ObamaCare: Improving Reform’s Bill of Health Presented by Keith Wilkerson, Jordaan Williams, & Timothy Wirth February 8, 2010

Introduction President Obama and Congress are attempting to push through healthcare reform legislation Despite having many supporters early on, effort has lost steam in the people Since lawmakers continue to push healthcare reform, the content of the legislation must be helping a lack in popularity

History of Healthcare Reform 1912 – Theodore Roosevelt runs for President with social insurance on platform 1915 – American Association of Labor Legislation publishes draft bill of health insurance 1934 – President Franklin D. Roosevelt pushes for national healthcare as part of the New Deal 1939 – First Blue Shield plans for physician care

History of Healthcare Reform 1948 – National Health Assembly encourages universal health coverage Medicare and Medicaid signed into law 1993 – President Clinton’s Health Security Act Introduced to Congress 2006 – Massachusetts provides for healthcare coverage to nearly all residents 2009 – Reform Efforts by President Obama

Current Healthcare Reform Bill For Those Already With Health Insurance: No more discrimination for pre-existing conditions Limit of discrimination based on gender and age Insurance companies cannot “drop” you if you get sick Cap of Out-of Pocket Expenses and no extra fees for preventive care

Current Healthcare Reform Bill For Medicare Beneficiaries: Protection of Medicare for Seniors Elimination of “the donut-hole” coverage gap

Current Healthcare Reform Bill For Those Without Insurance: New Insurance marketplace Tax credits for insurance Public health insurance option

Current Healthcare Reform Bill For Everyone: Won’t add to the deficit Additional cuts to Plan if savings don’t happen Includes numerous cost-cutting and fraud prevention measures Coverage requirement of certain employers

Suggestions The overall cost to government of a healthcare program must be reduced Improve and/or change elements of the plan so as not to make beneficiaries and the country worse off Federal Government Needs to Play a Larger Role in Shaping and Overseeing the Healthcare System

The Cost of Healthcare Total cost of a program would be around $900 Billion over 10 years If Congress passed a healthcare bill, the budget deficit will inflate to $239 Billion over the same 10 year period

Reducing the Cost of Healthcare Ways of Securing Money to cover the cost: Squeeze Savings out of Medicare and Medicaid $465 Billion over 10 years Tax the Wealthy $544 Billion over 10 years Tax Employee Health Insurance Benefits $418.5 Billion over 10 years

Reducing the Cost of Healthcare Ways of securing money to cover the cost: Limit itemized deductions of the wealthy $267 Billion over 10 years Penalize employers who do not offer health insurance $163 Billion over 10 years

Changing the Scope and Coverage of the Plan Least Popular Elements of the Plan: Mandate for Individual Insurance or Penalty Government Defined “Basic” Package Late Effective Date Limited Increase in Medicare Payments to Providers

Changing the Scope and Coverage of the Plan Individual Plan Mandate Patients don’t mind having health insurance because it is often cheaper to have as compared to paying out-of-pocket Patients don’t want to be charged, however, for NOT having health insurance Government Defined “Basic” Plan As always, patients would prefer not to be told what to have in a plan Insurance companies are the same Government should provide guidelines for plans, but should not mandate a specific set of benefits

Changing the Scope and Coverage of the Plan Late Effective Date Patients do not wish to wait until after Obama leaves office for legislation to take effect Effective date needs to be moved closer to the present so patients can begin to be covered or save money Limited Increase in Medicare Payments to Providers Physicians and Pharmacists are already being paid very little for services rendered to Medicare patients Increases in Medicare payments are necessary for providers to stay in business and control costs

Healthcare Regulation The Food and Drug Administration (FDA) is really the only government agency that regulates healthcare The FDA regulates drug trials, pharmaceutical research and development, and determines which technologies are available to be used for research

Healthcare Regulation There can be no real market for healthcare unless the government sets the rules for one The government would need a large role in shaping and overseeing the system

Healthcare Regulation Possible ideas include: Set up a national technology assessment board Create an ethics board to review hospitals and insurance companies

Discussion Points Reducing the Cost Americans already pay higher taxes, and increasing government spending may result in higher taxes Employers that do not offer health insurance should still be required to help in paying for their employee’s insurance Obama said he plans to tax the wealthy…why not a better way to start!

Discussion Points Changing the Scope and Coverage of the Plan Patients shouldn’t be penalized for a lack of health insurance while paying higher taxes for it By having legislation become effective earlier, patients are sure to be covered by insurance and saving money earlier Although the government might find an advantage to controlling the benefits in a health plan, it is to the patient’s advantage to have differences in plans Increased payments by Medicare to providers will help keep high-quality care in the United States

Discussion Points Healthcare Regulation Healthcare is relatively unregulated Costs become unnecessarily high and patients are stuck paying the difference in their co-pays and out-of-pocket expenses Since there is really no market in healthcare, there is comparatively little competition, and costs are allowed to skyrocket Review Boards can be sure that technology is state of the art

Conclusion Changes in cost, coverage, and regulation are requisite to having President Obama’s healthcare plan regain support from voters With these changes, constituents will most likely support national healthcare Having a reformed healthcare system will improve one of the more sophisticated systems in the world

References Feldman, R.D. (Ed.). (2000). American Health Care Government, Market Practices, and the Public Interest. New York: Transaction. Kaiser Family Foundation (n.d.). Timeline: History of Health Reform Efforts in the U.S. Retrieved February 6, 2010, from Kaiser Family Foundation (2009, September). Kaiser Health Tracking Poll: September Retrieved February 6, 2010, from Kaiser Family Foundation (2010, January). Kaiser Health Tracking Poll: January Retrieved February 6, 2010, from Terry, K. (2007). Rx for Health Care Reform. New York: Vanderbilt UP. The White House (n.d.). The Obama Plan: Stability and Security for All Americans. Retrieved February 7, 2010, from