T Nation

Obama's Healthcare Plan


Seems he has announced his plan. I was surprised no other thread had been started discussing it. Anyway, what do you all think?

The Obama Plan: Stability & Security for all Americans

"It will provide more security and stability to those who have health insurance. It will provide insurance to those who donâ??t. And it will lower the cost of health care for our families, our businesses, and our government."

â?? President Barack Obama
If You Have Health Insurance
More Stability and Security

* Ends discrimination against people with pre-existing conditions. Over the last three years, 12 million people were denied coverage directly or indirectly through high premiums due to a pre-existing condition.  Under the Presidentâ??s plan, it will be against the law for insurance companies to deny coverage for health reasons or risks. 
* Limits premium discrimination based on gender and age. The Presidentâ??s plan will end insurersâ?? practice of charging different premiums or denying coverage based on gender, and will limit premium variation based on age. 
* Prevents insurance companies from dropping coverage when people are sick and need it most.  The Presidentâ??s plan prohibits insurance companies from rescinding coverage that has already been purchased except in cases of fraud.  In most states, insurance companies can cancel a policy if any medical condition was not listed on the application â?? even one not related to a current illness or one the patient didnâ??t even know about. A recent Congressional investigation found that over five years, three large insurance companies cancelled coverage for 20,000 people, saving them from paying $300 million in medical claims - $300 million that became either an obligation for the patientâ??s family or bad debt for doctors and hospitals.
* Caps out-of pocket expenses so people donâ??t go broke when they get sick.  The Presidentâ??s plan will cap out-of-pocket expenses and will prohibit insurance companies from imposing annual or lifetime caps on benefit payments. A middle-class family purchasing health insurance directly from the individual insurance market today could spend up to 50 percent of household income on health care costs because there is no limit on out-of-pocket expenses.
* Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money. The Presidentâ??s plan ensures that all Americans have access to free preventive services under their health insurance plans. Too many Americans forgo needed preventive care, in part because of the cost of check-ups and screenings that can identify health problems early when they can be most effectively treated. For example, 24 percent of women age 40 and over have not received a mammogram in the past two years, and 38 percent of adults age 50 and over have never had a colon cancer screening.
* Protects Medicare for seniors. The Presidentâ??s plan will extend new protections for Medicare beneficiaries that improve quality, coordinate care and reduce beneficiary and program costs.  These protections will extend the life of the Medicare Trust Fund to pay for care for future generations. 
* Eliminates the "donut-hole" gap in coverage for prescription drugs.  The Presidentâ??s plan begins immediately to close the Medicare "donut hole" - a current gap in its drug benefit - by providing a 50 percent discount on brand-name prescription drugs for seniors who fall into it.  In 2007, over 8 million seniors hit this coverage gap in the standard Medicare drug benefit.  By 2019, the Presidentâ??s plan will completely close the "donut hole".  The average out-of-pocket spending for such beneficiaries who lack another source of insurance is $4,080.

If You Don't Have Insurance
Quality, Affordable Choices for All Americans

* Creates a new insurance marketplace â?? the Exchange â?? that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.  The Presidentâ??s plan allows Americans who have health insurance and like it to keep it.  But for those who lose their jobs, change jobs or move, new high quality, affordable options will be available in the exchange.  Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality. 
* Provides new tax credits to help people buy insurance. The Presidentâ??s plan will provide new tax credits on a sliding scale to individuals and families that will limit how much of their income can be spent on premiums.  There will also be greater protection for cost-sharing for out-of-pocket expenses.
* Provides small businesses tax credits and affordable options for covering employees. The Presidentâ??s plan will also provide small businesses with tax credits to offset costs of providing coverage for their workers.  Small businesses who for too long have faced higher prices than larger businesses, will now be eligible to enter the exchange so that they have lower costs and more choices for covering their workers.
* Offers a public health insurance option to provide the uninsured and those who canâ??t find affordable coverage with a real choice.   The President believes this option will promote competition, hold insurance companies accountable and assure affordable choices. It is completely voluntary.  The President believes the public option must operate like any private insurance company â?? it must be self-sufficient and rely on the premiums it collects. 
* Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.  For those Americans who cannot get insurance coverage today because of a pre-existing condition, the Presidentâ??s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.

For All Americans
Reins In the Cost of Health Care for Our Families, Our Businesses, and Our Government

* Wonâ??t add a dime to the deficit and is paid for upfront.  The Presidentâ??s plan will not add one dime to the deficit today or in the future and is paid for in a fiscally responsible way.   It begins the process of reforming the health care system so that we can further curb health care cost growth over the long term, and invests in quality improvements, consumer protections, prevention, and premium assistance.  The plan fully pays for this investment through health system savings and new revenue including a fee on insurance companies that sell very expensive plans.
* Requires additional cuts if savings are not realized. Under the plan, if the savings promised at the time of enactment donâ??t materialize, the President will be required to put forth additional savings to ensure that the plan does not add to the deficit.
* Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality.  The Presidentâ??s plan includes proposals that will improve the way care is delivered to emphasize quality over quantity, including:  incentives for hospitals to prevent avoidable readmissions, pilots for new "bundled" payments in Medicare, and support for new models of delivering care through medical homes and accountable care organizations that focus on a coordinated approach to care and outcomes.
* Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.   The Presidentâ??s plan will create an independent Commission, made up of doctors and medical experts, to make recommendations to Congress each year on how to promote greater efficiency and higher quality in Medicare.  The Commission will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care.  It will ensure that your tax dollars go directly to caring for seniors.
* Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.  The Presidentâ??s plan instructs the Secretary of Health and Human Services to move forward on awarding medical malpractice demonstration grants to states funded by the Agency for Healthcare Research and Quality as soon as possible.
* Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.   Under the Presidentâ??s plan, large businesses â?? those with more than 50 workers â?? will be required to offer their workers coverage or pay a fee to help cover the cost of making coverage affordable in the exchange. This will ensure that workers in firms not offering coverage will have affordable coverage options for themselves and their families.  Individuals who can afford it will have a responsibility to purchase coverage â?? but there will be a "hardship exemption" for those who cannot.


"You lie!"

Not adding to this discussion whatsoever but I did a double-take when that happened.


Pelosi about broke her neck whipping it around to find the culprit. It's about damn time we stop being so civil.



I don't think it's correct to say he presented a plan.

He presented a campaign-promises-type speech touting a claimed plan that in fact has not been presented to Congress or the public and I expect not in fact written.

Where is the actual Obama plan? With the concrete details.

Why not present it to the public and Congress as a bill that's ready to be voted on?


because, he hasn't done his job, and read it.



It's done this way because its not some type of Emergency Powers Act...its a Bill.

And Bills are meant to go through the scrutiny of Congress; not written by a President for the Congress to say "Yea" or "Nay" on.



What's missed here is he has touted the fact that illegals won't be given free healthcare. Right. They will try to pass this bill, then pass amnesty before the 2010 election and count on new citizens to reelect them for giving them citizenship and free healthcare.


Agreed, but I am assuming that the WH is going to reveal it? I mean, there needs to be a written plan for it to pass in Congress, correct? However from what I understand, a lot of politicians don't even read the fucking thing. Too busy playing Solitaire.


That's right. Socialism is okay so long as it's for the citizens and not those "illegals".



Sucks for all those young women who are going to have to pay for old men's care.

I can agree on this.

This is silly. Whose income is the cap going to be tailored to?

If its the middle class, poor people still won't be able to afford. If the cap is designed for the poor everyone is going to have to pay through higher premiums.

How is the cap going to work? An annual total cap? A cap per procedure based on a list they generate? Caps based on a %?

lol. "protect it for future generations". Its going broke in 8 years. He thinks he can extend its life 50 years with some tweaks?

"Eliminating the donut-hole" and "won't add a cent to the debt" can't be in the same bill.

Call me a cynic but this just looks like a way to buy concerned older voters.

Summary of Section: Insurance is going to be more expensive.

If he wants individuals to keep their insurance when they lose their jobs, why doesn't he offer the same tax breaks to individuals.

Wait, what is he doing? Theres no plan here, just promises.

If his insurance reforms above are going to make it cheaper, why do we need a pulic option?

Their goal is 97% coverage. Even if we use their bogus 40 million uninsured thats ~90% coverage. His insurance reforms can't scrape 7% more policies out of the system? Back to the drawing board.

Cool, higher taxes!

If their are additional cuts to be made without affecting quality of care why not do them now?

Or is he saying if he fucks up the math and this costs us a fortune he'll have to cut things that enhance quality of care.

Doesn't medicare have one of these? Is it working?

Tort reform with no tort reform. Excellent.

Since when is 50 workers a large company?


MOST voters will wake up this morning and wonder which party member was brazen enough to shout out like that while the POTUS has the floor. They will not agree with you that less civility is a good thing. The louder and more shrill the republicans get, the bigger the losses come election time.

I am embarrassed for Wilson. He needs to rethink his strategy. It might work in small enclaves (like parts of SC), but the country as a whole will reject a party that encourages this type of behavior.



If its being written by Congress(as it should be) how can he go up their and say my plan will do X,Y,Z.

Its not his bill
There is no one bill
How can he know what its going to do?


He doesn't talk about 'unionization of healthcare workers'. Now, this isn't in the text of the bullet points the OP posted, but it is in the House version of the bill. I think it's fair to say that these provisions are not 'veto material' as the President has huge backing from Big Labor (and that's probably an understatement).

If you're in the healthcare field, prepare for the notion of being unionized. If you're not unionized now and you think that nothing will change, then consider that:
1) You will not be able to negotiate your wages because of 'collective bargaining' contracts where the union negotiates your salary
2) If you don't join, you will still pay 'Fair Share' fees to the Union for their services
3) Substandard workers will be 'protected' by unions and not be vetted as in open shops. Think of government employees that never get fired because of imcompetence.

WSJ: Unionized Healthcare (take note of the last sentence below)

[i]In the heated debates on health-care reform, not enough attention is being paid to the huge financial windfalls ObamaCare will dole out to unionsâ??or to the provisions in the various bills in Congress that will help bring about the forced unionization of the health-care industry.

Tucked away in thousands of pages of complex new rules, regulations and mandates are special privileges and giveaways that could have devastating consequences for the health-care sector and the American economy at large.


The current House version of ObamaCare (H.R. 3200) goes much further. Section 225(A) grants Secretary of Health and Human Services Kathleen Sebelius tremendous discretionary authority to regulate health-care workers "under the public health insurance option." Monopoly bargaining and compulsory union dues may quickly become a required standard resulting in potentially hundreds of thousands of doctors and nurses across the country being forced into unions.[/i]


Not less civillity but the fact that someone actually spoke up to represent the people.

Only the curs of this country our offended by this, This administration and congress have been ramming their thoughts down our throats fromt he start it's about time we start gagging them,

And don't give me it isn't the right forum bull, there is no other forum in which it can be done that would have this impact, honestly I wish all the republicans would have given some sort disapproval as soona sthe public option started, and from there on, these people need to realize they don't have a blank check to give it to us in the ass.


AP fact check as to the economics of the proposal(s) - too lengthy to post:



It won't do any of the things he says it will. It will do the exact opposite.

Government making choices is by default anti-choice for everyone involved.


But Presidents have legislative power and input by virtue of the veto. And, he is the one with the priorities to reform - if it were a situation of merely waiting for a bill to trickle through Congress, he wouldn't be standing before a convened joint session of Congress to encourage the passing of his priorities.


Represent which people?? The rude morons who can't find a decent way to share their thoughts -so they shout them out without any consideration of context or tone? I am glad that Wilson (who has since apoligized- indicating that he knows he screwed the pooch on this one) self-identified as their representatitve.

Republicans will not win anything in '10 if this is the tone they take. It NEVER works.



I'm embarrassed for Wilson too. He apologized and his own party has roundly condemned him. I'd be embarrassed to be exposed as a coward in a party of cowards as well.



Why doesn't someone ask him what his plan was during his campaign run in 2008? He mentioned his plan while running for president, so how come someone doesn't simply ask him what his plan was when he was running? We all know why, but the fact that someone doesn't actually put him on the hot seat bothers me.

Also, I am not convinced that he is sincere in PROPERLY addressing the health care issue. Tort reform is HUGE, but won't confront it. The Heller Amendment, which would verify someone's legal status upon using the government option, was shot down. So anyone can walk in and claim to be a citizen without actually checking. So this tells me, how sincere is he in upholding his policies and truly addressing the issues with HealthCare? These are the reasons that I don't believe him, along with more than questionable actions taken by his administration.