Obama Health Care - The Good, The Bad, and The Ugly

Senator Barak Obama is definitely a likable fellow. He is very well spoken, seems genuine, and has a fire that resonates with many. The true question hanging over Senator Obama's head is, "What experience does he have?". I understand that he has spent some time in the Senate and that he has a background as a lawyer (what politician doesn't). It was reported in the New York Times on October 28,2007 that Senator Obama has received $2.2 million in donations from the health care industry. This does not sound good for someone promoting change. I thought I would look at Senator Obama's health care policy in three sections; the good, the bad , and the ugly.

THE GOOD

• Mandatory Coverage of Children: Obama will require that all children have health care coverage. Obama will expand the number of options for young adults to get coverage, including allowing young people up to age 25 to continue coverage through their parents' plans.


• Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.


• Portability and choice. Participants in the new public plan and the National Health Insurance Exchange will be able to move from job to job without changing or jeopardizing their health care coverage


• Require full transparency about quality and costs. Obama will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care. Health plans will also be required to disclose the percentage of premiums that go to patient care as opposed to administrative costs


• Reform medical malpractice. Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and will promote new models for addressing errors that improve patient safety, strengthen the doctor-patient relationship and reduce the need for malpractice suits.


• Improve Mental Health Care. Mental illness affects approximately one in five American families. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As president, Obama will support mental health parity so that coverage for serious mental illnesses are provided on the same terms and conditions as other illnesses and diseases.

THE BAD

• Align incentives for excellence. Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded for achieving performance thresholds on outcome measures.


• Obama will expand eligibility for the Medicaid and SCHIP programs and ensure that these programs continue to serve their critical safety net function.


• National Health Insurance Exchange: The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group 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. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public.

THE UGLY

• Employer Contribution: Employers that do not offer 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. Small employers that meet certain revenue thresholds will be exempt.


• Flexibility for State Plans: Due to federal inaction, some states have taken the lead in health care reform. The Obama plan builds on these efforts and does not replace what states are doing. States can continue to experiment, provided they meet the minimum standards of the national plan

Overall, Senator Obama seems to have more positives than negatives. I do not agree with making small business owners bear the brunt of the employee health care coverage since this would put undo burden on the employer. If government were to give tax cuts to the small businesses or let them join together in order to get better rates then this may be achievable. He comes close to declaring a Universal Health Care system, but his fear of upsetting the Pharma and Insurance lobby is showing. His plan, simply will not work, for one good reason. Medicine can no longer continue to fiunction in a "for profit" model. He has many good ideas and is much more descriptive than McCain, but I fear he is trying to please too many "lobbies" and is not going far enough to protect the patients.