Wednesday, January 21, 2009

Health Care and the New National Health Care Agenda

A new President took the Oath of Office on January 20, 2009, with a new agenda of change for the country. Barack Obama will have his hands full with many pressing needs in homeland security, the economy, the war on terror in Iraq and Afghanistan, and health care reform. He has proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference according to the White House website. The Obama plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors, and plans.

President Obama, according to the White House, has proposed the following guidelines:
--Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
--Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
--Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
--Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
--Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees' health care.
--Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
--Ensure everyone who needs it will receive a tax credit for their premiums.

The White House also reports that the President's plan will reduce costs and save a typical American family up to $2,500 as reforms phase in:
--Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs, and taking on drug companies that block cheaper generic medicines from the market.
--Require hospitals to collect and report health care cost and quality data.
--Reduce the costs of catastrophic illnesses for employers and their employees.
--Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.

According to Law.com, when you talk about Obama's health care agenda, there are several parts. The reauthorization of SCHIP, or the State Children's Health Insurance Program, which entails federal funding to states to insure low-income children whose families don't meet Medicaid income eligibility guidelines, has happened. Health-related information technology, through provisions in the stimulus package, is a big initiative. So is comparative effectiveness research, which is an analysis of different ways to treat a medical condition and whether there is any science that justifies the more expensive treatment approach. One thing that hasn't happened is expanding access to health care. That's far more difficult. It is far more controversial, and not going to be as easy as everyone seems to think it's going to be.

According to DotMedNews, if the new administration is to succeed in pushing through health care reform, it will require bipartisan cooperation. Following is a quick look at what the president-elect plans in key health policy areas, compiled from platform documents, the American Association of Retired Persons (AARP), and Internet sources.
INSURANCE:
-Replace personal tax exclusions for employer-provided health insurance with a $2,500 tax credit ($5,000 for families) to help people buy their own insurance.
-Close the "doughnut hole" in President Bush's Medicare Part D Prescription Drug Act, which limits seniors' benefits.
-Allow individuals to buy any plan available, regardless of state of residence.
-Lower drug costs by allowing imports of less expensive drugs from Canada and other developed nations.
-Use health information technology, such as electronic records, to reduce health care system billing.
-Hold costs down by letting seniors choose from a pool of competing private plans and one public plan similar to Medicare.
-Require that all children have health insurance, with costs subsidized by repealing President Bush's tax cuts for households earning more than $250,000.
-Allow children up to age 25 to keep coverage under their family health plan.
-Revise the "antiquated" Medicare reimbursement system for doctors to provide "fair and reasonable" physician payments to ensure access to high-quality care.
PREVENTION:
-Medicare recipients will use primary-care doctors as gatekeepers for their basic health care needs. (Now, many seniors go directly to specialists for chronic conditions and bypass internists, which is not cost-effective.)
-Doubling Federal funding for cancer research and re-instating embryonic stem cell research .

Experts estimate, according to DotMedNews, that Barack Obama's plan would cost the American people about $1.7 trillion, but they say figures are all over the map as no one can guess what people will choose to do if and when changes are made to the U.S. health system. The plan is probably too much of a radical departure from the traditional U.S. healthcare system to pass during the next four years, experts say. However, the next four years will set the stage for changes to come, and the program will likely be passed in increments.

According to ZDNet Healthcare, the President calls for creating a $634 billion fund, over 10 years, to cover the uninsured, paid for by rolling back the Bush tax cuts and reducing Medicare payments. Liberals are going hip hip hooray. And, Conservatives should know a big source of savings will be cutting out the reimbursement advantages of private Medicare Advantage plans, created under the Bush Administration. According to NPR.com, Conservative opponents detect a move toward universal health care — and a danger in the return to what they characterize as the failed economic policies of the 1930s. That's when the theories of economist John Maynard Keynes held sway: He argued that significantly distressed economies need big infusions of government money. This current President is not afraid to spend money. Obama is also proposing to extend Medicaid benefits to workers receiving unemployment checks, as well as their families; to have the government pick up, for one year, 65% of COBRA premiums paid by laid-off workers to extend their job-based insurance coverage; and to significantly increase unemployment benefits, job training and food stamp funding.

America is on the road to financial jeopardy with the new stimulus package. The US must watch out so bankruptcy is not the end result in the long term in order to make people happy in the short term. Health care is a complicated issue, and there are huge consequences if the Congress and the President decide they want to spend money that doesn't exist.

Until next time. Let me know what you think.

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