Obama seeks universal coverage, cheaper drugs

October 7, 2008



Senator Barack Obama promises healthcare coverage for every qualified U.S. resident, though a closer analysis suggests he would require coverage for all children and allow some adults to voluntarily go without insurance.

Obama would keep the current employer-paid healthcare scheme. Premiums would be lowered for individuals and families that already have health insurance. He promises coverage for uninsured patients, including those with preexisting conditions. The plan would be financed by eliminating the Bush-enacted tax breaks for those earning more than $250,000 per year, which may not be welcomed by the typical high-income radiologist.

The Obama national health plan features guaranteed eligibility; comprehensive benefits; affordable premiums, copayments, and deductibles; and subsidies for individuals and families who do not qualify for Medicaid or the State Children's Health Insurance Program. Insurance companies participating 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.

All children would be covered. Young adults would choose from various options including coverage from their parents' plans. Medicaid and SCHIP would be expanded, and state-level initiatives would not be discouraged.

Obama would also create a National Health Insurance Exchange to help individuals purchase private health insurance. Employers who do not offer healthcare benefits would be required to contribute a proportion of their payroll to help cover the costs of the national plan.

Hospitals and providers would be required to collect and publicly report cost and quality information, including data about preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care.

Obama would establish an independent institute to guide reviews and research on comparative effectiveness, so patients and their doctors would have accurate and objective data to make the best decisions for their health and well-being.

Like his opponent, Obama strongly supports electronic health technology. He promises to invest $10 billion annually for five years for a standards-based electronic health information system, including electronic health re¬cords, and would phase in requirements for national implementation of healthcare IT.

Obama promises to inject competition into the insurance and pharmaceutical industries. His plan would require a reasonable share of insurance premiums to be spent on patient care, rather than profits and administrative overhead. He would drop the ban that forbids the government from negotiating with drug companies, which he estimates could save the government up to $30 billion.

Obama supports funding for the NIH and the National Science Foundation. He promises to strengthen funding for biomedical research and to improve the efficiency of that research through improved coordination within government and through private-public partnerships.

He backs continued federal commitment to fight the worldwide AIDS epidemic, more support for disabled residents, parity in coverage for serious mental illnesses and physical ailments, a policy to reduce lead and mercury poisoning, and $1 billion for autism research.

--JB