by Freedom, Mon Feb 11, 2008 at 08:51:12 PM EST
Since currently there are some discussion on the healthcare plan of the two democratic candidates on this site, I thought of posting the following that I came upon while doing some research on the subject.
It comes from MedPage Today:
On their Web sites, the candidates offer lengthy tomes on how they envision medicine of the post-November world, and in debates they have squabbled, for instance, over mandates for all or some. But specifics are hard to come by.
Ironically, Hillary Clinton has spent years trying to live down the humbling defeat of the Clinton administration health plan of the 1990s, which was criticized as too complex and, indeed, threatened to micromanage one-seventh of the nation's economy. The present-day Clinton campaign says many of the details of the senator's plan will have to be worked out in congressional committees.
That's true of any health plan. Congress will insist on a major role in deciding the future of American healthcare. Lobbying groups representing the major players in the industry -- health professionals, pharmaceutical companies, and health plans -- will try to exert their influence before any legislation passes.
Still, the lack of information about how the plans will directly affect physicians is frustrating. Repeated requests to the campaigns are rebuffed, for example, on details about how they might reform the Medicare pay formula, where physicians face annual cuts and Congress rides to the rescue to restore them at the last minute. So far, no campaign has responded with any specifics.
Neither have they gotten specific about how they would try to fulfill promises of improved efficiency and reduction of fraud and waste in the healthcare system.
One Clinton healthcare adviser is Jonathan Gruber, Ph.D., a professor of economics at the Massachusetts Institute of Technology. A member of the Institute of Medicine and former Deputy Assistant Secretary for Economic Policy at the Treasury Department, he's written extensively about healthcare policy.
Austan Goolsbee, Ph.D., a professor of economics at the University of Chicago Graduate School of Business, has been a top economics adviser to Obama since he ran for the Senate. A member of the Panel of Economic Advisers to the Congressional Budget Office, he helped formulate Obama's healthcare plan.
For McCain, his top domestic adviser is Dan Crippen, Ph.D., who headed the Congressional Budget Office for four years, retiring in 2003. Dr. Crippen was a domestic policy adviser to Ronald Reagan.
Democrats: Mandates for all or just some?
Barack Obama and Hillary Clinton have health plans with only subtle differences. But those positions are disguised by the fierce accusations they and their supporters hurl at each other.
Both promise affordable universal coverage through a mix of private and public insurance. However, both insist they don't want a government-run scheme and they dismiss non-specific Republican accusations of "socialist medicine." They favor "shared responsibility" among patients, insurers, pharmaceutical companies, employers, health plans, health providers, and government.
Clinton and Obama both would require large employers to provide insurance coverage or contribute to the cost of employees' coverage. Both would prevent plans from denying coverage to patients with pre-existing conditions or charging them higher rates.
Just how would all this work, and what would it cost? Where would physicians fit in? Don't ask.
Clinton and Obama each would create public plans that would compete with private ones. They'd expand government programs such as Medicaid and the State Children's Health Program. Tax credits or subsidies would be provided to those who can't afford insurance. Both candidates describe health plans and pharmaceutical companies as the "powerful special interests" they'll battle to achieve reform.
They'd insist that Medicare negotiate directly with pharmaceutical companies for lower prices. Both say they'd pay for their plans by rolling back President Bush's tax cuts on the wealthy and through greater efficiency by promoting prevention, electronic health records, and other reforms. Neither favors caps on malpractice awards for pain and suffering promoted by the American Medical Association.
So what's the big fight about?