Sunday, March 9, 2008

Goverment vs Market Reform - Short Take on Clinton, Obama, and McCain Proposals

What - Health reform policies of the three presidential candidates still standing

Why – Because their policies may determine the future state of health care and your practice.

When – The winning candidate’s policies may kick in over the next four years, depending on what president is elected the make-up of Congress and opposition of powerful lobbyists from major sectors whose ox is being gored.

How - Clinton and Obama disagree on one health care matter. Clinton wants universal coverage for all with individual mandates; Obama wants universal coverage of children with decreased costs.

But Senators Clinton and Obama propose and agree upon the following actions, all of which will require a much larger federal role with tax increases in $110 to $120 billion to start with.

Government would require, i.e. mandate

• Insurers to charge the same premium to everyone regardless of age, gender, or occupation, called community rating.

• Insurers to cover anyone who applies through guaranteed issue and prohibiting denials for pre-existing conditions.

• Insurers to offer health insurance that is as generous as the comprehensive coverage available to members of Congress

• Employers to contribute to the health coverage for their workers through a "pay or play" mandate, with small business getting added help to offset costs
In addition, government would,
• Repay businesses for some of the catastrophic costs of employees with large medical expenses, providing certain conditions are met.

• Open the Federal Employees Health Benefits Program to millions more workers and setting up other regulated health insurance purchasing exchanges.

• Expand Medicaid and the State Children's Health Insurance Program.

• Allow people to buy in to Medicare, thereby setting up competition between a taxpayer-subsidized program with federal pricing and policing authority and private health plans.

• Curtail private competition in Medicare by scaling back payments for Medicare Advantage and allowing the government, rather than private companies, to negotiate prescription drug prices for the Medicare drug benefit.

• Allow prescription drug importation from abroad, which means importing other countries' systems of price controls (as Sen. McCain also has proposed), and placing new controls on prescription drug prices.

• Promote greater government involvement in determining the comparative effectiveness of medical treatments and requiring doctors and hospitals to practice according to its evidence-based protocols.
McCain proposes: Moving more power and control over health insurance and health care decisions to patients.

Who - Who to vote for? The question for voters this fall will be whether government can create greater efficiency and choice into the health sector or whether the private sector puts doctors and patients in charge, gives incentives competing plans and doctors to offer more affordable care and coverage.

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