Obama's Health Care Plan

Great Debates
1

I don’t see a thread dedicated to Obama’s health care plan, so I thought I’d start one. I’ll do the same for McCain’s plan.

For reference, here’s his plan: BARACK OBAMA’S PLAN FOR A HEALTHY AMERICA

In short form, here’s what he plans to do:

[ul]
[li]Guaranteed eligibility. No American will be turned away FROM ANY INSURANCE PLAN because of illness or pre-existing conditions.[/li][li]Comprehensive benefits. The benefit package will be similar to that offered through the Federal Employees Health Benefits Program (FEHBP), the program through which Members of Congress get their own health care. The new public plan will include coverage of all essential medical services, including preventive, maternity and mental health care. Coverage will include disease management programs, self management training and care coordination for appropriate individuals.[/li][li]Affordable premiums, co-pays and deductibles. Participants will be charged fair premiums and minimal co-pays for deductibles for preventive services.[/li][li]Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need assistance will receive income-related federal subsidies to keep health insurance premiums affordable. They can use the subsidy to buy into the new public plan or purchase a private health care plan.[/li][li]Simplifying paperwork and reining in health costs. The plan will simplify paperwork for providers and will increase savings to the system overall.[/li][li]Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.[/li][li]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.[/li][li]Quality and efficiency. Participating hospitals and providers that participate in the new public plan will be required to collect and report data to ensure that standards for health care quality, health information technology and[/li]administration are being met.
[li]EMPLOYER CONTRIBUTION. Employers that do not offer meaningful coverage 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.[/li][/ul]

Those are the bullet points. How he intends to do that is more detailed.

I’ll kick this off by stating that this looks to me like a very clever way to move the country to a national, government-run health insurance program without actually claiming to do that. How? By setting up a very generous government health program to compete with private insurance, then rigging the rules against private insurers in a way that makes it impossible for them to compete.

Take that first clause. NO insurer will be allowed to deny someone insurance due to a pre-existing condition. Got that? You can be a diabetic AIDS patient with an artificial heart, and an insurance company has to insure you.

But wait, won’t they already do that? Sure they will. You can get insurance for anything, so long as you’re willing to pay the premium. When people say they can’t get health insurance because of a pre-existing condition, what they mean is that they can’t get inexpensive health insurance they can afford because of their pre-existing condition. If I’m an insurer, and I look at your condition and see that there’s no way you’re going to cost me less than $10,000/yr in medical costs, and there’s a 50% chance you’ll cost me $100,000/yr, then I’m going to charge you $55,000 per year for insurance, plus paperwork and managerial costs, plus whatever my profit margin is. If you’ll pony up that kind of money, you can get health insurance.

But what Obama is saying is that no one can be turned away, AND the insurer has to charge a ‘fair’ and ‘affordable’ price. For many people with a pre-existing condition, the insurance company is guaranteed to lose money. This requirement would force them out of business, or force them to raise rates on everyone to compensate.

But if they raise rates on everyone, people will go to the cheaper government health insurance system.

In short, his plan puts severe price controls on private insurance, then covers the inevitable insurance shortage with a government health care plan. And because he’s forcing employers to pay into the government plan if they don’t provide their employees with private health insurance, he’s going to make every company in the U.S. fund a state health insurance system.

Like a lot of Obama’s plans, this seems to pay lip service to the market and doesn’t appear to be a huge government takeover of the health insurance industry, but in effect that’s exactly what it will do.

Tell me where I’m wrong.

2

I can’t say you are wrong.

But I can say we spend $83,000 a minute in Iraq - all that money has to be redirected somewhere… I think his plan has some issues but in all it’s going to change the direction of how medical coverage is sought in this country, that’s a good start for me.

Oops scratch that…the $83k a minute is how much Exxon Mobile profits each year…and we still give them 17 billion a year of taxpayer money :rolleyes:

3

Since Exxon Mobil paid $30 billion in taxes last year, I don’t know where you are getting your numbers from.

4

From NPR today, Senator McCaskill said it: cite
I only remembered snippets of the conversation so I posted the wrong info…I had to go back before the edit ran out.

5

What’s wrong with a government takeover of the health industry? I am totally for socialized medicine. The more government control, the better. I don’t understand why people are so eager to be raped by insurance companies?

6

We’ve done that thread many many times, I’d imagine. It would be a more productive use of this thread to discuss the specifics of Obama’s plan, I think.
I do wonder if this sort of half-assed socialized medicine will end up being worse than just going single player. With this we’ll retain the complications of the private insurance system but stress them and force them into even more drastic cost saving measures.

7

That’s why I think we need to socialize it and take the insurance companies right out it.

8

How is this insurance? Insurance is about an equitable transfer of risk. This does not look like insurance at all. Is the government going to give the insurance companies money to subsidize the premiums down to an affordable level? If not, why would anyone want to provide health “insurance”?

9

How can an insurance company metaphorically rape anyone? Insurance companies do not force people to join their plans.

10

Yes, and you can be arrested for driving without auto insurance. You can elect to pay ridiculous medical costs that can easily exceed your yearly salary out of pocket. Insurance is a Hobson’s choice in this country.

11

Is it true what Warren Beatty says in the 1998 film Bulworth? He belies the myth that government is wasteful and industry efficient by claiming that government runs Medicare for a fourth of the overhead raked off by insurance companies for equivalent health care. I’ve heard that Medicare is actually one of the great government success stories.

12

It is the government, not the insurance companies, that requires auto insurance.

The whole point of insurance is to transfer. You have risk, and you pay the insurance company to take it off your hands. As you say the costs of medical care can be ridiculous so you can expect the insurance to be expensive. Depending on how risk averse you are, this might be a good decision.

13

I think this is the equivalent of putting a fresh coat of paint on a condemned house. It’s expensive, convoluted, and doesn’t appear to improve the situation much at all. The health care system in this country needs to be bull-dozed and built up as a single payer system. Anything else will just increase the gap between us and other countries in what we pay for health care, while masking the problems with our system.

14

Will this cover the reduction of my Senescence in perpetuity?

15

Sam while I have my problems with Obama’s plan, your critique is based on some basic misunderstandings of it, and more so of FEHBP. Those misunderstandings lead you to faulty conclusions.

FEHBP is not “a very generous government health program [set up] to compete with private insurance”, it is not “government-run” healthcare - it is an example of managed competition in which private insurers provide the services. The Feds contribute a fixed amount and provide a pooled purchasing mechanism for which many insurers compete. Employees pay a variable amount based on which plan they choose. Large group pooling allows for lower administration costs than small companies or of course individual purchasers could benefit from.

The competition would be between insurers all of whom must take all comers whether they are signing up within a company sponsored plan, via the FEHBP model one, or as individuals. (Although I am not sure that his plan requires payors to charge the same price for the same plan regardless of pre-existing condition to individuals, although such would allow for a fairer competition and should be part of the plan.)

The accurate criticism of it is, in truth, not that it gives the government sponsored plan an unfair advantage, but that it might create a government sponsored plan with adverse risk selection, by virtue of the lack of a mandate. Without a mandate the lowest risk individuals may opt out completely, at least until they develop a health problem, after which they may opt in. Obama’s answer to this is to provides subsidies to entice the young and healthy to opt in anyway. That approach is insufficient and likely to result in a costlier plan overall.

His plan also still uses the employer model as a backbone by continuing the tax subsidization of such plans created by allowing the purchase of such plans with pre-tax dollars. By so doing insurance purchased via employer-sponsored plans is given a competitive advantage to those plans purchased via the FEHBP model. McCain’s tax code modifications to diminish that tax advantage and to instead move it to an individual tax credit applicable to any health insurance purchase makes sense even if it is woefully insufficient in and of itself.

The expansion of government run health insurance is there, but only in the expansion of Medicaid and SCHIP. These are needed safety net programs.

In short, your portrayal of Obama’s plan as a move to “government take over” is very inaccurate.

But to work best his plan should add in the Clinton proposed mandate to have health care and the McCain proposed tax revision.

16

(Actually, I’d like to see McCain tax credit for health insurance purchase be progressive - highest for the lower income groups and non-existent for the very highest groups. That along with Medicaid and SCHIP expansion. But that is another thread as you have said.)

17

Be careful about believing information about public policy from films. As this report discusses, Medicare and private insurance are set up in ways that don’t lend to an easy apples-to-apples comparison about overhead. But when you actually crunch the numbers, it appears Medicare has only slightly less overhead costs than regular insurance. And, yes, the report comes from the insurance industry. I’ve read it, though, and can’t find any flaws.

18

Obama isn’t going to use FEHBP. He’s setting up a government-run health insurance system. The system will use a schedule of benefits similar to what FEHBP offers, but it’s a totally new, government-run program.

19

That’s crazy. What will you then do about the immediate and massive unemployment spike?

20

I wish I shared your confidence. As Michael Moore has correctly pointed out, WRT working out a new health-care policy in America, the health-insurance companies are the enemy and should not have a place at the table. Based on the above, I’m not sure Obama really appreciates that fact.