which have to come from somewhere. Once again they come from the consumer. A fully state-run system doesn’t have that problem.

From what I’m to understand, the money-eater in the US health system is lawsuit payouts and lawsuit insurance. Minus that, we’d be essentially equal with other countries.

(And I’ll note that neither of those is evil corporations being at blame, but rather the average–greedy–man.)

[Cyberhwk]

@sugar_and_spice

Per link:

Serves me right for rushing the post as I’m walking out the door. Thank you for the correction. :o

[Dr.Love]

Does anyone have data about what is driving the cost of health care? I recall reading several years ago that more than half of the increase in health care costs is due to technological change. (I don’t have a cite on hand, can’t find the book, but I’ll look for it again later.) If my memory is correct, this suggests that the only serious options for bringing down costs is either (1) less health care or (2) old-school health care. Seeing as neither candidate endorses either of these options I don’t have much of an opinion.

@A_shameful_cracka

Another advantage to a national health care program would be the tracking of illegal aliens and wanted criminals. If almost everyone has an insurance card, people who do not have one or do not want to provide one will be much more noteworth. Today, there are thousands of clinics that have a large number of cash customers, some guy trying to stay under the radar who pays cash for his medical bill is not going to stand out. When uninsured people are a small minority, law enforcement will have an easier time of tracking these people down.

All I have to say is: arguing that NHC would make it easier for the government to spy on us is not going to win me over.

[Dr.Love]

I found the book, but unfortunately the data is quite a bit older than I had thought. The original research was published in 1995 by Harvard economist David Cutler and Health Policy professor Joseph Newhouse, and indicated that technological advance accounts for 49 to 70% of real increase in health care costs from 1940-1990. Does anyone know of newer data?

[UnwrittenNocturne]

@Sage_Rat

From what I’m to understand, the money-eater in the US health system is lawsuit payouts and lawsuit insurance. Minus that, we’d be essentially equal with other countries.

(And I’ll note that neither of those is evil corporations being at blame, but rather the average–greedy–man.)

“Lawyers. Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office. Defensive medicine, the practice of ordering extra tests or procedures to protect against lawsuits, might add another few percentage points, according to some estimates.”

from http://www.consumerreports.org/health/doctors-hospitals/health-care-security/who-is-to-blame-for-high-costs/health-care-security-costs.htm

eta: so I’m putting it back on the corporations

[Dr.Love]

Thanks for the link UnwrittenNocturne. Unfortunately, the data provided is not terribly helpful and, IMHO, unsurprising. It tells us that “Doctors and Hospitals,” an exceedingly broad category, “account for by far the largest share, 52 percent in 2006, of all national health spending [my emphasis],” while the government, another exceedingly broad category, “directly controls only 46 percent of national health spending [again, my emphasis].” I wonder, in what sense is 52% far greater than 46%*? Trends within either “doctors and hospitals” or “politicians and government regulators” are completely ignored, meaning that policy suggestions out of this sort of data will be quite hard to justify.

*Note: there is clearly some overlap in the categories, since drug companies account for 10% of the total, alreay bringing us to 108% of medical costs without considering any of the other categories.

[Sage_Rat]

@UnwrittenNocturne

from http://www.consumerreports.org/health/doctors-hospitals/health-care-security/who-is-to-blame-for-high-costs/health-care-security-costs.htm

eta: so I’m putting it back on the corporations

Your link places the cost on the hospitals and doctors, not pharmaceutical and medical supply companies.

Given that whole specialties of medical care are leaving certain states due to malpractice cost, I’d gather that the doctors can’t afford that extra 2%. Given that they’re costing so much to get at all, I’m guessing that our supply is also too low. I’ll have to research specific numbers later.

[UnwrittenNocturne]

@Dr.Love

Thanks for the link UnwrittenNocturne. Unfortunately, the data provided is not terribly helpful and, IMHO, unsurprising. It tells us that “Doctors and Hospitals,” an exceedingly broad category, “account for by far the largest share, 52 percent in 2006, of all national health spending [my emphasis],” while the government, another exceedingly broad category, “directly controls only 46 percent of national health spending [again, my emphasis].” I wonder, in what sense is 52% far greater than 46%*? Trends within either “doctors and hospitals” or “politicians and government regulators” are completely ignored, meaning that policy suggestions out of this sort of data will be quite hard to justify.

*Note: there is clearly some overlap in the categories, since drug companies account for 10% of the total, alreay bringing us to 108% of medical costs without considering any of the other categories.

I see where you are on that - my point is that the oft-blamed lawsuits really aren’t taking up that much space.

[Quartz]

@UnwrittenNocturne

I see where you are on that - my point is that the oft-blamed lawsuits really aren’t taking up that much space.

Does this vary by speciality? Gerontology probably doesn’t have too many lawsuits, but what about Obstetrics? I remember reading about a lawyer who specialised in suing over childbirth and had to go out of state when she became pregnant because nobody would treat her.