Obama-Biden Healthcare Plan

Again, the Republican spin on this plan is that it forces Americans to enroll in a grossly inefficient, government-run plan. That is a complete and utter lie. No one is forced into anything.

So here are some of the highlights of the plan:

1. Electronic Health Information Technology Systems: healthcare providers frequently write things on the fly during your examinations and doctor/dentist visits. They also submit claims on paper as well. A RAND study indicates that processing paper claims costs twice as much as electronic claims. Further, if most hospitals and doctors' offices adopted electronic health records, they could realize up to $77 billion each year through reduced hospital stays, duplicate testing, more appropriate drug use, and other efficiencies. The cost to invest in this IT would be about $5o billion over five years. Already you can see $335 billion in benefits.
2. Disease management programs: the plan calls for promotion of disease management programs to help people with chronic illnesses, which cost about $1.7 trillion a year to treat. The plan will encourage providers to team up to do a better job of managing these illnesses. Any effort to contain costs here would be a huge benefit.
3. Transparency of quality and costs: the government will require healthcare providers and hospitals to collect and report publicly measures of costs and quality. Health plans would be required to disclose just how much of the premiums paid goes to patient care as opposed to administration.
4. Reform Medical Malpractice: here is an area that, in my opinion, doesn't go far enough. Both my father and older brother are physicians who spend ridiculous amounts on malpractice insurance. The lawsuits filed against doctors, hospitals, and drug companies do two main things: they increase the cost of health care, and they drive many otherwise excellent doctors to stop providing care where it might be needed. My father has related to me stories of OB/GYNs in Nevada who have stopped delivering babies or who have left the state due to the cost of insurance. The Obama plan addresses anti-trust issues among insurers regarding the cost of permiums, as well as new models to improve patient safety, strengthen the doctor-patient relationship, and reduce the need for lawsuits. However, just what the plan will do to reduce lawsuits is unclear to me. Unless there is an effort to make it less attractive for patients to seek compensation in court, including a limit on punitive damages, then there will be no way lawyers will not try to hit every deep pocket around to find some money somewhere. Calculating actual damages and future costs could be easily figured out, but putting a price tag on how much a provider or hospital should pay for causing their patient emotional stress is too subjective for a court or jury. It's the need for revenge, to "get those guys who did this to my family," that drives this insanely litigious society.
5. Lowering costs by taking on anti-competitive practices in the industry: Drug companies and insurers prevent competition by talking to each other to fix prices. It's no secret. When the cost of insurance premiums has risen 11% per year for the past six years, outpacing inflation five-fold, then you know that someone's pocketing a lot of extra scratch. The Obama plan wants to do away with this monopoly power by hitting windfall profits and forcing it back into paying for non-competitive plans. Their new National Health Insurance Exchange will help to increase competition.
6. Eliminate excessive subsidies to Medicare Advantage: Medicare, which is an efficient, government run program has a private plan alternative called Medicare Advantage. Independent reports show that MA costs 12% more for the government to pay out under this plan than traditional Medicare. Billions of dollars are lost each year, and incentives are there for the industry to stick it to seniors. Obama's plan calls for subsidies to MA to be eliminated, and payouts would be the same as traditional Medicare.
7. Importing drugs from other countries: We all heard about people buying drugs from Canada at a much lower cost. Big Pharma cried foul and it was made illegal, but it's total BS, since studies show that drugs in Canada and Europe are just as safe and effective. It's just that Pharma charges 67% more in the US for drugs. This would be eliminated. Look for a big battle here.
8. More generic drugs: It's no surprise that Pharma companies pay generic manufacturers not to produce generic versions of brand-name drugs. Generic manufacturers don't care where they get their money, so if they can generate the same income without manufacturing and sitting it out, why not? The plan would fight this practice.
9. Let government negotiate for cheaper drug prices: Currently, under the 2003 Medicare Drug program, the government has to pay whatever price the companies want to charge. This doesn't work to bring down healthcare costs, so the plan will eliminate this restriction and force drug companies to be competitive. See the pattern of government enabling of enriching business at the expense of the working American?

Now, here is the scary part for Republicans.

• Guaranteed Eligibility: pre-existing conditions are covered for everyone.
• National Health Insurance Exchange: individuals can buy affordable plans if they are uninsured or want new insurance. Any American can enroll in the new public plan or an approved private plan, with sliding-scale tax credits for people who need it. So it's voluntary, not mandatory. Insurers who participate in the Exchange (again, voluntary)must issue every applicant coverage and charge fair premiums regardless of health status. All private plans must be as generous as the public plan and live up to the same standards as the public plan. Any above-average premium increase would have to be justified. Enrollment would be easy, and people can move from job to job without loss in coverage.
• Tax credits for small businesses: up to 50% credit back from the government for the healthcare premiums they pay for their employees. To get the credit, the business would have to provide a good plan and cover a meaningful share of the employee health premiums. I'm a little leery of this aspect, since it sounds a little like the Republican tax credit plan. That plan gives a $5,000 tax credit once a year to individuals who are taxed on their health-care benefits.
• Employer Contribution: large employers who do not provide meaningful coverage or pay a meaningful portion of the cost for their employees would have to pay a percentage of their payroll toward the costs of the national plan. Sounds like they would be forced to opt out of providing coverage for their employees unless it were meaningful, which looks like people would be forced into the public plan. But if the national plan is better than what they large employer would provide and pay for, this is a win-win for everyone. Plus, under the Exchange, there are a range of options from the public plan to approved private plans, so there is always a cafeteria-style approach to selecting one's health plan. Again, no one is forced into anything, and the Republican charges are a steaming pile of manure.

Finally, the plan calls for employers, schools, and citizens to do their part to encourage healthy lifestyles. Diabetes, obesity, asthma, heart disease, HIV/AIDS -- all these conditions are preventable with proper diet, exercise, and avoidance of risky sexual behavior. Anyone who's been to Disneyland on any given day knows that it is no longer the happiest place on earth, but the fattest place on earth. Anyone with children in public schools knows that the school lunches provided are frequently laden with fat (my older son only wants the lunches that are fried chicken nuggets or pizza, and he never eats the fruit or other healthy sides that accompany these crap dishes). As great as this idea is, it needs to go further. We have to create incentives for Americans to live healthier lives. Adequate exercise and good diets decrease their health-care coverage overall by cutting down on doctor visits, but this is not enough. Reductions in insurance premiums would be better.

In all of this, I would say that the good outweighs the bad. There will always be some who are negatively affected by this plan, but overall I would say that this plan offers coverage for all Americans at affordable prices, while doing everything possible to minimize government intrusion into fair business practices. Sunsetting the Bush tax cuts for the wealthy, the addition of paperless delivery, an eventual reduction in military spending, and heavy emphasis on prevention and wellness, will help significantly to pay for the additional costs of administering the plan.