Obama’s Heath Reform Proposal Helen Halpin, PhD. Professor of Health Policy UC Berkeley, SPH

Obama’s Goals for the US Health Care System Health care is a right; every American has access to affordable, high quality health care. Universal coverage is the goal. Give Americans more choices. Reduce the costs of health care to individuals and families. Emphasize prevention and public health. Improve the quality of care. Achieve greater efficiency in delivery of health care.

Obama’s Proposal 1.All large businesses offer coverage or pay into the pool -- offering choices of private plans or a single payer plan (like Medicare). 2.Small businesses offer coverage or put employees in the pool at no cost. 3.The uninsured (those without employer or govt. coverage) can buy coverage in the pool. 4.Choices in the pool include a list of private plans (like FEHBP) or a public plan where you can go to any MD or hospital with no insurance company involvement (like traditional Medicare). 5.Premiums in the pool will be directly subsidized based on household income and will be offered at group rates. 6.Expand Medicaid and SCHIP; improve Medicare. 7.Regulate insurance companies so that they cannot deny coverage or charge higher rates for people with pre-existing conditions. 8.Paid for by rolling back the Bush tax cuts for person earning over $250,000/yr (35% to 39% bracket 2000 levels)

A Centrist Reform that Builds on the Existing System “Free-riders”: Most are in the age group. Obama will allow adult children to stay on their parent’s family policies (NJ permits to age 30). There is no such thing as free health care. Mandates: Does not mandate coverage for adults (only for children). Choice - Increases choices for Americans. Promotes efficiency - reduce administrative costs (3% under Medicare/15-20% under private insurance). Government “run”/Socialism - NO GOVERNMENT TAKE OVER OF THE MEANS OF PRODUCTION OR PROVISION OF CARE. Ownership and operation of all private health care institutions and salaries/wages of private health care professionals remain in the private sector. Does not cover undocumented workers but covers legal residents. Universal coverage: 95-98% of Americans covered under Obama’s plan. Individual market - no one will be forced to buy coverage in the individual market and insurers can no longer exclude pre-existing conditions or medically underwrite.

Obama vs McCain on Health Reform Sector ObamaMcCain EmployersLarge: play or pay into pool Small: pool is free Tax employee health benefits; 20+ million lose coverage MedicareImprove drug benefit; reduce payments to HMOs Cut Medicare by $880 billion over 10 years MedicaidExpand to all <100% FPLCut Medicaid by $400 billion SCHIPRenew and expand to all kids under 300% of poverty (Voted 2X against SCHIP renewal) UninsuredChoice of private plans (like FEHBP) or single payer plan (like Medicare) in the pool Get a tax credit worth less than half the amount required to buy in the private market ($5,000 for a $12,000 policy) Private Insurance Market No exclusion of pre-existing conditions Deregulate (like banking!) to get around state regulations. Allow pre-existing condition exclusions