Know Obama

• Require all children to have health insurance.
• Require employers to offer "meaningful" coverage or contribute a percentage of payroll toward the costs of the public plan.

Obama would lock in the employment-based system with new mandates on employers and parents with mandates to insure their children. [1]

McCain would allow people to purchase health insurance across state lines and would give states new incentives and resources to make sure everyone has access to coverage. He says that bringing millions of new buyers into the health care marketplace will expand competition and force insurers and providers to offer more affordable options. This would bring health care costs down. [2]

The bottom line question will be whether individuals or government will be in control of health care in the future.

• Expand Medicaid and SCHIP.
• Create a new public plan so that small businesses and individuals without access to other public programs or employer-based coverage could purchase insurance. Plan coverage would offer comprehensive benefits similar to those available through FEHBP.
• Coverage under the new public plan would be portable.

Obama's Pay or Play Mandate Health Care Reform does not have an individual mandate to purchase health insurance - this plan would potentially leave millions of people in the United States without insurance. [3]

Obama states he would reinsure employer plans to decrease a portion of their catastrophic costs. This is not cost reduction - this is cost shifting from the employer to the government. This will reduce the employer costs - but it will increase someone else's cost - such as the taxpayer. In addition to this - by shifting the costs from the employer to the government - this takes away the incentives of market cost control away - thus raising health care costs.[1]

McCain would boost options for individually owned health insurance by making everyone eligible for a refundable tax credit to help them buy health insurance. [2]

• Create a National Health Insurance Exchange through which individuals could purchase the public plan or qualified private insurance plans.
• Require participating insurers to: offer coverage on a guaranteed issue basis; charge a fair and stable premium that is not rated on the basis of health status, and meet standards for quality and efficiency.
• Require plans of participating insurers to offer coverage at least as generous as the new public plan.
• Exchange would evaluate plans and make differences among them transparent.

• Prohibit insurers from denying coverage based on pre-existing conditions.
• Children up to age 25 could continue family coverage through their parents' plan.
• In market areas where there is not enough competition, require insurers to pay out a "reasonable share" of premiums on patient care benefits.
• Prevent insurers from abusing monopoly power through unjustified price increases.
• Require health plans to disclose the percentage of their premiums that actually goes to paying for patient care as opposed to administrative costs.

• Invest $50 billion toward adoption of electronic medical records and other health information technology.
• Promote insurer competition through the national Health Insurance Exchange and by regulating the portion of health plan premiums that must be paid out in benefits.
• Improve prevention and management of chronic conditions.
• Initiate policies to promote generic drugs, allow drug reimportation, and repeal the ban on direct price negotiation between Medicare and drug companies.
• Pay Medicare Advantage plans the same as regular (traditional) Medicare.
• Require hospitals and providers to publicly report measures of health care costs and quality.
• Promote and strengthen public health and prevention.
• Reform medical malpractice while preserving patient rights by strengthening antitrust laws and promoting new models for addressing physician errors.

Obama's plan is to shift the cost of insurance from the responsibility of the individual to the responsibility of the government and it is his belief that it will make a more efficient health care system. Obama states health insurance will be more affordable for the people because the government will spend many billions of dollars subsidizing access for everyone.

This brings up the question of where will the money the government spends come from?

In addition - Obama's plan would pour inflationary "gas dollars on the fire" by adding tens of billions of dollars more into the health care system with no effective cost containment features to offset the new inflationary pressures. Thus - in turn this would raise the cost of health care with Obama's plan in action.[1]

• Support an independent institute to guide comparative effectiveness reviews and required reporting of preventable errors and other patient safety efforts.
• Reward provider performance through the National Health Insurance Exchange and other public programs.
• Address health disparities, promote preventive care and chronic disease management, and require quality and price transparency from providers and health plans.
• Require health plans to collect, analyze and report health care quality data for disparity populations, and hold plans accountable.

• Expand funding to improve the primary care provider and public health practitioner workforce, including loan repayments, improved reimbursement, and training grants.
• Support preventive health strategies including initiatives in the workplace, schools, and communities.
• Support strategies to improve the public health infrastructure and disaster preparedness at the state and local level.

Please see John McCain's straight talk on health care reform.

1. http://www.barackobama.com/issues/healthcare/
2. http://www.health08.org/candidates/obama.cfm
3. http://www.barackobama.com/pdf/Obama08_HealthcareFAQ.pdf