# What is Obama's proposed health care solution, in a nutshell **URL:** \ **Category:** Factual Questions\ **Created:** [August 4, 2009, 3:46pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299 "2009-08-04T15:46:43Z")\ **Posts on this page:** 16\ **Page:** 1
**Author:** ![Polerius](https://avatars.discourse-cdn.com/v4/letter/p/d78d45/32.png) [@Polerius](https://boards.straightdope.com/u/Polerius)\ **Post date:** [August 4, 2009, 3:46pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/1 "2009-08-04T15:46:43Z")
I haven’t kept up with the health care reform proposals and discussions, so can someone bring me up to speed on what exactly Obama is proposing, in a nutshell? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [August 4, 2009, 5:40pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/2 "2009-08-04T17:40:12Z")
I am afraid it would take a really big nutshell. [Here](http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf) is the text of the bill (PDF). [ul][li]It will cost at least $1.2 trillion. ([Cite](http://www.washingtonpost.com/wp-dyn/content/article/2009/07/16/AR2009071602242.html)). [/li][li]Almost half the currently uninsured will not be covered [/li][li]It is expected to increase health care costs in the US rather than decrease them. [Cite.](http://www.msnbc.msn.com/id/31949211/ns/politics-cq_politics/) [/li][li]Obama is talking about paying for it with a surtax on people making more than $280K per year, or couples making $500K per year. This will cover about one third of the projected increased cost. [Cite.](http://www.nytimes.com/2009/07/21/health/policy/21health.html?_r=1&pagewanted=2) [/li][li]Obama promised that his health care bill would not add to the deficit, so somehow he has to raise taxes somewhere else and/or cut about a trillion or so from other spending. [/li][/ul] Regards, Shodan ---
**Author:** ![mlees](https://avatars.discourse-cdn.com/v4/letter/m/ba8739/32.png) [@mlees](https://boards.straightdope.com/u/mlees)\ **Post date:** [August 4, 2009, 6:12pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/3 "2009-08-04T18:12:29Z")
**Shodan** , how much of that House Bill is Congressional input, and how much of that Bill is Obama’s? ---
**Author:** ![Markxxx](https://avatars.discourse-cdn.com/v4/letter/m/5daacb/32.png) [@Markxxx](https://boards.straightdope.com/u/Markxxx)\ **Post date:** [August 4, 2009, 6:36pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/4 "2009-08-04T18:36:26Z")
Look at Mr Obama’s [website](http://www.barackobama.com/issues/healthcare/), you’ll get the ideas in a nutshell. It’s hard to disagree with what he’s saying, but it’s easy to disagree when something effects you and no one else. As Gracie Allen said in 1940 when she ran for president. “A chicken in every pot sound like a great idea, that is unless you’re the chicken.” ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [August 4, 2009, 7:29pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/5 "2009-08-04T19:29:24Z")
> [@mlees](#): > > **Shodan** , how much of that House Bill is Congressional input, and how much of that Bill is Obama’s? I have no idea. If you look at his website, Obama made a whole bunch of promises during the campaign, and is now pushing a plan to fulfill some of them. If it passes Congress and he signs it, it will be the law of the land. If Obama doesn’t want to be held accountable for it then, he shouldn’t be pushing it now. Regards, Shodan ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [August 4, 2009, 7:43pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/6 "2009-08-04T19:43:51Z")
The plan is still being banged out by various committees in Congress. But so far, the key elements are: 1. Create a public insurance option that competes in the marketplace with private insurers. 2. Set up health insurance exchanges (HIE) for those not insured by their jobs in every state that will be sort of a one-stop shop for a health care plan where individuals can compare different plans with neutral advice. 3. Offer subsidies for low-income users of private and public insurance through the HIE system. 4. Set requirements for participation in the HIEs, including the inability to deny coverage on the basis of a preexisting condition. 5. Subsidize health information technology systems. 6. Require employers to offer insurance of to contribute to the subsidies in the plan. ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [August 4, 2009, 7:56pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/7 "2009-08-04T19:56:32Z")
Oh, and in reference to Shodan’s outdated cite about 1.2 trillion price tag: > [@](#): > > The Congressional Budget Office (CBO) released estimates this evening confirming for the first time that H.R. 3200, America’s Affordable Health Choices Act, is **deficit neutral over the 10-year budget window – and even produces a $6 billion surplus**. CBO estimated more than $550 billion in gross Medicare and Medicaid savings. More importantly, the bill includes a comprehensive array of delivery reforms to set the stage for lowering the future growth in health care costs. > > Net Medicare and Medicaid savings of $465 billion, coupled with the $583 billion revenue package reported today by the House Committee on Ways and Means, fully finance the previously estimated $1.042 trillion cost of reform, which will provide affordable health care coverage for 97% of Americans. [Link](http://edlabor.house.gov/newsroom/2009/07/cbo-scores-confirms-deficit-ne.shtml) ---
**Author:** ![mlees](https://avatars.discourse-cdn.com/v4/letter/m/ba8739/32.png) [@mlees](https://boards.straightdope.com/u/mlees)\ **Post date:** [August 4, 2009, 7:56pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/8 "2009-08-04T19:56:55Z")
> [@Shodan](#): > > I have no idea. > > If you look at his website, Obama made a whole bunch of promises during the campaign, and is now pushing a plan to fulfill some of them. If it passes Congress and he signs it, it will be the law of the land. If Obama doesn’t want to be held accountable for it then, he shouldn’t be pushing it now. > > Regards, > Shodan Sorry, please don’t think I’m pickin’ on you just 'cuz. Sometimes I take an OP too literally. I am only asking because the thousand+ page Bill Congress came up with may not (or it might) be what Obama had in mind during the campaign. The OP asked about Obama’s plan. I don’t know if there is a difference between what he wanted and what Congress dreamed up. ---
**Author:** ![HorseloverFat](https://avatars.discourse-cdn.com/v4/letter/h/8e8cbc/32.png) [@HorseloverFat](https://boards.straightdope.com/u/HorseloverFat)\ **Post date:** [August 4, 2009, 9:21pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/9 "2009-08-04T21:21:13Z")
Obama’s plan was a single-payer system. That is clearly not happening now. Now we’re looking at some kind of exchange market for health care and subsidization for low income people. It may end up being 100% private with no public insurance. ---
**Author:** ![Simplicio](https://avatars.discourse-cdn.com/v4/letter/s/c37758/32.png) [@Simplicio](https://boards.straightdope.com/u/Simplicio)\ **Post date:** [August 4, 2009, 9:24pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/10 "2009-08-04T21:24:45Z")
> [@HorseloverFat](#): > > Obama’s plan was a single-payer system. That is clearly not happening now. Now we’re looking at some kind of exchange market for health care and subsidization for low income people. It may end up being 100% private with no public insurance. Really? I don’t recall Obama ever proposing a single payer system. One of his buzz-words during the campaign was that you could keep your current health insurance policy if it suited you under his plan, which seems impossible if he planned for a single payer system. Do you have a cite? ---
**Author:** ![Ca3799](https://avatars.discourse-cdn.com/v4/letter/c/9f8e36/32.png) [@Ca3799](https://boards.straightdope.com/u/Ca3799)\ **Post date:** [August 5, 2009, 12:06am UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/11 "2009-08-05T00:06:53Z")
Here is a link to the three bills (they are still in progress) side-by-side. [http://www.kff.org/healthreform/upload/healthreform\_sbs\_full.pdf](http://www.kff.org/healthreform/upload/healthreform_sbs_full.pdf) ---
**Author:** ![DanBlather](https://avatars.discourse-cdn.com/v4/letter/d/f4b2a3/32.png) [@DanBlather](https://boards.straightdope.com/u/DanBlather)\ **Post date:** [August 5, 2009, 12:39am UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/12 "2009-08-05T00:39:36Z")
One of the key points is making the entire population a single “risk pool” so that insurance companies can not reject people with pre-existing condtions or retro-actively cancel insurance after accepting payments for years. This one point by itself may make the biggest difference. ---
**Author:** ![DanBlather](https://avatars.discourse-cdn.com/v4/letter/d/f4b2a3/32.png) [@DanBlather](https://boards.straightdope.com/u/DanBlather)\ **Post date:** [August 5, 2009, 12:40am UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/13 "2009-08-05T00:40:41Z")
A related question: what does \*single-payer \* mean? ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [August 5, 2009, 1:03am UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/14 "2009-08-05T01:03:42Z")
> [@DanBlather](#): > > A related question: what does \*single-payer \*mean? It means that private health insurance is abolished, and all payment for health care comes from the government, funded by taxes or premiums, or both. Single-payer health care is not currently being proposed by Congress or the White House. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [August 5, 2009, 12:19pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/15 "2009-08-05T12:19:05Z")
> [@Richard\_Parker](#): > > Oh, and in reference to Shodan’s outdated cite about 1.2 trillion price tag: > > [Link](http://edlabor.house.gov/newsroom/2009/07/cbo-scores-confirms-deficit-ne.shtml) The actual CBO document ([here](http://www.talkingpointsmemo.com/documents/2009/07/cbos-analysis-of-house-health-care-bill.php?page=6)) seems to say otherwise - > [@](#): > > H.R. 3200 would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period Regards, Shodan ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [August 5, 2009, 1:29pm UTC](https://boards.straightdope.com/t/what-is-obamas-proposed-health-care-solution-in-a-nutshell/505299/16 "2009-08-05T13:29:55Z")
Except that isn’t the actual CBO document in question. There was a July 14 analysis, and a subsequent July 24 analysis. The numbers I quoted refer to the latter analysis. Because these CBO analyses track changing bills, their results change until we get a final product. So it is important to look at the most recent ones.