We’re in an
economy where the Dow, NASDAQ and S&P500 are spiraling downward, and
unemployment, foreclosures and the price of oil are soaring. More than 48
million Americans are without health insurance. Hospitals are seeing record
levels of uncompensated care and bad debt. Health insurer competitive rivalry
is compressing margins and health plans are reporting very little membership
growth. There’s no doubt that health care is a leading domestic policy issue
for the upcoming presidential campaign.
In an
already politically divisive landscape, get ready for a sharp debate over the
next five months. In order to set the stage, following is a high-level recap of
the candidates’ health care positions to date –
Obama
Barack Obama, a Democrat, has served as a
Senator from Illinois since 2004. He served in the Illinois State Senate from 1997 to 2004. Obama says:
“We now face an opportunity – and an obligation – to turn
the page on the failed politics of yesterday’s health care debates.... My plan
begins by covering every American. If you already have health insurance, the
only thing that will change for you under this plan is the amount of money you
will spend on premiums. That will be less. If you are one of the Americans who
don’t have health insurance, you will have it after this plan becomes law. No
one will be turned away because of a preexisting condition or illness.”
Obama’s
plan has the following features:
Guaranteed Eligibility No American will be turned away from
any insurance plan because of illness or pre-existing conditions.
Comprehensive Benefits 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 under a plan with affordable premiums, co-pays and deductibles.
National Health Insurance Exchange Provide help to individuals who
wish to purchase a private insurance plan by establishing an Exchange to act as
a watchdog group. This Exchange will facilitate the reform of the private
insurance market by creating rules and standards for participating insurance plans.
It will ensure fairness and make individual coverage more accessible.
Employer Contribution Employers that do not offer insurance,
or make a meaningful contribution to the cost of coverage for their employees,
will be required to contribute a percentage of payroll toward the costs of the
national plan.
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.
Mandatory Coverage of Children Require all children have health
care coverage. The goal is to 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.
McCain
John McCain, a Republican, has served as a
Senator from Arizona
since 1986. Previously he served as the Representative from Arizona's 1st Congressional District. McCain Says:
“The key to health care reform is to restore control to the
patients themselves. We want a system of health care in which everyone can
afford and acquire the treatment and preventative care they need. Health care
should be available to all and not limited by where you work or how much you
make. Families should be in charge of their health care dollars and have more
control over care.”
McCain’s
plan has the following features:
Make it easier for individuals and families
to obtain insurance. An important part
of a plan is to use competition to improve the quality of private health
insurance with greater variety to match people's needs, lower prices, and
portability.
Change the tax
code. While
still having the option of employer-based coverage, every family will receive a
direct refundable tax credit - effectively cash - of $2,500 for individuals and
$5,000 for families to offset the cost of insurance. Families will be able to
choose the insurance provider that suits them best and the money would be sent
directly to the insurance provider.
Making insurance
more portable. Give Americans insurance that follows them from job to job. Provide
insurance that is still there if they retire early and does not change if they
take a few years off to raise the kids.
Expand Health
Savings Accounts (HSAs). When families are informed about medical choices, they are
more capable of making their own decisions and often decide against unnecessary
options. Health Savings Accounts take an important step in the direction of
putting families in charge of what they pay for.
Care for the traditionally uninsurable. Make coverage accessible for those without prior group
coverage and those with pre-existing conditions who have the most difficulty on
the individual market.
Establish
guaranteed state run access plans. Develop a state-run model - Guaranteed
Access Plan or GAP - to ensure high risk patients have access to health
coverage. One approach would establish a nonprofit corporation to contract with
insurers to cover patients who have been denied insurance.
To drill-down into the details of each candidate’s health care position, the
following Kaiser Family Foundation website provides a side-by-side comparison
of each candidate’s health care platform – http://www.health08.org/sidebyside.cfm.
Stay
tuned. There will be flip flops, promises and finger-pointing as the candidates
jawbone over one of the most pressing issues facing Americans – our health
