What Obama Win Means For Health Care

Experts Say Financial Crisis Could Hamper Obama's Plans For Health Care Reform

(WebMD)  Tuesday's election of Barack Obama ushers in a new administration that is all but certain to include some level of health care reform. Less clear is how extensive that reform will be and when it will come.

The Illinois senator has proposed sweeping changes in the health care system designed to provide health coverage to millions of uninsured Americans.

But experts tell WebMD that the current financial crisis makes sweeping change unlikely any time soon.

"I have no inside track, but I would bet that in this economic climate it is far more likely that changes will be phased in over time," says Karen Davis, president of the health policy and research group Commonwealth Fund.

University of Michigan health economist Thomas Buckmueller, PhD, agrees that the economic climate is likely to slow reform. "I am not extremely optimistic that major reform will happen, but this seems to be the best chance we have had in a long time."

Obama's Health Plan

Obama spoke often during the campaign about his mother's battle with ovarian cancer to illustrate his commitment to changing the health care system.

He told of her final days, spent battling insurance company bureaucrats who did not want to pay for her treatment. "I know what it's like to see a loved one suffer, not just because they are sick, but because of a broken health care system," he said at a rally last week and at countless campaign stops before that.

Obama's plan would extend health coverage by expanding existing private and public programs with the help of federal subsidies and mandates.

He has repeatedly claimed the reforms will lower the average family's health insurance premiums by about $2,500 a year.

These reforms include:

• Requiring employers, except small businesses, to provide health insurance to their employees or contribute to the cost.



• Requiring that all children have health insurance.



• Expanding Medicaid and the State Children's Health Insurance Program (SCHIP).



• Creating a National Health Insurance Exchange to pool risk and give people the choice of competing private or public health plans.

According to the Tax Policy Center, a nonpartisan tax analysis group, the president-elect's plan, if fully implemented, would reduce the number of uninsured Americans from a projected 67 million to 33 million over the next decade at a cost of $1.6 trillion.

Obama has said he would pay for his plan by rolling back President Bush's tax cuts on people making more than $250,000 a year and keeping the estate tax at 2009 levels, but he has not been more specific. He has not provided a timetable for seeking his proposed reforms and has not said if he would present a comprehensive health care reform package or try for incremental change.

Expansion Likely for State Children's Health Insurance Program

Experts interviewed by WebMD agreed that expansion of the children's insurance program SCHIP is likely to be the first of the proposed reforms to be considered.

Last December, Democrats in Congress lost a yearlong fight to boost federal spending that would have expanded the program after two separate vetoes by Bush.

The program will be up for congressional review next March, and experts say it will probably be the Obama administration's first chance to make good on a health care promise.

"SCHIP is one of the big success stories in health policy over the last 20 years," Buckmueller says. "It has succeeded in getting kids the preventive care they need to keep them out of the ERs."

Medicare Reform More Problematic

Many of Obama's other proposals - from the expansion of Medicare to his National Health Insurance Exchange - will be much harder to win support for, even with a largely friendly Congress behind him.

Buckmueller believes the best chance for major reform lies in seeking bipartisan support for his proposals.

He says a key reason for the failure of President Clinton's 1993 health care reform effort is that his administration did not reach across the aisle. "Assuming that Obama has learned from the Clinton debacle, I think he would be wise to say, 'Here are the basic principles of my plan. You work out the details, get bipartisan support, and I'll sign it.'"

Health Spending 'Not Sustainable'

While sweeping reform may not come soon, experts contacted by WebMD agreed that the nation's broken health care system must be addressed and that this must happen sooner rather than later.

The statistics bear this out:

• 45 million Americans have no health insurance.



• 25 million more have health plans but are considered underinsured because their policies offer only minimal coverage, according to the Commonwealth Fund.



• 42 percent of U.S. adults under age 65 are uninsured or underinsured, up from 33 percent in 2003.

Total spending on health care represented around 16 percent of the gross domestic product in 2007, and the Congressional Budget Office says spending will rise to a quarter of gross domestic product by 2025.

"We are not going to reduce health care spending," says former Congressional Budget Office Director Alice Rivlin, PhD, who is now a scholar with the Brookings Institution. "The best we can do is reduce the rate of health care spending growth. That should be the No. 1 priority of any health care reform."

If jobs are the next thing to go in the current economic crisis, as many economists are predicting, the number of Americans without health insurance will quickly increase beyond projections.

"Something has to happen over the next few years, because the cost of doing nothing is too great," Rivlin says.

Davis echoes the thought. "We can't afford to stay on the path we are on with regard to total health spending," she says. "Employers can't afford it, the government can't afford it, and individuals can't afford it. It is just not sustainable."

In honor of Ted Kennedy they will usher in socialize medicine and name it in the to be soon, late Senator''s honor. The medical profession have priced themselves into this happening. They must have known it was coming with the run up in prices the last several years.
Hospital and doctors charge what ever they want and the time has come to get in step with the rest of the world.

[erasmus81]

We should be happy in our prime of 29 years of marriage, but we both worry about my heart.

Posted by blynnz at 12:09 AM : Nov 07, 2008

It makes me VERY,VERY, ANGRY, to hear about people like you, suffering and worrying about what they are going to do. I can''t even imagine what it must be like to worry everyday of your life over your health and whether you are going to die because of lack of health care. I wish you luck. Hopefully your new President will come through for you.

[belinda777]

I have Atrial Fibrulation and cant get insurance. The doctors told me before I went bankrupt on hospital bills for 2 Brain anyurism that my wife had. Then I had to be in the hospital 2 weeks after she came home.
That all I need is a out patient surgery which would only be the surgery and then I could go home. With what I make and my wifes little disabilty check I make to much to get any kind of medical help to fix my heart. My wife she has short term memory loss and she is only 46 myself I am 49 years old. We should be happy in our prime of 29 years of marriage, but we both worry about my heart.

[erasmus81]

Google in Canadian health care and you will see a report where 50% the orthopedic Doctors say their patients have to wait 6 mos. for a hip replacement. There are long waits for many types of treatment.

Posted by d7767w at 07:13 PM : Nov 06, 2008

Then perhaps you could explain to me why my mom and ex-sister-in-law had their hip replacements within 2 months? My mom had two eye surgeries, both were within a month. She also had an angioplasty within two weeks. I have an uncle, also, that was to see specialists, and had two surgeries, and that was all within a few weeks just before last Christmas. The second surgery was Christmas Eve. And no his problems weren''t life threatening. If they were, he would have been seen to IMMEDIATELY.

[erasmus81]

I know I can''''t get into a lot of specialists between December and May because so many Canadians are making appointments for things they can''''t get done in Canada.
If Canada''''s system is so good why does this happen (and it has for years)????

Posted by bob5ford at 02:37 PM : Nov 06, 2008

So they specifically told you that you couldn''t get an appointment between December and May BECAUSE that was the time for the Canadians?

Get a grip. If there are any Canadians coming down there, there isn''t THAT many. And the ones that come are the RICH snots that can''t wait a few days or a week. The rich have to have everything RIGHT NOW!

[mitch5511]

Time to bring HR676 into the limelight.

[navyjimfl]

Health insurance DOES NOT equal health CARE. Posted by kassandrasdu

you got that right...I work in a hospital and have health insurance but my wife and I have had terrible luck finding a good doctor and getting treated appropriately for ailments. we had 4 different doctors just to treat a kidney stone and finally had to switch insurance companies.......we need a top to bottom change in healthcare in the U.S.

[aster6]

It is not only those that cannot afford healthcare that suffer, though perhaps they dont know it yet. I must pay for my own healthcare and soon will not be able to afford it, it is draining my retirement and I am disabled and can no longer work.

Oh yes, social security did turn down my disability on a technicality rule too.

If I move out of Michigan to Florida where my kids are then I will loose my blue cross because Florida, unlike Michigan, allows blue cross to turn down those with pre existing conditions.

We went for 20 yrs with no insurance,self employed to raise our family. I have no choice but to pay for it now as long as I can even though it will bankrupt me soon.

So this is how a lifetime of work ends up going to the healthcare industry and in the end we end up on welfare.

Dont you see that society pays for the lack of healthcare in the end one way or the other?

More bankruptsys in this country are due to medical bills than any other reason.

We worked all our lives, raised our family, paid our bills and asked for nothing from anyone.

Can you see now that healthcare in this country must be for everyone?

In the end it will be much cheaper to provide it and regulate it then to bankrupt every one to the point of having to accept welfare just to survive.

[oneworldusa]

The problem is that fat CEOs tell employees they can''t afford good medical coverage while they rake in millions upon millions and save up for their parachutes. All this at the cost of faltering employee wages and benefits. Now that many of the parachutes will go away, there is no reason major employers can''t offer good coverage plans.

[incog-nito]

It''s only a matter time, but universal health care will become a reality in the U.S., especially with the upcoming new administration, and the realization of many Americans that the current system is broken beyond repair. UHC is considered a taboo subject not long ago, but politicians are openly touting it on their platform. It won''t be soon enough, but it will be here.

[erasmus81]

Posted by WogerWabbit at 12:59 AM : Nov 06, 2008

If you were living in Canada, you would be paying approximately $90 a month for you and your wife. And that is not EACH, that is the "total" amount. You wouldn''t have to be coming up with more money for chemo or bloodwork. You would never see a medical bill.

[incog-nito]

In conclusion: The U.S. health care system is fiscally and MORALLY bankrupt. It hits people the hardest precisely at a time when they need help the most. And we''re talking about people WITH health insurance.

There are health care systems in other countries that work very well AND cost less than the U.S.''s. Hopefully with the new administration we will be moving in that direction (with undoubtedly intense resistance from the insurance industry and overpaid doctors).

[wogerwabbit]

I''m a small buisness owner and I pay $788 a month to a major health insurance company for garbage coverage because of pre-existing conditions. My wife''s coverage just went up 15% to just under $400 per month for something she never uses. Let''s not forget the hefty deductibles and co-pays either. Something needs to be done... there''s too many middlemen taking a cut and getting rich off of the misery of others. Healthcare should be a right, not a privilege of the monied few. I don''t mind paying my way, but I despise getting bent over and drained of my hard earned money at a staggering rate because I''ve had cancer for 17 years... and outlived the original 5 - 10 year prognosis. I''m radioactive to insurance companies and there''s nothing I can do about it. I go for checkups and blood tests 3 or 4 times a year and get tapped for another $400+ every time I go. The chemo therapy I should be doing would cost me $700-$800 a month out of pocket so I do without. Doesn''t that suck! And I ain''t poor... but I''m not rich enough to stay alive with today''s system. That''s what needs to change.

[incog-nito]

Think universal health care will mean sub-standard care and no coverage for pre-existing conditions? AU CONTRAIRE. Here''s yet another excerpt from the Boston Globe:

The French system strongly discourages the kind of experience rating that occurs in the United States, making it more difficult for insurers to deny coverage for preexisting conditions or to those who are not in good health. In fact, in France, the sicker you are, the more coverage, care, and treatment you get.

[incog-nito]

Will universal health care deny people the right to buy private insurance? NOPE. Here''s another excerpt from the Boston Globe:

French legislators also overcame insurance industry resistance by permitting the nation''s already existing insurers to administer its new healthcare funds. Private health insurers are also central to the system as supplemental insurers who cover patient expenses that are not paid for by Securite Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.

[incog-nito]

Think universal health care will restrict your choice of doctors? Here are some excerpts from an article in the Boston Globe:

...the French share Americans'' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Virtually all physicians in France participate in the nation''s public health insurance, Sicuriti Sociale.

The French system is also not inexpensive. At $3,500 per capita it is one of the most costly in Europe, yet that is still far less than the $6,100 per person in the United States.

Moreover, in contrast to Canada and Britain, there are no waiting lists for elective procedures and patients need not seek pre-authorizations. In other words, like in the United States, "rationing" is not a word that leaves the lips of hopeful politicians.

[birdyspice7]

I hope they outlaw the pre-existing condition clause. My husband was just recently diagnosed with a lifelong disease and his doctor warned him to never lose his job and never lose his insurance.

This is ridiculous. When my husband was in grad school he was caught without insurance when he came down with meningitis. He''s got 150,000 of medical bills. We can''t buy a house. They don''t have problems like these in Canada and Europe. They have better health systems with longer average life spans.

[incog-nito]

Will universal health care cost the U.S. a ton of money? Here''s a comparative list of health care spending as a percentage of GDP (gross domestic product):

Australia 9.5%
Canada 9.8%
Germany 10.7%
Netherlands 9.2%
N. Zealand 9.0%
UK 8.3%
US 16.0%

[incog-nito]

Here is the ranking of world''s best healthcare systems, by country:

1. France
2. Italy
3. San Marino
4. Andorra
5. Malta
6. Singapore
7. Spain
8. Oman
9. Austria
10. Japan
11. Norway
12. Portugal
13. Monaco
14. Greece
15. Iceland
16. Luxembourg
17. Netherlands
18. United Kingdom
19. Ireland
20. Switzerland
21. Belgium
22. Colombia
23. Sweden
24. Cyprus
25. Germany
26. Saudi Arabia
27. United Arab Emirates
28. Israel
29. Morocco
30. Canada
31. Finland
32. Australia
33. Chile
34. Denmark
35. Dominica
36. Costa Rica
37. USA

By the way, the U.S. spends more per capita on health care by any other country by large margin.

[zev99]

In short, what Canada has now.