Elements of the Obama Health Proposal

PRINCIPLE 1: An American's rights to pursuit happiness are to be respected. The Obama health care plan attests this principle by granting each American the right to choose how he/she wishes to maintain his/her health .

PRINCIPLE 2: The role of government is to protect citizen rights, not to punish a citizen who chooses not to exercise his right. Thus no American will be forced to enroll in any government sponsored coverage.

Under Senator Obama's Health Care Plan:

• If you are enrolled in Medicaid or a state children health insurance program then you will be able to keep that coverage, and eligibility for coverage will expand to cover more of the poor and near poor are planned.

• If you are enrolled in Medicare then you will able to keep Medicare. Further, the Obama Administration will seek revision in Medicare Part D Drug Benefit to gain adequate drug coverage for the elderly, and give the federal government the power to negotiate drug prices.

• If you are enrolled in an employer sponsored plan and you like the coverage then you will be able to keep it.

• If you are employed in a small firm and your employer does not provide medical coverage then your employer will be required to purchase a plan, or contribute to a pool where you can purchase affordable and comprehensive coverage.

• If you work for a small firm, buy coverage in an individual insurance plan, uninsured or have inadequate coverage, then you can join a new pool that offers two options for choice:
o You can select from a menu of plans modeled after the federal employees benefits program or
o You can enroll in a public plan similar to Medicare.

Long run status of the Obama Plan
Policy planners estimate that the Obama plan can attain 95% coverage of the American public. The remaining 5% are the homeless, drug addicts, people who are in the country illegally and they choose not to expose themselves or their family members to government notice. The Obama Plan seeks to increase this coverage ratio with two additional strategies.

Increasing the coverage ratio
Uninsured young adult children ages 19 to 29 contribute significantly to those who do not seek coverage. They are about 14 million in population. The Obama Plan, which will permit coverage to adult children 19 - 25 under their parent's plans, will greatly reduce the uninsured within this group.

Sixty to seventy percent of the emergency care seekers are uncovered. The Obama Plan is considering to offer to these people, the option to enroll in the universal health care plan or be held responsible to pay the cost of care. Economist estimate approximately 60 to 70 percent of this group will choose enrollment.

The additions of these addendums are likely to reap a greater harvest of those who do not enroll within the first two years of the program.

Principle 2
Senator Obama seeks to set a health care policy for the 95% who want coverage. He believes the function of government is to protect people's rights, not to punish anyone whose rights are not met. With this approach, no American is left out, and no one will be forced to enroll in any government sponsored coverage.

Who will pay?
Under the Obama Plan, the direct premiums that you pay will be your monthly share of the cost of the plan. This premium is income based.

Cost
The cost of the health care program will ultimately be determined by the financial incentives Congress provides to employers. If the payroll tax is low, employers are likely to opt for the government single payer model which will grow to a large stable pool, allowing for the use of economy of scale and negotiating powers to keep track of costs. If the payroll tax is raised or remains the same, employers will likely seek less expensive alternatives.

Other features of the Obama Plan

• Public health will have a more prominent role in the health care system.
• Strong provisions for pandemic flu will be made.
• Increase use of tele-medicine to encourage shared expertise between distant medical centers and rural providers, thus increasing quality of care in rural areas.
• Reinsurance for catastrophic illness to ease employer's care cost.

Will everyone in the United States be covered?
No. The plan does not offer coverage to the undocumented workers and their family members, who live and work in this country but choose to be invisible to government for economic reasons.

Universal Coverage?
Yes, The Obama Plan will provide comprehensive coverage to all who are eligible to enroll. So the plan is universal in its scope, by Principle 1; de facto it is not by Principle 2.

Conclusion: Untreated issues
There are many untreated issues about medical care. Primarily they are issues that can only be resolved in the long run. I hope they will be approached with an urgency to be resolved in the short run.

• Quality, how can it become a natural part of this system?
• How can the plan encourage the production of needed family practitioners?
• How does war and neighborhood development affect health?
• What can be done to control inflation within the system?
• Should the single payer model be the goal of a US health plan?

Someone to follow to learn more about the Obama Plan

This post was gleamed from a review of the Obama health care proposal by Helen Halpin April 17, 2008.

Helen Halpin, one of Obama's chief health care advisors.

Helen Halpin: Distinguised Faculty.