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The Problem
Millions of Americans are uninsured or underinsured because of rising
medical costs: 47 million Americans — including nearly 9 million children
— lack health insurance with no signs of this trend slowing down.
Health care costs are skyrocketing: : Health insurance premiums have risen
4 times faster than wages over the past 6 years.
Too little is spent on prevention and public health: The nation faces
epidemics of obesity and chronic diseases as well as new threats of
pandemic flu and bioterrorism. Yet despite all of this less than 4 cents
of every health care dollar is spent on prevention and public health.
Barack Obama's Plan: Quality, Affordable and Portable Coverage
for All
Obama's Plan to Cover Uninsured Americans: Obama will
make available a new national health plan to all Americans, including the
self-employed and small businesses, to buy affordable health coverage that
is similar to the plan available to members of Congress. The Obama plan
will have the following features:
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Guaranteed eligibility. No American will be turned
away from any insurance plan because of illness or pre-existing
conditions.
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Comprehensive benefits. The benefit package will be
similar to that offered through Federal Employees Health Benefits
Program (FEHBP), the plan members of Congress have. The plan will cover
all essential medical services, including preventive, maternity and
mental health care.
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Affordable premiums, co-pays and deductibles.
Subsidies. Individuals and families who do not qualify for Medicaid or
SCHIP but still need financial assistance will receive an income-related
federal subsidy to buy into the new public plan or purchase a private
health care plan.
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Simplified paperwork and reined in health costs.
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Easy enrollment. The new public plan will be simple
to enroll in and provide ready access to coverage.
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Portability and choice. Participants in the new
public plan and the National Health Insurance Exchange (see below) will
be able to move from job to job without changing or jeopardizing their
health care coverage.
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Quality and efficiency. Participating insurance
companies in the new public program will be required to report data to
ensure that standards for quality, health information technology and
administration are being met.
National Health Insurance Exchange: The Obama plan will create a
National Health Insurance Exchange to help individuals who wish to
purchase a private insurance plan. The Exchange will act as a watchdog
group and help reform the private insurance market by creating rules and
standards for participating insurance plans to ensure fairness and to make
individual coverage more affordable and accessible. Insurers would have to
issue every applicant a policy, and charge fair and stable premiums that
will not depend upon health status. The Exchange will require that all the
plans offered are at least as generous as the new public plan and have the
same standards for quality and efficiency. The Exchange would evaluate
plans and make the differences among the plans, including cost of
services, public.
Employer Contribution: Employers that do not
offer or make a meaningful contribution to the cost of quality health
coverage for their employees will be required to contribute a percentage
of payroll toward the costs of the national plan. Small employers that
meet certain revenue thresholds will be exempt.
Mandatory Coverage of Children: Obama will
require that all children have health care coverage. Obama will expand the
number of options for young adults to get coverage, including allowing
young people up to age 25 to continue coverage through their parents'
plans.
Expansion Of Medicaid and SCHIP: Obama will
expand eligibility for the Medicaid and SCHIP programs and ensure that
these programs continue to serve their critical safety net function.
Flexibility for State Plans: Due to federal
inaction, some states have taken the lead in health care reform. The Obama
plan builds on these efforts and does not replace what states are doing.
States can continue to experiment, provided they meet the minimum
standards of the national plan.
Lower Costs by Modernizing The U.S.
Health Care System
Reducing Costs of Catastrophic Illnesses for Employers and Their
Employees: Catastrophic health expenditures account for a high
percentage of medical expenses for private insurers. The Obama plan would
reimburse employer health plans for a portion of the catastrophic costs
they incur above a threshold if they guarantee such savings are used to
reduce the cost of workers' premiums.
Helping Patients:
Support disease management programs. Seventy five percent of total health
care dollars are spent on patients with one or more chronic conditions,
such as diabetes, heart disease and high blood pressure. Obama will
require that providers that participate in the new public plan, Medicare
or the Federal Employee Health Benefits Program (FEHBP) utilize proven
disease management programs. This will improve quality of care, give
doctors better information and lower costs.
Coordinate and integrate care. Over 133 million
Americans have at least one chronic disease and these chronic conditions
cost a staggering $1.7 trillion yearly. Obama will support implementation
of programs and encourage team care that will improve coordination and
integration of care of those with chronic conditions.
Require full transparency about quality and costs.
Obama will require hospitals and providers to collect and publicly report
measures of health care costs and quality, including data on preventable
medical errors, nurse staffing ratios, hospital-acquired infections, and
disparities in care. Health plans will also be required to disclose the
percentage of premiums that go to patient care as opposed to
administrative costs.
Ensuring Providers Deliver Quality Care:
Promote patient safety. Obama will require providers to report preventable
medical errors and support hospital and physician practice improvement to
prevent future occurrences.
Align incentives for excellence. Both public and
private insurers tend to pay providers based on the volume of services
provided, rather than the quality or effectiveness of care. Providers who
see patients enrolled in the new public plan, the National Health
Insurance Exchange, Medicare and FEHBP will be rewarded for achieving
performance thresholds on outcome measures.
Comparative effectiveness research. Obama will
establish an independent institute to guide reviews and research on
comparative effectiveness, so that Americans and their doctors will have
the accurate and objective information they need to make the best
decisions for their health and well-being.
Tackle disparities in health care. Obama will
tackle the root causes of health disparities by addressing differences in
access to health coverage and promoting prevention and public health, both
of which play a major role in addressing disparities. He will also
challenge the medical system to eliminate inequities in health care
through quality measurement and reporting, implementation of effective
interventions such as patient navigation programs, and diversification of
the health workforce.
Reform medical malpractice. Obama will
strengthen antitrust laws to prevent insurers from overcharging physicians
for their malpractice insurance and will promote new models for addressing
errors that improve patient safety, strengthen the doctor-patient
relationship and reduce the need for malpractice suits.
Lowering Costs Through Investment in Electronic Health Information
Technology Systems: Most medical records are still stored on paper, which
makes it hard to coordinate care, measure quality or reduce medical errors
and which costs twice as much as electronic claims. Obama will invest $10
billion a year over the next five years to move the U.S. health care
system to broad adoption of standards-based electronic health information
systems, including electronic health records, and will phase in
requirements for full implementation of health IT.
Obama will ensure that patients'
privacy is protected.
Lowering Costs by Increasing Competition in the
Insurance and Drug Markets: The insurance business today is dominated
by a small group of large companies that has been gobbling up their
rivals. There have been over 400 health care mergers in the last 10 years,
and just two companies dominate a full third of the national market. These
changes were supposed to make the industry more efficient, but instead
premiums have skyrocketed by over 87 percent.
Barack Obama will prevent companies from abusing
their monopoly power through unjustified price increases. His plan
will force insurers to pay out a reasonable share of their premiums for
patient care instead of keeping exorbitant amounts for profits and
administration. His new National Health Exchange will help increase
competition by insurers.
Lower prescription drug costs. The
second-fastest growing type of health expenses is prescription drugs.
Pharmaceutical companies are selling the exact same drugs in Europe and
Canada but charging Americans more than double the price. Obama will allow
Americans to buy their medicines from other developed countries if the
drugs are safe and prices are lower outside the U.S. Obama will also
repeal the ban that prevents the government from negotiating with drug
companies, which could result in savings as high as $30 billion. Finally,
Obama will work to increase the use of generic drugs in Medicare,
Medicaid, and FEHBP and prohibit big name drug companies from keeping
generics out of markets.
Fight for New Initiatives
Advance the Biomedical Research Field: As a result of
biomedical research the prevention, early detection and treatment of
diseases such as cancer and heart disease is better today than any other
time in history. Barack Obama has consistently supported funding for the
national institutes of health and the national science foundation. Obama
strongly supports investments in biomedical research, as well as medical
education and training in health-related fields, because it provides the
foundation for new therapies and diagnostics. Obama has been a champion of
research in cancer, mental health, health disparities, global health,
women and children's health, and veterans' health. As president, Obama
will strengthen funding for biomedical research, and better improve the
efficiency of that research by improving coordination both within
government and across government/private/non-profit partnerships. An Obama
administration will ensure that we translate scientific progress into
improved approaches to disease prevention, early detection and therapy
that is available for all Americans.
Fight AIDS Worldwide. There are 40 million
people across the planet infected with HIV/AIDS. As president, Obama will
continue to be a global leader in the fight against AIDS. Obama believes
in working across party lines to combat this epidemic and recently joined
Senator Sam Brownback (R-KS) at a large California evangelical church to
promote greater investment in the global AIDS battle.
Support Americans with Disabilities: As a former
civil rights lawyer, Barack Obama knows firsthand the importance of strong
protections for minority communities in our society. Obama is committed to
strengthening and better enforcing the Americans with Disabilities Act
(ADA) so that future generations of Americans with disabilities have equal
rights and opportunities. Obama believes we must restore the original
legislative intent of the ADA in the wake of court decisions that have
restricted the interpretation of this landmark legislation.
Barack Obama is also committed to ensuring that disabled Americans receive
Medicaid and Medicare benefits in a low-cost, effective and timely manner.
Recognizing that many individuals with disabilities rely on Medicare,
Obama worked with Senator Ken Salazar (D-CO) to urge the department of
health and human services to provide clear and reliable information on the
Medicare prescription drug benefit and to ensure that the Medicare
recipients were protected from fraudulent claims by marketers and drug
plan agents.
Improve Mental Health Care. Mental illness
affects approximately one in five American families. The National Alliance
on Mental Illness estimates that untreated mental illnesses cost the U.S.
more than $100 billion per year. As president, Obama will support mental
health parity so that coverage for serious mental illnesses are provided
on the same terms and conditions as other illnesses and diseases.
Protect Our Children from Lead Poisoning. More
than 430,000 American children have dangerously high levels of lead in
their blood. Lead can cause irreversible brain damage, learning
disabilities, behavioral problems, and, at very high levels, seizures,
coma and death. As president, Obama will protect children from lead
poisoning by requiring that child care facilities be lead-safe within five
years.
Reduce Risks of Mercury Pollution. More than
five million women of childbearing age have high levels of toxic mercury
in their blood, and approximately 630,000 newborns are born at risk every
year. Barack Obama has a plan to significantly reduce the amount of
mercury that is deposited in oceans, lakes, and rivers, which in turn
would reduce the amount of mercury in fish.
Support Americans with Autism. More than one
million Americans have autism, a complex neurobiological condition that
has a range of impacts on thinking, feeling, language, and the ability to
relate to others. As diagnostic criteria broaden and awareness increases,
more cases of autism have been recognized across the country. Barack Obama
believes that we can do more to help autistic Americans and their families
understand and live with autism. He has been a strong supporter of more
than $1 billion in federal funding for autism research on the root causes
and treatments, and he believes that we should increase funding for the
Individuals with Disabilities Education Act to truly ensure that no child
is left behind.
More than anything, autism remains a profound mystery with a broad
spectrum of effects on autistic individuals, their families, loved ones,
the community, and education and health care systems. Obama believes that
the government and our communities should work together to provide a
helping hand to autistic individuals and their families.
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