ObamaCare: Improving Reform’s Bill of Health

Presented by Keith Wilkerson,

Jordaan Williams, & Timothy Wirth

February 8, 2010

Introduction

President Obama and Congress are attempting to push through healthcare reform legislation

Despite having many supporters early on, effort has lost steam in the people

Since lawmakers continue to push healthcare reform, the content of the legislation must be helping a lack in popularity

History of Healthcare Reform

1912 – Theodore Roosevelt runs for President with social insurance on platform

1915 – American Association of Labor Legislation publishes draft bill of health insurance

1934 – President Franklin D. Roosevelt pushes for national healthcare as part of the New Deal

1939 – First Blue Shield plans for physician care

History of Healthcare Reform

1948 – National Health Assembly encourages universal health coverage

1965 - Medicare and Medicaid signed into law

1993 – President Clinton’s Health Security Act Introduced to Congress

2006 – Massachusetts provides for healthcare coverage to nearly all residents

2009 – Reform Efforts by President Obama

Current Healthcare Reform Bill

For Those Already With Health Insurance:

No more discrimination for pre-existing conditions

Limit of discrimination based on gender and age

Insurance companies cannot “drop” you if you get sick

Cap of Out-of Pocket Expenses and no extra fees for preventive care

Current Healthcare Reform Bill

For Medicare Beneficiaries:

Protection of Medicare for Seniors

Elimination of “the donut-hole” coverage gap

Current Healthcare Reform Bill

For Those Without Insurance:

New Insurance marketplace

Tax credits for insurance

Public health insurance option

Current Healthcare Reform Bill

For Everyone:

Won’t add to the deficit

Additional cuts to Plan if savings don’t happen

Includes numerous cost-cutting and fraud prevention measures

Coverage requirement of certain employers

Suggestions

The overall cost to government of a healthcare program must be reduced

Improve and/or change elements of the plan so as not to make beneficiaries and the country worse off

Federal Government Needs to Play a Larger Role in Shaping and Overseeing the Healthcare System

The Cost of Healthcare

Total cost of a program would be around $900 Billion over 10 years

If Congress passed a healthcare bill, the budget deficit will inflate to $239 Billion over the same 10 year period

Reducing the Cost of Healthcare

Ways of Securing Money to cover the cost:

Squeeze Savings out of Medicare and Medicaid$465 Billion over 10 years

Tax the Wealthy$544 Billion over 10 years

Tax Employee Health Insurance Benefits$418.5 Billion over 10 years

Reducing the Cost of Healthcare

Ways of securing money to cover the cost:

Limit itemized deductions of the wealthy$267 Billion over 10 years

Penalize employers who do not offer health insurance$163 Billion over 10 years

Changing the Scope and Coverage of the Plan

Least Popular Elements of the Plan:Mandate for Individual Insurance or Penalty

Government Defined “Basic” Package

Late Effective Date

Limited Increase in Medicare Payments to Providers

Changing the Scope and Coverage of the Plan

Individual Plan MandatePatients don’t mind having health insurance because it

is often cheaper to have as compared to paying out-of-pocket

Patients don’t want to be charged, however, for NOT having health insurance

Government Defined “Basic” PlanAs always, patients would prefer not to be told what to

have in a plan Insurance companies are the sameGovernment should provide guidelines for plans, but

should not mandate a specific set of benefits

Changing the Scope and Coverage of the Plan

Late Effective DatePatients do not wish to wait until after Obama leaves

office for legislation to take effectEffective date needs to be moved closer to the

present so patients can begin to be covered or save money

Limited Increase in Medicare Payments to ProvidersPhysicians and Pharmacists are already being paid

very little for services rendered to Medicare patients Increases in Medicare payments are necessary for

providers to stay in business and control costs

Healthcare Regulation

The Food and Drug Administration (FDA) is really the only government agency that regulates healthcare

The FDA regulates drug trials, pharmaceutical research and development, and determines which technologies are available to be used for research

Healthcare Regulation

There can be no real market for healthcare unless the government sets the rules for one

The government would need a large role in shaping and overseeing the system

Healthcare Regulation

Possible ideas include:

Set up a national technology assessment board

Create an ethics board to review hospitals and insurance companies

Discussion Points

Reducing the Cost

Americans already pay higher taxes, and increasing government spending may result in higher taxes

Employers that do not offer health insurance should still be required to help in paying for their employee’s insurance

Obama said he plans to tax the wealthy…why not a better way to start!

Discussion Points

Changing the Scope and Coverage of the Plan

Patients shouldn’t be penalized for a lack of health insurance while paying higher taxes for it

By having legislation become effective earlier, patients are sure to be covered by insurance and saving money earlier

Although the government might find an advantage to controlling the benefits in a health plan, it is to the patient’s advantage to have differences in plans

Increased payments by Medicare to providers will help keep high-quality care in the United States

Discussion Points

Healthcare Regulation

Healthcare is relatively unregulated

Costs become unnecessarily high and patients are stuck paying the difference in their co-pays and out-of-pocket expenses

Since there is really no market in healthcare, there is comparatively little competition, and costs are allowed to skyrocket

Review Boards can be sure that technology is state of the art

Conclusion

Changes in cost, coverage, and regulation are requisite to having President Obama’s healthcare plan regain support from voters

With these changes, constituents will most likely support national healthcare

Having a reformed healthcare system will improve one of the more sophisticated systems in the world

References

Feldman, R.D. (Ed.). (2000). American Health Care Government, Market Practices, and the Public Interest. New York: Transaction.

Kaiser Family Foundation (n.d.). Timeline: History of Health Reform Efforts in the U.S. Retrieved February 6, 2010, from http://healthreform.kff.org/flash/health-reform-new.htm

Kaiser Family Foundation (2009, September). Kaiser Health Tracking Poll: September 2009. Retrieved February 6, 2010, from http://www.kff.org/kaiserpolls/upload/7989.pdf

Kaiser Family Foundation (2010, January). Kaiser Health Tracking Poll: January 2010. Retrieved February 6, 2010, from http://www.kff.org/kaiserpolls/upload/8042-C.pdf

Terry, K. (2007). Rx for Health Care Reform. New York: Vanderbilt UP.

The White House (n.d.). The Obama Plan: Stability and Security for All Americans. Retrieved February 7, 2010, from http://www.whitehouse.gov/issues/health-care/plan