I thought it might be a good idea to post some of the Healthcare reform plans supported and put forward by some of the candidates. For now I've got three, I'll post a teaser and then a link to the specific candidate's website, where their respective platforms and more details on their healthcare plans can be found.
I think it's important to remember that incremental steps to improving healthcare access in America are important. I dont believe there could be an overnight reconfiguration of our system that would not have it's own set of pitfalls.
So, that said, no plan we see here presented by likely candidates, will be perfect, but any one of them is an improvement and the beginning of the journey to a better, more efficient system.
Hillary Clinton:
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: ... the plan provides tax credits for working families to help them cover their costs...
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.
Small businesses are the engine of new job growth in the U.S. economy but face bigger challenges when it comes to providing health care for their employees. Hillary would give tax credits to small businesses ...
Insurance companies won't be able to deny you coverage or drop you...
Barak Obama
Obama’s plan will provide affordable, comprehensive and portable health coverage for all Americans by:
• ...national health program that will allow individuals and small businesses to buy affordable health care similar to that available to federal employees.
• Making available a National Health Insurance Exchange to reform the private insurance market.
• Ensuring all of the 9 million currently uninsured children have affordable,
high-quality health coverage
• Expanding Medicaid and SCHIP and ensuring they continue to serve their critical safety net function.
• Requiring employers to make a meaningful contribution to the health coverage of their employees.
Obama’s plan will reduce costs and save a typical American family up to $2,500 each year by:
• Driving adoption of state-of-the-art health information technology systems
Improving access to preventive care and chronic disease management programs
• Requiring hospitals to collect and report health care cost and quality data
• Reforming our market structure to increase competition in the insurance and drug markets
• Reducing the costs of catastrophic illnesses for employers and their employees
• Lowering drug costs by allowing importation of safe medicines from other developed countries and increasing use of generics in public programs
John Edwards:
Under the Edwards Plan:
Families without insurance will get coverage at an affordable price.
Families with insurance will pay less and get more security and choices.
Businesses and other employers will find it cheaper and easier to insure their workers.
The Edwards Plan achieves universal coverage by:
Requiring businesses and other employers to either cover their employees or help finance their health insurance.
Making insurance affordable ...
Creating regional "Health Care Markets" to let every American share the bargaining power...
Monday, September 17, 2007
Tuesday, September 11, 2007
Recap and Analysis of Legislative Floor Debates on California Health Care
California Progress Report
September 11, 2007
Recap and Analysis of Yesterday's Legislative Floor Debates on
California Health Care
By Hanh Kim Quach, Health Care Policy Coordinator, Health Access
California
The California Senate and Assembly passed historic health care reform
legislation Monday... AB 8 (Nunez/Perata).
Yet even before the debate on AB 8 (Nunez/Perata) was finished in the
Assembly, Gov. Arnold Schwarzenegger announced -- though not
unexpectedly -- that he would veto the bill and call the Legislature
back to work in a "special session" to "keep working until we achieve
the kind of historic solution that all of us and the people of
California want."
Sen. Sam Aanestad and other Republican legislators attempted to
disparage AB 8 by comparing it with the Massachusetts plan, pointing
out that Governor Romney in "running from it." While AB 8 certainly
shares certain features with the Massachusetts plan, one missing
provision is glaringly obvious: the absence of any mandate to buy
coverage in the individual market. Even for group coverage, AB 8 does
not require anyone to have coverage if they can't afford it.
Affordability is explicitly defined in the bill – unlike in
Massachusetts. No worker would have to take up coverage if their
health care costs – premiums and out-of-pocket costs --would exceed 5
percent of a person’s wages.
Many lawmakers, including Assembly Speaker Fabian Nunez, said AB 8
was California's opportunity to provide a model for the federal
government to implement health care reform. "We have a broken health
care system in California and we must do something to fix it now...
This health care package will deliver what the federal government has
failed to do: to provide all Americans with affordable health care
coverage," Nunez said.
As part of a special session, (Sen. Don Perata said), "we would
continue where we left off..."
Click link in Title to article or cut and paste:
http://www.californiaprogressreport.com/2007/09/recap_and_analy.html
September 11, 2007
Recap and Analysis of Yesterday's Legislative Floor Debates on
California Health Care
By Hanh Kim Quach, Health Care Policy Coordinator, Health Access
California
The California Senate and Assembly passed historic health care reform
legislation Monday... AB 8 (Nunez/Perata).
Yet even before the debate on AB 8 (Nunez/Perata) was finished in the
Assembly, Gov. Arnold Schwarzenegger announced -- though not
unexpectedly -- that he would veto the bill and call the Legislature
back to work in a "special session" to "keep working until we achieve
the kind of historic solution that all of us and the people of
California want."
Sen. Sam Aanestad and other Republican legislators attempted to
disparage AB 8 by comparing it with the Massachusetts plan, pointing
out that Governor Romney in "running from it." While AB 8 certainly
shares certain features with the Massachusetts plan, one missing
provision is glaringly obvious: the absence of any mandate to buy
coverage in the individual market. Even for group coverage, AB 8 does
not require anyone to have coverage if they can't afford it.
Affordability is explicitly defined in the bill – unlike in
Massachusetts. No worker would have to take up coverage if their
health care costs – premiums and out-of-pocket costs --would exceed 5
percent of a person’s wages.
Many lawmakers, including Assembly Speaker Fabian Nunez, said AB 8
was California's opportunity to provide a model for the federal
government to implement health care reform. "We have a broken health
care system in California and we must do something to fix it now...
This health care package will deliver what the federal government has
failed to do: to provide all Americans with affordable health care
coverage," Nunez said.
As part of a special session, (Sen. Don Perata said), "we would
continue where we left off..."
Click link in Title to article or cut and paste:
http://www.californiaprogressreport.com/2007/09/recap_and_analy.html
Monday, September 03, 2007
Response to Jonathan Cohn's "case for thinking big" on health care By Don McCanne
Okay. If we're going to get anywhere in our discussion on how to fix
our health care system, we'd better look at some numbers that will
give us a better perspective of the problem.
This year, according to CMS, our projected health care spending is
$2.2 trillion, or $7500 per each individual in the United States.
With a median household income of about $46,000, it is easy to
understand why a family of four would have difficulty paying its
equal (not equitable) share of $30,000. (Before you divert the debate
into the subject of apples and oranges, keep in mind that that the
topic is health care reform, and the numbers are being used to
demonstrate merely the magnitude of the problem.)
When there is general agreement that everyone should be covered,
these numbers lead us to the insurance function of pooling risk - for
all of us. Traditionally, health insurance provided for a transfer
from the many who are healthy to the few with significant health care
needs. Distributing costs evenly over the risk pool worked.
Something happened in the interim. Health care costs skyrocketed, but
we were caught off guard because they were gradually phased in at
high single or low double digit annual rates. But here we are. At
$7500 per person, health care simply costs too much for average
income individuals to pay their equal (again, not equitable) share of
any system of universal coverage. Like it or not, we are now faced
with the need to transfer not only from the healthy to the sick, but
also from the wealthy to average- and lower-income individuals with
health care needs.
Our current fragmented system of multiple private plans and public
programs is not serving us well in this transfer function. Economists
may not have a definition of unaffordability, but polls show that
over 90 percent of us recognize it when we see it in our health care
system.
Actually, we could resolve this problem quite readily by establishing
a single national risk pool and fund it equitably through progressive
tax policies. Not only would that make health care affordable for
each individual, based on ability to pay, it would also establish a
single payer that could use its monopsony powers to slow health care
inflation to a more sustainable rate (which raises other issues that
may be covered this week).
Regarding reform, there are two basic models under consideration.
Either we could establish a single national health insurance program,
or we could build on our current system of private plans and public
programs (with many sub-variations such as employer mandate,
individual mandate, Medicaid and SCHIP welfare programs, or a new
Medicare-as-an-option program available to everyone).
A crucial question is how well would private plans serve us in a
universal system? Well, let's see how they are serving us now. 59
percent of us are insured through our employment, yet employer-
sponsored plans are paying only 19 percent of our health care costs.
Already we have a problem. Private insurers have skimmed off the
healthiest sector of our society - healthy, gainfully employed
individuals and their young, healthy families - and they are
sticking us with the other four-fifths of our nation's health care
bill. The insurers have already defeated the insurance function of
transferring funds from the many who are healthy to the few who have
significant health care needs.
And how efficient are the insurers in performing this transfer
function for their cream-skimmed risk pools of healthy individuals?
In 2005, the six largest private insurers in the nation had an
average medical-loss ratio of about 80 percent. This means that they
used about 20 percent of health insurance premiums for their own
intrinsic purposes - administrative functions and profits. Further,
about 12 percent of premiums were used by physicians and hospitals to
pay for the administrative burden of billing and insurance functions
related to the private plans. So one-third of these private insurance
premiums were burned up in administrative costs. Who says that the
private market is always more efficient than the government?
This leads us to one of the most important questions facing those
concerned about the reform process. When private insurers have
abandoned their crucial function of transferring risk, and they have
demonstrated their profound administrative inefficiencies, why would
any policymaker insist that private insurers must be a part of any
model of reform? The resources we waste on them would be far better
spent on health care for the uninsured and underinsured.
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day
our health care system, we'd better look at some numbers that will
give us a better perspective of the problem.
This year, according to CMS, our projected health care spending is
$2.2 trillion, or $7500 per each individual in the United States.
With a median household income of about $46,000, it is easy to
understand why a family of four would have difficulty paying its
equal (not equitable) share of $30,000. (Before you divert the debate
into the subject of apples and oranges, keep in mind that that the
topic is health care reform, and the numbers are being used to
demonstrate merely the magnitude of the problem.)
When there is general agreement that everyone should be covered,
these numbers lead us to the insurance function of pooling risk - for
all of us. Traditionally, health insurance provided for a transfer
from the many who are healthy to the few with significant health care
needs. Distributing costs evenly over the risk pool worked.
Something happened in the interim. Health care costs skyrocketed, but
we were caught off guard because they were gradually phased in at
high single or low double digit annual rates. But here we are. At
$7500 per person, health care simply costs too much for average
income individuals to pay their equal (again, not equitable) share of
any system of universal coverage. Like it or not, we are now faced
with the need to transfer not only from the healthy to the sick, but
also from the wealthy to average- and lower-income individuals with
health care needs.
Our current fragmented system of multiple private plans and public
programs is not serving us well in this transfer function. Economists
may not have a definition of unaffordability, but polls show that
over 90 percent of us recognize it when we see it in our health care
system.
Actually, we could resolve this problem quite readily by establishing
a single national risk pool and fund it equitably through progressive
tax policies. Not only would that make health care affordable for
each individual, based on ability to pay, it would also establish a
single payer that could use its monopsony powers to slow health care
inflation to a more sustainable rate (which raises other issues that
may be covered this week).
Regarding reform, there are two basic models under consideration.
Either we could establish a single national health insurance program,
or we could build on our current system of private plans and public
programs (with many sub-variations such as employer mandate,
individual mandate, Medicaid and SCHIP welfare programs, or a new
Medicare-as-an-option program available to everyone).
A crucial question is how well would private plans serve us in a
universal system? Well, let's see how they are serving us now. 59
percent of us are insured through our employment, yet employer-
sponsored plans are paying only 19 percent of our health care costs.
Already we have a problem. Private insurers have skimmed off the
healthiest sector of our society - healthy, gainfully employed
individuals and their young, healthy families - and they are
sticking us with the other four-fifths of our nation's health care
bill. The insurers have already defeated the insurance function of
transferring funds from the many who are healthy to the few who have
significant health care needs.
And how efficient are the insurers in performing this transfer
function for their cream-skimmed risk pools of healthy individuals?
In 2005, the six largest private insurers in the nation had an
average medical-loss ratio of about 80 percent. This means that they
used about 20 percent of health insurance premiums for their own
intrinsic purposes - administrative functions and profits. Further,
about 12 percent of premiums were used by physicians and hospitals to
pay for the administrative burden of billing and insurance functions
related to the private plans. So one-third of these private insurance
premiums were burned up in administrative costs. Who says that the
private market is always more efficient than the government?
This leads us to one of the most important questions facing those
concerned about the reform process. When private insurers have
abandoned their crucial function of transferring risk, and they have
demonstrated their profound administrative inefficiencies, why would
any policymaker insist that private insurers must be a part of any
model of reform? The resources we waste on them would be far better
spent on health care for the uninsured and underinsured.
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day
Sick: The Untold Story of America's Health Care Crisis
TPMCafe Book Club
Sick: The Untold Story of America's Health Care Crisis---and the
People Who Pay the PriceBy Jonathan Cohn
Health care: The case for thinking big
By Jonathan Cohn
One of the most fascinating products of researching my new book,
Sick, was also one of the most depressing: the realization that we've
been here before.
If you go back to the late 1920s and early 1930s, you'll find a
situation that looks more than vaguely familiar. As medical care was
becoming more expensive, large numbers of people were finding they
literally could not afford to get sick. Many of these people weren't
indigent in the narrow sense of the word. They had homes. They had
jobs. And yet when they got sick, their lives unraveled. Some went
into debt to pay for it. Some rationed their own care. The result was
financial misery, medical hardship, or both.
That situation eventually gave birth to the insurance system we have
today - a system, based primarily upon job-provided private
insurance, that is now faltering as the price of medical care rises.
If you read the eight stories in the book, you'll get a sense not
just of how devastating loss of insurance can be today, but also of
how vulnerable to this problem even the middle class has become -
just like it was nearly a century ago.
It's this increasingly vulnerability that has provoked a new debate
about universal health care - and given would-be reformers some cause
for optimism. But now that this debate is unfolding, it's brought us
to yet another familiar place: The argument about what kind of system
to create.
On one extreme of the progressive political spectrum you have...
(Click Title Link to the rest of the story)
TPMCafe Book Club features an ongoing discussion on health care reform led off by Jonathan Cohn, timed with release of his new book, "Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price."
The online discussion will feature such notables as Jonathan Cohn,
Jacob Hacker, Ezra Klein, Matthew Holt, Roger Hickey, Diane Archer,
Don McCanne and others (incomplete list). Responses of readers are
welcome.
With the renewed enthusiasm for reform, this discussion is very
timely and should be very informative, if not provocative. You can
follow it at:
http://bookclub.tpmcafe.com/
Sick: The Untold Story of America's Health Care Crisis---and the
People Who Pay the PriceBy Jonathan Cohn
Health care: The case for thinking big
By Jonathan Cohn
One of the most fascinating products of researching my new book,
Sick, was also one of the most depressing: the realization that we've
been here before.
If you go back to the late 1920s and early 1930s, you'll find a
situation that looks more than vaguely familiar. As medical care was
becoming more expensive, large numbers of people were finding they
literally could not afford to get sick. Many of these people weren't
indigent in the narrow sense of the word. They had homes. They had
jobs. And yet when they got sick, their lives unraveled. Some went
into debt to pay for it. Some rationed their own care. The result was
financial misery, medical hardship, or both.
That situation eventually gave birth to the insurance system we have
today - a system, based primarily upon job-provided private
insurance, that is now faltering as the price of medical care rises.
If you read the eight stories in the book, you'll get a sense not
just of how devastating loss of insurance can be today, but also of
how vulnerable to this problem even the middle class has become -
just like it was nearly a century ago.
It's this increasingly vulnerability that has provoked a new debate
about universal health care - and given would-be reformers some cause
for optimism. But now that this debate is unfolding, it's brought us
to yet another familiar place: The argument about what kind of system
to create.
On one extreme of the progressive political spectrum you have...
(Click Title Link to the rest of the story)
TPMCafe Book Club features an ongoing discussion on health care reform led off by Jonathan Cohn, timed with release of his new book, "Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price."
The online discussion will feature such notables as Jonathan Cohn,
Jacob Hacker, Ezra Klein, Matthew Holt, Roger Hickey, Diane Archer,
Don McCanne and others (incomplete list). Responses of readers are
welcome.
With the renewed enthusiasm for reform, this discussion is very
timely and should be very informative, if not provocative. You can
follow it at:
http://bookclub.tpmcafe.com/
Sunday, September 02, 2007
Mirror, Mirror on the Wall
The Commonwealth Fund
May 15, 2007
Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care
By Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report — an update to two earlier editions — includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations — Australia, Canada, Germany, New Zealand, the United Kingdom — the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill. The findings indicate room for improvement across all of the countries, especially in the U.S. If the health care system is to perform according to patients' expectations, the nation will need to remove financial barriers to care and improve the delivery of care. Disparities in terms of access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home.
Full report:
http://www.commonwealthfund.org/usr_doc/Davis_mirrormirrorinternationalupdate_1027.pdf?section=4039
Quote-of-the-day mailing list Quote-of-the-day@mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day
May 15, 2007
Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care
By Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report — an update to two earlier editions — includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations — Australia, Canada, Germany, New Zealand, the United Kingdom — the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill. The findings indicate room for improvement across all of the countries, especially in the U.S. If the health care system is to perform according to patients' expectations, the nation will need to remove financial barriers to care and improve the delivery of care. Disparities in terms of access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home.
Full report:
http://www.commonwealthfund.org/usr_doc/Davis_mirrormirrorinternationalupdate_1027.pdf?section=4039
Quote-of-the-day mailing list Quote-of-the-day@mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day
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