Question about Healthcare:

[rucky]

From the debate, it sounded like Edwards and Clinton have fundamentally the same healthcare plan - universal and mandatory. Edwards made a point about his plan that Medicaid would be a buy-in option, presumably so there's a not-for-profit plan out there that can control pricing and keep the private plans from doing what they've been doing to us.

What's Hillary's mechanism to keep healthcare affordable?

Do either of them - or Obama for that matter - have a mechanism in-place to ensure quality of care?

Columbo edit (one more thing): Why is single-payer "off the table"?

[Sarah Ibarruri]

1. I don't know but in the debate it came out that Obama's health care is NOT universal. nt

[rucky]

2. and that's fine, too.

At least an improvement.

Which reminds me of my next question:

Why is single-payer "off the table," exactly?

[Sarah Ibarruri]

3. I have no idea. nt

[OzarkDem]

6. No, its not good

Having a system that doesn't provide universal coverage means people won't buy it until they get sick. Its the reason we have rising costs today - because everyone isn't covered and paying into the system. The biggest health insurance pool is the most cost effective.

[rucky]

12. (i was being polite)

[OzarkDem]

13. Ok, good questions

I wish single payer were on the table, too, but Edwards plan is the one most likely to get us there.

[1corona4u]

18. Oh bullshit.....

that is not the reason we have rising health care cost. The health insurance companies and medical communities are raping people. That's why it's out of control. Physicians are paying more in insurance, because of malpractice lawsuits too. That's the reason.

[OzarkDem]

20. Many causes of rising costs, lack of universal pool is one of them

You won't be able to have sustainable, affordable health care reform if all people aren't in the pool, even with other cost cutting measures. Yes, health insurance companies are increasing prices and cherry-picking customers, but we won't make a difference by using taxpayer dollars to subsidize them and still leaving large numbers of people uninsured.

[sandnsea]

8. Mandates will not pass n/t

[CelloPaddy]

40. This is right nt

[jody]

4. The fundamental question is who pays for universal health care. Will it be foreign investors who own

an increasing share of our companies and use creative accounting to shift their profits offshore away from U.S. taxes?

[OzarkDem]

9. Yes, and more

Having universal health care without competition in the insurance market will cause us to end up like Massachusetts, with very high costs as private insurance premiums keep rising. Insurance companies will raise their premiums when they know the government is helping subsidize them.

You need competition between public and private insurance to keep premium costs down.

[jody]

15. I have dozens of close friends who are MDs and nurses and none of them are getting fabulously

wealthy.

The U.S. health care bill approaches $2 trillion and I wonder how much of that goes to drug and various medical test companies?

[OzarkDem]

22. or just to insurance company profits

[jody]

23. Right, every increase in cost is pure profit because the number of claims does not increase. n/t

[OzarkDem]

5. Difference between Edwards and Clinton plan

Both are universal, but Clinton only allows low income and disabled to apply for public health care (Medicare, etc.) Everyone else, including employers, has to purchase from private insurance.

Edwards gives everyone a CHOICE between purchasing from public insurance OR private insurance pools - forcing private insurance to compete w/ public, driving costs down.

Both Edwards and Clinton plans are Universal in they require everyone be covered and if you can't afford it, you'll get subsidies to help buy it.

Obama's plan says he will cover low income uninsured w/ public programs and will help everyone else buy private insurance. But he doesn't require everyone be covered, nor require employers to provide coverage or help pay for insurance. His plan leaves lots of people uninsured, which is what drives up the cost of insurance and health care.

[Mist]

10. It seems both Clinton and Obama are still too worried about providing for

insurers, rather than the insured.

[OzarkDem]

14. Its a bridge they don't want to cross

and without it, we won't be able to have real health care reform.

[1corona4u]

19. Do you even know what the fuck you're talking about??

I don't think you do. From Hillary's website;

Hillary's American Health Choices Plan covers all Americans and improves health care by lowering costs and improving quality. It speaks to American values, American families, and American jobs.

It puts the consumer in the driver's seat by offering more choices and lowering costs. If you're one of the tens of million Americans without coverage or if you don't like the coverage you have, you will have a choice of plans to pick from and that coverage will be affordable. Of course, if you like the plan you have, you can keep it.



Affordable: Unlike the current health system where insurance premiums send people into bankruptcy, the plan provides tax credits for working families to help them cover their costs. The tax credits will ensure that working families never have to pay more than a limited percentage of their income for health care.

Available: No discrimination. The insurance companies can't deny you coverage if you have a pre-existing condition.

Reliable: It's portable. If you change or lose your job, you keep your health care.



If you have a plan you like, you keep it. If you want to change plans or aren't currently covered, you can choose from dozens of the same plans available to members of Congress, or you can opt into a public plan option like Medicare. And working families will get tax credits to help pay their premiums.

[OzarkDem]

24. Hillary's plan doesn't force competition between public and private insurance

I've read all the plans thoroughly. Clinton's is good, but the fatal flaw is not giving everyone a choice between public and private plans - forcing private insurance pools to compete w/ lower cost government run plans.

Putting government subsidies in the hands of private health insurance companies w/o forcing them to compete w/ public plans will drive up costs, period.

[1corona4u]

26. Yeah, what the fuck ever.

THERE IS A CHOICE BETWEEN PRIVATE AND PUBLIC PLANS. DID YOU NOT READ IT?????

[OzarkDem]

28. Yes, I did

and public insurance under that plan is only an option for low income, seniors, and those with disabilities. We need a choice for everyone, regardless of age or income level.

[1corona4u]

29. Then your comprehension is missing.

I have no more time for stupid arguments.

[sandnsea]

7. Obama has insurance regulations, and Hospital Report Card

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.

He passed the Hospital Report Card in Illinois and has introduced similar legislation in DC.

http://origin.barackobama.com/issues/healthcare/

[OzarkDem]

11. He doesn't mention penalties or remedies

All the regulations in the world are meaningless unless there is real enforcement. If the only penalty for violating regulations is a small fine or slap on the wrist, insurance companies will do as they do now, simply add the cost of those small penalties into the cost of doing business.

Obama's plan also doesn't provide for competition between more expensive private insurance and lower cost public insurance. As private insurance premiums keep rising, more and more people will opt out of health insurance.

[sandnsea]

17. Each state has an insurance commission

When insurance companies violate laws, state commissions hold them accountable. You can absolutely make requirements at the state level and enforce them.

He absolutely does offer a "new public plan", along with subsidies for private insurance if people prefer.

It's about the best policy with the best opportunity for passing. There will be no mandated insurance so it's just ridiculous to pretend this is a legitimate debate. It's primary pandering of the worst sort and it's too bad so many people are falling for it.

Edwards is completely dishonest on the issue of mandates because he doesn't mandate until all the other portions of his plan are implemented anyway, which is the exact same position as Obama.

"Once these steps have been taken, requiring all American residents to get insurance."
http://www.johnedwards.com/issues/health-care/

[OzarkDem]

25. And most of them don't have strong enforcement or private remedy either

Obama's only public plan is one that expands Medicare / Medicaid /SCHIP plans to people at higher income levels, IIRC 200% of FPL.

It doesn't give every person in the US, regardless of income, a chance to buy into public insurance plans.

[sandnsea]

31. And so they'll be forced to get one

and that will be a good thing.

And everybody will be allowed to buy into the public plan that will be similar to FEHBP, separate from the programs for poor and low income people.

As long as a plan has real subsidies that make the policies truly affordable, unlike in Mass, and they wait for the mandates until they're sure the program is affordable, then it will have a chance to pass.

[OzarkDem]

34. Under plans all Dems propose, the states will have no role

Edwards and Clinton are talking about regional pools - that means regulations and enforcement would fall under the federal umbrella.

Leaving it to states is a poor option. It would completely undercut universal health care reform if states allowed private insurance companies to pick and choose who they cover and what they cover.

[sandnsea]

36. That was one part of the plan

but now you're into twisting and distortion games so I can see you aren't interested in an honest debate.

[hedgehog]

16. You asked about quality of care; is this what you meant:

Aside from guaranteeing the same coverage Congress gets now, Obama has also proposed:

Helping Patients:
Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. This will improve quality of care, give doctors better information and lower costs.

Coordinate and integrate care. Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. Obama will support implementation of programs and encourage team care that will improve coordination and integration of care of those with chronic conditions.

Ensuring Providers Deliver Quality Care:

Promote patient safety. Obama will require providers to report preventable medical errors and support hospital and physician practice improvement to prevent future occurrences.

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.

Comparative effectiveness research. Obama will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.

Tackle disparities in health care. Obama will tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. He will also challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.

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.

http://www.barackobama.com/issues/healthcare/

[rucky]

21. Yes.

This is just as important as coverage. You can't have a plan without these assurances.

Hell, I could get coverage for $50 per month right now, but it wouldn't really help much.

Also check out Sandnsea's post on the Hospital report cards.

[OzarkDem]

27. All the Dem candidates health care reform plans do the same

Problem is, Obama and Clinton's plans are not sustainable and will end up collapsing because of high costs. Edwards is the only plan that forces competition and gives everyone a choice of buying public or private insurance.

[rucky]

30. That appears to be the case.

:thumbsup:

It's the next best thing to single-payer - and I suspect most Americans would go with the Govt plan.

[sandnsea]

32. Obama has a public plan

The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have. The plan will cover all essential medical services, including preventive, maternity and mental health care.

Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.

[rucky]

33. It all really depends on how the qualifications are drawn.

as to how many people you can get into the public plan. If it's not done carefully, there will be lots of those "free-riders" waiting to get sick - especially folks earning in the 20-40K range. I think to make it work you'll need a generous sliding scale.

[sandnsea]

35. Which is why he puts more into the front end

Oregon subsidizes up to 95% and if there were enough money invested, everybody would be in. Edwards doesn't mandate until the very end, Obama has said he'd consider it. They are truly the ones who are closest on health care. Hillary offers tax credits which isn't going to help those $20-40,000 people at all.

[rucky]

37. I get the impression from the info here...

that Edwards and Obama are trying to open the door to single-payer, and Hillary is trying to shut it for good.

[sandnsea]

38. I have no idea on Hillary's intentions

I just know their stupid Hope tax credit didn't do a thing to solve college problems, as hopeful as I was at the time. Tax credits don't work. When you mandate without having the economic details worked out, that is terrifying. And mandated health insurance will kill any candidate who suggests it. Kerry's health plan wasn't even mandated and they called it socialized medicine. The only way we win on any of this is exactly the way Obama says, create such a movement of change that it becomes easy to push the legislation through. I had thought Edwards could do that back in 2003, he failed. Hillary sure can't do it. I'm hopeful Obama can.

[orleans]

39. i thought obama said his plan is to only cover people 25 & younger

and not illegals (excluding their kids too) did i misunderstand?

i don't think tax credits will work either. and you're right--mandating something and offering a tax credit is very scary (for those of us in that above poverty but barely getting by stage)

[sandnsea]

41. Under a parents plan

Which is helpful because children on a parents' plan are cheaper than having to buy a separate adult policy. Young adults can get coverage through school and possibly a year or two while they're getting established in a career. That was just that part of his plan.

http://origin.barackobama.com/issues/healthcare/

I've been told Edwards supports monthly subsidies, but I only see tax credits in his plan too. I like Health Care Markets if they compare private plans directly to a public plan. I like the part of Obama's plan that would require every private insurance policy to care what the public plan does, at a minimum. Everyone has to be accepted and there would also be a mechanism to measure the fairness of rates. It seems to go a little further in regulation than Edwards' health markets. Edwards' plan also doesn't rely on mandates to bring costs down or spead costs or any of that. I don't like people who misrepresent what their doing to score political points and I can't see any other reason that Edwards is letting people believe his mandates have something to do with the cost of his plan.

http://www.johnedwards.com/issues/health-care/