Obama health care plan explained

Undesired Walrus

Penultimate Amazing
Undesired Walrus
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Apr 10, 2007
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Can someone explain to me what Obama's health care plan actually entails? What does it propose to do? There is so much partisan statements on it from all over (from both wings) that I still have no idea what the hell it's all about. How will such a plan be passed?
 
Undesired Walrus said:
Can someone explain to me what Obama's health care plan actually entails? What does it propose to do?
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I believe there are 3 different versions of it, though I think only the one has passed the committees now. I don't know the details (and it's a big, detail-laden thing), but in broad terms, it's a health insurance reform bill that will provide some consumer protections (insurance companies can't deny a claim or coverage because of a pre-existing condition, for one thing), and it will establish a public insurance plan--sort of like a non-profit insurance company intended to provide insurance at lower premiums for the currently uninsured and intended to drive the profits of private insurance companies down indirectly by competition. There's a LOT more to it, but I think these are the broad ideas.

How will such a plan be passed?
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The usual way a law is passed. See School House Rock's I'm Just a Bill.

 
A couple of other points in the health insurance reform bill (according to Obama's recent statement):

It would force insurance companies to remove per year or lifetime caps on benefits.

It will limit how much out-of-pocket expenses the insurance companies can require the patient to pay.

It will require the insurance companies to cover routine checkups and preventive care such as mammograms and colonoscopies with the intention of catching serious problems earlier (and thus making them less expensive to treat, aside from the fact of letting people enjoy better health).

I'm not sure how it fits into the legislation, but Obama is also claiming that he's gotten health care providers to agree to lower costs and drug companies have agreed to provide prescription drugs at a lower cost to seniors.

ETA: Not from Obama's recent statement, but my understanding is not only will covering most or even all of the currently uninsured be the right and fair thing to do, it will also reduce costs because the uninsured tend not to get much medical care unless or until they have a condition so very serious that they go to the ER and get treated regardless of their ability to pay. So preventive and maintenance of their health is cheaper (and has better outcomes) than waiting until the condition gets really really bad. Also, they'd be paying a premium of some sort rather than nothing.

Oh yeah--I think I was wrong that just one version of the bill has passed through several committees. I think we're still dealing with multiple versions of it. I don't know anything about how the bills vary.
 
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JoeTheJuggler said:
It would force insurance companies to remove per year or lifetime caps on benefits.
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Which will drive up costs.

It will limit how much out-of-pocket expenses the insurance companies can require the patient to pay.
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Which will drive up costs.

It will require the insurance companies to cover routine checkups and preventive care
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Which could drive up costs.

So preventive and maintenance of their health is cheaper (and has better outcomes) than waiting until the condition gets really really bad.
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No, it isn't cheaper. Treatment for specific conditions might be, but lifetime treatment costs are not. It's like smoking: although it incurs medical costs, lifetime decreases save taxpayer money overall. I'm not saying we shouldn't do it (because better outcomes is a good thing), but cost savings isn't supported.
 
I think there are plenty of active threads with the debate you seem intent on engaging in. I'd be happy to respond to them, but I think the topic of this thread is Walrus' question about what's in the bill and what it is meant to accomplish.
Ziggurat said:
Which will drive up costs.



Which will drive up costs.



Which could drive up costs.



No, it isn't cheaper. Treatment for specific conditions might be, but lifetime treatment costs are not. It's like smoking: although it incurs medical costs, lifetime decreases save taxpayer money overall. I'm not saying we shouldn't do it (because better outcomes is a good thing), but cost savings isn't supported.
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I found a Kaiser Family Foundation side by side comparison of the various healthcare bills.

I haven't read it yet. (Probably will do so when I have time this coming week.)

http://www.kff.org/healthreform/sidebyside.cfm

ETA: After just a quick glance through, it looks like many of the proposed plans have a requirement that everyone has to have insurance. What they're calling the Obama plan (on the side-by-side chart) mostly just shows his goals and intentions, but not specifics of how they're to be met.
 
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JoeTheJuggler said:
I believe there are 3 different versions of it, though I think only the one has passed the committees now. I don't know the details (and it's a big, detail-laden thing), but in broad terms, it's a health insurance reform bill that will provide some consumer protections (insurance companies can't deny a claim or coverage because of a pre-existing condition, for one thing)...
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Is there anything in there about a risk compensation pool, as used in European countries, to counter adverse selection?
 
Ziggurat said:
Which will drive up costs.

Which will drive up costs.

Which could drive up costs.

No, it isn't cheaper.
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Maybe so. But Obama's proposal will increase revenue at the same time. Look at all those paragraphs either incentivising or mandating that people should acquire insurance. This is going to bring many many young healthy people who have been riding their luck into the insurance fold. This has two benefits. First, for the small minority of people in that category whose luck runs out and they have an expensive accident or illness, it saves them from the consequences of their folly. (And while we're at it, it saves the current apology for universal emergency care from picking up their bill.) And second, it brings in the premiums of the vast majority of this group, which are profitable.

Rolfe.
 
Thanks for you're help, but I still have no idea how this is related to universal health care. It just seems like a simple reform to me. Are his plans in any way comparable to the NHS?
 
Undesired Walrus said:
Thanks for you're help, but I still have no idea how this is related to universal health care. It just seems like a simple reform to me. Are his plans in any way comparable to the NHS?
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Very few universal healthcare systems use the NHS model. Many European countries use a mandatory insurance system which seems to be the way Obama is going. That's why I asked about a risk compensation pool - all the European countries that use this system had to put it in place to counter adverse selection problems.
 
I figure this is just as good a place to post as any....

As a Canadian, one who likes and admires his southern American brothers/sisters, I am AMAZED (in a sad, angry way), at what I see going on in the USA right now with respect to Health Care. I have two words that sum up my advice!

"CATCH UP!"

The rest of the civilized world, many nations of which have been rated superior to the USA in health care, utilizes some form of NATIONALIZED health care. Are they perfect? No, far from it, but they are superior to the American System, as I am sure even many Americans would admit.

The system we use in Canada is one such system. Now it is far from perfect (We are ranked 30, USA is 37 http://www.photius.com/rankings/healthranks.html), but we do have guaranteed health care for EVERYONE. We are currently looking at a combination of private and public health care, but it is a slow and resistant road. Our wait lists are longer, for sure, but as a physician I can tell you, if I feel someone needs a test urgently, they can get it within a week or two, if an emergency they get the test and see a specialist THAT DAY!

Even more so, I think (and I know this will cause american groans) the USA should look to France (Ranked #1) as a model.

http://www.boston.com/news/globe/ed...s/2007/08/11/frances_model_healthcare_system/

Very good article.

Overall I just thought I would vent. I am appalled at what I see on the TV. The fake protests, the Republican obstruction. Now I am sure a few conservatives will get on here and try to beat down what I have said...ok, have at it. It is your system, and you will as a nation, do with it as you will (that is the wonderful thing about democracy), but I think it is sad that you are so close to actually fixing your system, and yet some are blinded to it (either through greed or fear).

TAM:)
 
Undesired Walrus said:
So this system will mean you have to be insured?
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That's it in a nutshell. And when they talk about the "public option", they mean that the government would be offering insurance plans alongside the private companies.

So pretend you're on ehealthinsurance.com post-reform (only it will be called an "Exchange"). As you scan through plans and prices, mixed in with "Blue Cross", "Aetna", and "United" will be "Federal Health Plan". Only maybe they'll give it a snappier name, like "Obamacare: The Health Plan that will kill your Downs Syndrome Babies".
 
Rolfe said:
Maybe so. But Obama's proposal will increase revenue at the same time. Look at all those paragraphs either incentivising or mandating that people should acquire insurance. This is going to bring many many young healthy people who have been riding their luck into the insurance fold. This has two benefits. First, for the small minority of people in that category whose luck runs out and they have an expensive accident or illness, it saves them from the consequences of their folly. (And while we're at it, it saves the current apology for universal emergency care from picking up their bill.) And second, it brings in the premiums of the vast majority of this group, which are profitable.

Rolfe.
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That's a good point. Reform is essentially going to bring in two very distinct groups into the insurance risk pool. The first group are the people with pre-existing conditions that can't get approved for coverage today. Obviously, this is going to increase costs. The second group are the healthy uninsured that don't buy insurance due to apathy or financial hardship. These members are going to decrease average costs.

I've seen a lot of actuarial modeling on this issue, and I think it's safe to say nobody really knows whether these two groups will counter-balance each other. Tweak a factor here, and everything looks rosy. Tweak a factor there, and everybody's premiums go up 30% when reform kicks in.

As politically unpopular as it may be, the mandate has to have some teeth to it. Penalties for non-compliance need to be stiff and the subsidies at the lower income levels need to be generous.
 
Can someone clarify for me, as I am not overly familiar with the minutia of the US health care.

When you buy "health care insurance" does it cover medications, or is that to be purchased seperately?

I ask because here is how it works in Canada.

1. Standard Health Care
- Government provided via Provincial Health Care Services
- Includes Doctor Visits, All Investigations (Radiology, Bloodwork, everything), Hospital stays (and expenses), surgical procedures, etc...
- Does not cover MEDICATIONS, COSMETIC SERVICES, LOST WAGES WHILE NOT WORKING

2. Health Insurance
- Can cover missed time (wrt wages), medications, Physiotherapy, Massage Therapy, Chiropracty, etc...depending on the insurance type.

TAM:)
 
T.A.M. said:
Can someone clarify for me, as I am not overly familiar with the minutia of the US health care.

When you buy "health care insurance" does it cover medications, or is that to be purchased seperately?

I ask because here is how it works in Canada.

1. Standard Health Care
- Government provided via Provincial Health Care Services
- Includes Doctor Visits, All Investigations (Radiology, Bloodwork, everything), Hospital stays (and expenses), surgical procedures, etc...
- Does not cover MEDICATIONS, COSMETIC SERVICES, LOST WAGES WHILE NOT WORKING

2. Health Insurance
- Can cover missed time (wrt wages), medications, Physiotherapy, Massage Therapy, Chiropracty, etc...depending on the insurance type.

TAM:)
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My health insurance doesn't even cover doctor visits, much less medication.
 
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