Have you actually read through the Obama & Clinton health plans posted on their Web Sites?

[hedgehog]

Obama's:

http://www.barackobama.com/issues/healthcare/


Clinton's:

http://www.hillaryclinton.com/feature/healthcareplan/

Here's why I prefer Obama's plan: He goes beyond paying for the health care system we have to improving the system itself. For example, he calls for coordination of care for people with chronic illnesses to ensure that if someone has multiple doctors, the doctors are working together and communicating. If you have a chronic illness, patient education and access to prescription drugs can mean the difference between a full life and one interrupted by emergency hospital admissions. Obama's plan also goes after insurance companies that raise malpractice premiums while also working to determine why medical mistakes happen and to prevent medical mistakes. Obama's plan also takes note on the decreased competition in the health insurance industry.


Here's a red flag that jumped out at me from Clinton's plan:

"Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health "plans.

while maintaining consumer price consciousness in choosing health plans.


There is a belief among some policy wonks that people abuse health insurance by going to the doctor too much, that people must be forced to feel the pain of costs in order to keep overall coasts down. I don't know about you, but when I suspected that my daughter had ruptured her spleen in a bicycle accident, I drove her to what I thought was the best facility, not the cheapest. And when they transferred her by ambulance to a regional center, I didn't stop to compare room rates or suggest putting her back in my car for the trip!

How do people end up in emergency rooms? All too often it's because they don't have the money to go to the doctor and get the check-up that spots diabetes or high blood pressure. All too often it's because they have been saving money by not using that inhaled steroid to control their asthma.

A health plan should focus on saving money by improving care, not just on saving money!

[LWolf]

1. There is a good reason why I do not support either plan.

I don't want to "pay for the health care system we have." I don't want to "improve" the current system.

I want to scrap it in favor of a BETTER system.

Happily, that better system is "on the table." HR 676. Dennis Kucinich.

[JeffR]

2. You saved me the trouble of saying this

and said it much better than I could. This whole debate between these two picayune pseudo-visions for health care is laughable, though nobody should be laughing.

[LWolf]

6. I'm not laughing.

I AM cutting my medication in half to make sure I have enough gas money to get to work this month.

[hedgehog]

8. Boy, I bet you're really there with the " consumer price consciousness in choosing health plans"

I never ask "What does this pill do for me and what are the possible side effects and what are the alternative therapies?"

I always ask " what is this pill going to cost and wouldn't lot be better for us all if I just bit my lip and tried to work through the pain?"





Seriously, I've stood in a pharmacy while a mother tried to figure out how she was going to pay for the prescription her daughter needed.The hospital had sent the kid home with a prescription, the mother didn't have the money to pay for the prescription and if the kid didn't get the medicine, she was going to start vomiting again and end up back in the hospital (emergency admission, of course!)

[LWolf]

42. Actually, I always ask

"What does this pill do for me and what are the possible side effects and what are the alternative therapies?"

That's why I'm having trouble paying for the medication. I chose a gentler, alternative form of the medication, and my insurance doesn't cover it.

[cuke]

43. You are lucky to have the luxury of not having to ask about price

My mother has a condition that is expensive to deal with. I must ALWAYS ask about cost becuase if I don't, her money will run out and then how will she be able to pay for the care she requires.

[JeffR]

9. E pluribus unum, land of the free, greatest nation on earth

Yeah, we're a real shining city on the hill, aren't we? This is all beyond fucking appalling.

[gateley]

28. I hear you. nt

[sniffa]

14. ditto

:thumbsup:

i don't understand those who think any of the "viable" candidates' plans will be a good thing. they will most likely hurt the people they intend to help, especially if all that is enacted is requiring everyone to have health insurance. for-profit needs to be addressed and altered or blown up.

[JeffR]

26. Blown up

sounds good to me!:toast:

[hedgehog]

3. Even Krugman admitted that Obama's plan is a path to single payer.

"Best of all, the Obama plan contains the same feature that makes the Edwards plan superior to, say, the Schwarzenegger proposal in California: it lets people choose between private plans and buying into a Medicare-type plan offered by the government.

Since Medicare has much lower overhead costs than private insurers, this competition would force the insurance industry to cut costs — making our health-care system more efficient. And if private insurers couldn’t or wouldn’t cut costs enough, the system would evolve into Medicare for all, which is actually the best solution. "

http://select.nytimes.com/2007/06/04/opinion/04krugman....





Given the size of the dinosaur we're dealing with, I think evolution is the way to go. I think it sidesteps the opposition to "socialized medicine" (I actually heard someone use that phrase last summer!) while giving people in the health insurance industry time to get a different job instead of throwing them all out of work on day 1. It also allows Medicare time to grow instead of choking it with an impossible work load.

[LWolf]

5. A key element is missing.

The "not for profit" part.

Leaving the insurance companies in the game defeats the purpose.

[hedgehog]

7. Hey, if they can deliver the same coverage as Medicare, for the same

price and still make a profit, more power to them!

I'd like to see them try.

[LWolf]

41. And I'd like to see them lose the ability to make a profit

off of deciding how much care, and what kind of care, I, or anyone else, is allowed to have.

[JeffR]

11. No.

The USA is the only industrialized nation on the planet without universal health care. Also the richest.

Incrementalism will not make this happen. Radical as my own views are, I acknowledge that incrementalism is the way things generally have to get done. But in this instance, incrementalism is beyond pathetic. Vision and activism are what's needed on this issue, and a candidate who advocates that is a candidate to get behind. Neither plan, Obama's or Clinton's, is anywhere near bold and visionary enough. That's one of many reasons, for me, that the "frontrunners" disappoint.

[hedgehog]

20. I think this is a case of not letting the perfect be the enemy of the

less than perfect. There are people today who need health care now. They can't afford to wait however many more years it takes to come up with the perfect single payer plan.

[JeffR]

25. You're right about "perfect" not being good enough here & now.

But I don't think baby steps are either. It's a crisis for a lot of people now, and will be a crisis for many more going forward. This country put astronauts on the moon less than ten years after deciding it was going to do so. Why should moving to universal health care be treated as anything less of a worthy and (relatively) immediate goal?

[hedgehog]

27. Trust me: putting a man on the moon is easy - just solve about half a million

technical problems, one step at a time.

Going from the mess we have now to universal single payer? THAT'S hard! You have to deal with non-profit hospitals, for profit hospitals, teaching hospitals, medical schools, free clinics, HMOs, doctors, nurses, pharmacists, pharmacy chains, insurance companies, working people, unemployed people, part timers, regional variations in treatments (in some regions you'll get a prescription, in others it's straight to surgery), drug companies, rural physician shortages, malpractice claims, etc. etc.

[sandnsea]

4. National Health Insurance Exchange

Obama's plan calls for real reform of insurance, straight to the point. His plan also calls for real subsidies, not end of the year tax credits. It's real and it's better. Once it's proven to work without bankrupting people, it can be mandated, but not until.

"Obama will create a National Health Insurance Exchange to help individuals who wish to purchase private insurance. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums. The Exchange will require benefits comparable to those offered in the new public plan. Insurers would be required to justify an above-average premium increase. The Exchange would evaluate plans and provide information about differences between them."

[cuke]

10. Have you actually read through the Obama & Clinton health plans posted on their Web Sites?

All of the things you say like about Obama's plan are included in Clinton's plan

"he calls for coordination of care for people with chronic illnesses to ensure that if someone has multiple doctors, the doctors are working together and communicating. If you have a chronic illness, patient education and access to prescription drugs can mean the difference between a full life and one interrupted by emergency hospital admissions."

Obama's plan also goes after insurance companies that raise malpractice premiums while also working to determine why medical mistakes happen and to prevent medical mistakes. Obama's plan also takes note on the decreased competition in the health insurance industry.


http://www.hillaryclinton.com/news/speech/view/?id=3006

On coordination of care

I'll also support doctors by creating a Best Care Practices Institute, a public-private partnership to fund comparative effectiveness research and disseminate it across the country. Right now so much of the information on which drugs, devices, surgeries and treatments work best, either isn't researched, it isn't compared, it isn't published, and it isn't circulated. It takes years for an agreed upon treatment that a medical center like this one knows is the best practice to be disseminated across our country. So this Best Practices Institute will serve as a central national clearinghouse so no matter where you are, you and your doctor can access information on what the best treatments should be.

On malpractice reform

In addition to helping doctors provide the best care, I plan to finally implement medical malpractice reforms that work for doctors and patients alike. Many of the physicians that I meet say that high malpractice premiums force them to alter their practice-- and even consider leaving the profession altogether. I've also heard first hand from families who've experienced serious medical errors and have trouble getting the relief that they deserve. The current political stalemate on this issue leaves both patients and physicians in the lurch.

and more on coordination of care

So we wind up treating patients like walking collections of symptoms and diseases -- each to be treated discretely. But that is not how illness works, that's not how the body or the mind works. For example, if you are a diabetic with high blood pressure, your high blood pressure obviously affects your diabetes, and vice versa. So there's incredible value to coordinating care and in having doctors, nurses, social workers, nutritionists and other professionals working together as a team.

That's exactly how it's done at the Mayo Clinic, one of the most respected health care institutions in America, actually probably in the world. Under their integrated healthcare system, primary care physicians work together with specialists to develop a comprehensive approach to treat each patient. The result is better care, lower costs, and fewer hospitalizations and doctor visits. The result is better care, lower costs, and fewer hospitalizations and doctor visits. In fact, if hospitalizations and doctor visits across America mirrored the numbers at Mayo, for certain conditions, inpatient Medicare spending would decrease 20 percent, Medicare costs for doctor visits would decrease 35 percent. That's billions of dollars in savings. But at the same time physicians salaries are above the national average. So when I'm President, I'll support federal reimbursements for precisely this kind of team approach to medicine. We know it saves money -- and saves lives.

From her plan, on chronic conditions
http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf

Prioritize Prevention to Reduce the Incidence of Disease that Impose Huge Human
and Financial Burdens: Only half of recommended clinical preventive services are
provided to adults and less than half of adults had their doctors provide them advice
on weight, nutrition, or exercise.ii Only 38 percent of adults receive recommended
colorectal screening. Hypertension contributes to 35 percent of all heart disease and
dramatically increases the risk of stroke, yet only one in three people with this
condition know it, despite simple, proven screening tests. Along with guaranteeing
accessible insurance throughout the system, the American Health Choices Plan
requires coverage of preventive services that experts agree are proven and effective.

• Improve Care of the Chronically Ill: Americans with multiple chronic diseases –
including heart disease and diabetes – account for 75 percent of our total national
health expenditures and are the leading causes of death in the U.S.iii The American
Health Choices Plan will promote chronic care management programs as well as
innovative models such as “medical homes.”

There is a belief among some policy wonks that people abuse health insurance by going to the doctor too much, that people must be forced to feel the pain of costs in order to keep overall coasts down.

Umm, the reference to cost was referring to the cost of the PREMIUMS. Going to the doctor too much was the justification for co-pays and deductibles. I think you're very confused about this. The reference to cost consciousness was reference to differences in premiums the various plans will charge.

A health plan should focus on saving money by improving care, not just on saving money!

And as I just proved, every cost saving measure that's in Obama's plan is also in Clintons and Clinton has cost savings measures that Obama's does not (ex EMR, more on coordination of care, more on malpractice reform, more fed money dedicated to reducing costs, prioritization of costly conditions, reducing overpayments, etc)

[JeffR]

12. Yes, I have.

And they both suck elephant dick, if you'll pardon the expression.

[cuke]

13. Thanks for the substantive response

Wouldn't expect any less from you

[sniffa]

15. And another Obama supporter who can't defend Obama

[JeffR]

16. Cuke, I guess this is the 2nd time this week we're at odds,

but despite the flippant language I used, my point was that both of these plans, IMHO, are lousy. Really lousy, from anyone who purports to be fit to lead this country. Both the one from your candidate, and the one from the candidate you (and I) don't like. Pardon my reflexive use of the vulgate; that's pretty much how I talk.

[cuke]

37. IIRC, the last time you criticized me for being petty

I would say that your flippant language made your response a petty one.

And if you would like to discuss your complaints of those plans in a civil and substantive manner, let me know. I think you are way off base and that your complaints amount to little more than shallow slogans.

I don't dislike the other candidate or his plan. Nor do I have a problem with vulgar language. My problem is the shallow approach to the issue you take and the unwillingness to consider the merits of these plans.

I'll assume your objections are based on the notion that these plans are a good thing for insurers because they require that everyone buys insurance. This notion assumes that insurers want to insure everything. Unfortunately, nothing could be further from the truth.

Insurers do not want to insure everyone. They want to engage in a tactic known as "cherry picking", which means they only insure healthy people and refuse to cover people with expensive conditions. The premise behind your shallow objection is false.

[hedgehog]

19. The difference is that Obama makes these points on his front page.

Another difference is that he outlines a series of broad goals. Senator Clinton lists a series of steps. On page 11 of her adobe document she talks about "excessive Medicare overpayments to HMO and other managed care plans" She also talks about"Dedicate Portion of Savings Achieved from Reduced need for Uncompensated Care Payments.

I'm not sure what overpayments are; I just know that my family doctor has to limit the number of medicare patients he takes because his compensation rate is so low. I think the other phrase might be about paying hospitals for taking care of people with no money.


There are several problems with this kind of language. I don't know what taking these steps means to me, so I don't know if I support them or not. Will they put my local doctor out of business? What about the company that does MRIs and takes x-rays here in town? Will I have to drive 30 miles to Syracuse for a mammogram because someone in Washington decided that it's cheaper to centralize services? I think by focusing on methods rather than goals, Senator Clinton makes a political mistake. I'm afraid she would end up in the same fight she was in back in 92 and that she would lose again. Again, if she makes the cuts and changes she wants, what happens if the results aren't what she expected? I'm afraid she's so focused on individual trees she can't see the forest.

[cuke]

38. You've got nothing more than bright shiny objects

Your parsing between "broad goals" and "series of steps" is laughable. Your unfamiliarity with overpayments (they cost us billions of dollars every year) does not help your case. Your claims of low Medicare reimbursement rates are belied by the way doctors and hospitals scramble for Medicare patients. Look in the Yellow Pages and see how many advertise that they accept Medicare. And your inability to understand what these "steps" mean to you (particularly when they are so similar to some of Obama's "broad goals") does not make those "steps" any less important.

Basically, all you have is word games, ignorance of the issues (ie overpayments, etc), and baseless and vaguelly rightwingish fears (about govt dictated health care beareaucrats telling you where to get your mammogram) that have no basis in the facts. There's nothing in there about having the govt tell you where to get mammograms and nothing about "cuts" in services. You just pulled that out of your ass.

Your inability to understand the Clinton plan is kind of odd given your OP

[hedgehog]

23. I do have to say, I did find this comment in Senator Clinton's plan

It's Adobe, so I have to re-type it, but


"Young adults are less likely to get insurance because they are more likely to work part year or part time jobs which rarely offer health benefits (23 percent of part time workers are uninsured.) Women also have higher health needs but lower incidence of paid work that offers insurance, The problem of affordability of insurance also contributes to racial disparities in health outcomes"



My reaction? Based on Senator Clinton's own research, I don't think we need mandates, I think we need cheaper health insurance!

[cuke]

39. You can't get to UNIVERSAL without a mandate

Even single payer has a mandate that requires every one to purchase govt insurance and pay for it with a portion of their income.

Since when have liberals been against mandates? Do you oppose being forced to pay taxes for Medicare and Medicaid? How about Social Security? How about the police and fire depts?

on edit: And did you realize the Obama's plan includes a mandate? I bet your opposition to mandates will suddenly allow exceptions

[jody]

17. Why? I will read proposals submitted by a president and get involved in congressional hearings on

any bill to implement comprehensive or partial health care reform.

Anything else is unproductive use of my time and most certainly to read incomplete policy ramblings about health care reform from people seeking to be their party's presidential candidate.

That's my optimistic view of Clinton and Obama's statements on health care reform. My pessimistic view is laden with profound profanities.

[ClarkUSA]

18. Fmr. Clinton Sec. of Labor and SS Trust Fund trustee Robert Reich has & he likes Obama's plans more

And he likes Obama's better.

Here's what Robert Reich had to say recently about the differences between the Obama and Clinton plans for SS and healthcare:

First, HRC attacked O's plan for keep Social Security solvent. Social Security doesn't need a whole lot to keep it going -- it's in far better shape
than Medicare -- but everyone who's looked at it agrees it will need bolstering (I was a trustee of the Social Security Trust Fund 10 years ago,
and I can vouch for this). Obama wants to do it by lifting the cap on the percent of income subject to Social Security payroll taxes, which strikes
me as sensible. That cap is now close to $98,000 (it's indexed), and the result is highly regressive. (Bill Gates satisfies his yearly Social Security
obligations a few minutes past midnight on January 1 every year.) The cap doesn't have to be lifted all that much to keep Social Security solvent --
maybe to $115,00. That's a progressive solution to the problem. HRC wants to refer Social Security to a commission. That's avoiding the issue,
and it's irresponsible: a commission will likely call either for raising the retirement age (that's what Greenspan's Social Security commission
came up with in the 1980s) or increasing the payroll tax on all Americans. So when HRC charges that Obama's plan would "raise taxes" and
her plan wouldn't, she's simply not telling the truth.

I'm equally concerned about her attack on his health care plan. She says his would insure fewer people than hers. I've compared the two plans
in detail. Both of them are big advances over what we have now. But in my view Obama's would insure more people, not fewer, than HRC's.
That's because Obama's puts more money up front and contains sufficient subsidies to insure everyone who's likely to need help -- including
all children and young adults up to 25 years old. Hers requires that everyone insure themselves. Yet we know from experience with mandated
auto insurance -- and we're learning from what's happening in Massachusetts where health insurance is now being mandated -- that mandates
still leave out a lot of people at the lower end who can't afford to insure themselves even when they're required to do so. HRC doesn't indicate
how she'd enforce her mandate, and I can't find enough money in HRC's plan to help all those who won't be able to afford to buy it. I'm also
impressed by the up-front investments in information technology in O's plan, and the reinsurance mechanism for coping with the costs of
catastrophic illness. HRC is far less specific on both counts. In short: They're both advances, but O's is the better of the two. HRC has no
grounds for alleging that O's would leave out 15 million people.

http://www.huffingtonpost.com/robert-reich/why-is-hrc-stooping-so-lo_b_75191.html

[Kucinich4America]

21. You want healthcare reform? Don't settle for less.

http://www.dennis4president.com/go/issues/a-healthy-nation/

[Sparkly]

22. I wish

But I think we will end up settling for less.

[Forkboy]

24. When I try to read them my eyes start to bleed, and I don't have the coverage to fix that.

x(

[gateley]

29. Biden's plan covers children and catastrophic conditions immediately. The

plan calls for a sliding scale premium, and if someone can't pay the premium, the health care is free. That seems like a better first step to single payer than Obama's or Clinton's, just from what I've read here.

[Lord Helmet]

30. I did a paper on it.

I think Kucinich's is the best and then Obama and Edwards, and Hillary's plan is a mess.

[ClarkUSA]

31. Could you tell us why you think Hillary's plan is a mess?

You could email me if you don't want to subject yourself to abuse here (although you seem the hardy sort to me). I'm interested in your educated
conclusions. I agree, by the way.

[Lord Helmet]

33. I left my zip drive at school so I'll have to get back to you.

I'm working on their economic plans now. I gotta say Huckabee's plan for a consumption tax looks pretty good.

[ClarkUSA]

34. Thanks

Looking forward to it. My email box is open to your analyses.

Huckabee has interesting ideas but let's hope he doesn't become Pastor-In-Chief anytime soon. ;)

[Lord Helmet]

35. no kidding!

Huckabee is a nice guy but has bats in the belfry.

[ClarkUSA]

36. Yup

Lots of guano in there, too.

[killbotfactory]

32. "while maintaining consumer price consciousness in choosing health plans."

You're right, that is a huge red flag.

[sampsonblk]

40. Neither plan will ever become law

What's more important is which candidate is most committed to improving our health care situation. That's Hillary Clinton by a mile. Once she gets into office, its going to be a major major issue until its something gets done. We know that for sure.

With everyone else, its just something they are using to run on.