Thursday, February 14, 2008

Obama-mania: Part 2

Continued from Part 1. As before, all quotes are taken from Obama's website.

"My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less." - Barack Obama

And his plan to do this? First:
"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." - Obama's website

This is an idea I both like and dislike at the same time.

I like this idea because I personally believe that catastrophic healthcare costs should be handled by the government, and Obama's plan actually works in a good way.

I dislike this idea because it leaves the impression that we will somehow be paying less. While it may save us money in premiums, it will also cost us money in taxes. Moving an expense to a different column doesn't save money.

The second part of Obama's plan, called "Helping Patients", is mostly a bunch of nice sounding ideas that are pretty vague on specifics. However, one part is worth noting:
"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." - Obama's website

Great idea! More government paperwork to fill out! Of course, compliance with this WILL cost money. Doctors, hospitals, and insurance companies will have to hire staff to fill out the new paperwork, which means another increase in healthcare costs passed along to the consumer. Not to mention another layer of government bureaucracy to process all this paperwork, which will be paid for by your taxes.

But what is truly great about this part is the "quality" aspect. Fear of malpractice lawsuits clearly don't do enough to prevent "medical errors". We need more government to do that!

Unfortunately, Obama is big on the "quality" healthcare thing, as his third part is dedicated to it. Most of the third part sounds nice, but is light on specifics. But one part scares me:
"[Obama] 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." - Obama's website

Note the last part in bold. Exactly how will affirmative action programs for our healthcare workers help anything? We will get better quality healthcare if we lower the standards to allow more minorities into healthcare?

The fourth part of Obama's plan is actually a decent idea:
"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." - Obama's website

This is one of those rare cases where spending public money could result in something useful.

The fifth part of Obama's plan is flawed in it's reasoning:
"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." - Obama's website

The reason premiums have skyrocketed is NOT because of insurance company mergers. The reason is because most Americans have public or private health insurance, and little reason to shop their healthcare around. So they go to doctors or pharmacies who take their insurance, with no regard to cost. They use the healthcare system regardless of whether they NEED it, thereby creating a greater demand for healthcare. Under the very simple laws of supply and demand, we know that when demand goes up while supply remains constant, prices will also rise. Obama (and most of Washington) ignore this fact.

Let's see where Obama's ignorance will take us:
"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." - Obama's website

By limiting profits for these companies, he will also restrict investment capital in new companies to compete with the existing companies. The great irony here is that he will be ensuring the monopoly status of the existing companies. His own idea shoots itself in the foot.

The next part is almost as stupid:
"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."

Tha last part in bold is the truly insane idea, because that will kill drug research in this country. Without the ability to market new drugs exclusively for a period of time, drug companies will have no incentive to research new drugs. The pipeline of innovative new drugs will come to a screeching halt.

Which brings us to Obama's "Fight for New Intiatives":
"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." - Obama's website

So as soon as Obama kills all private investment in medical research, federal funding will be the only source of new treatments. Translation: Instead of wealthy investors taking risks on researching new treatments, the risk will be transferred to the American taxpayer. Instead of stockholders holding companies accountable, it will fall to government bureaucrats instead.

Personally, I consider these two separate issues which he lumps into one because of "climate change" (note that it is no longer called "global warming").

Actually, this is one of the few areas I agree with Obama's plan, even if I don't agree with his reasons for it. We do need other energy sources. If government funding and tax incentives will help get us there, so be it.

The only areas I take exception with Obama's plan is his lack of any plans for expanding oil drilling within the U.S., as well as ignoring nuclear power as a potential source of power generation in this country.

Obama's plan here is right on the money, except for the last part below:
"Create Secure Borders
Obama wants to preserve the integrity of our borders. He supports additional personnel, infrastructure and technology on the border and at our ports of entry.

Improve Our Immigration System
Obama believes we must fix the dysfunctional immigration bureaucracy and increase the number of legal immigrants to keep families together and meet the demand for jobs that employers cannot fill.

Remove Incentives to Enter Illegally
Obama will remove incentives to enter the country illegally by cracking down on employers who hire undocumented immigrants.

Bring People Out of the Shadows
Obama supports a system that allows undocumented immigrants who are in good standing to pay a fine, learn English, and go to the back of the line for the opportunity to become citizens.

Work with Mexico
Obama believes we need to do more to promote economic development in Mexico to decrease illegal immigration.
" - Obama's website

In order to "fix" Mexico's economic problems, he will first have to rid their government of corruption. Short of taking over Mexico, I don't see that happening.

To be continued...

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