Obama Plan

What: Obama health reform plan

Why: Because at this point (July 22, 2008), Obama leads McCain 4.4% in aggregate polls, is a 2:1 favorite among Intrade oddsmakers, and is favored to win presidency.

When: His plan proposes to cut health costs by $214 billion and to cover all Americans by end of first term

How: By saving $77 billion with computerized health records, $46 billion by reducing administrative costs, and $81 billion by preventive and chronic disease management programs, and an unspecified amount by eliminating “unneeded procedures ”in plan largely devised by unpaid advisors from Harvard.

Where: Everywhere as directed by government.

Who: Obama wants government do job by spending more than $100 billion - $50 billion on EMRs and another $50 billion or so on tax subsidies for the “poor” and “middle-class” so they can join such plans as Federal Employee Health Benefit Program (FEHBP). Presumably money to pay for this would come from taxing the “rich”, i.e. ending Bush tax cuts for this group and by internal savings, such as having government negotiate lower Medicare drug prices.

Conclusion: Noble, but perhaps undoable in 4 years, maybe even in 10. It is true system is “bloated’ with waste, but government has poor record for containing costs: the “rich,” historically and paradoxically, pay less taxes when taxed more; health plans and drug companies and lobbyists will resist Obama’s plans to make them take all comers regardless of health status, and to negotiate drug prices; Medicare’s pilot project to coordinate care was cancelled because it failed to save money; and who is to say when a procedure is “unneeded “ – A Medicare official, a physician, or a patient.