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COVER STORY

Obama’s health reform plan:

Forget all the shouting – here are the facts By AMADEO CONSTANZO health@baycurrents.net

There have been plenty of heated debates over President Obama’s health reform plan. Most of the shouting at town hall meetings across the country – including a little friction at a Marine Park senior center meeting hosted by Congressman Anthony Weiner – is based on misrepresentation of the proposed reform legislation by Obama and Congressional Democrats.

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et’s clarify some common misunderstandings of the proposed health-insurance overhaul. For one thing, it’s not “socialized medicine.” Under socialized medicine prevalent in Europe, hospitals and doctors are government employees (although still highly paid ones). It’s really a misnomer to call the present controversy health care reform – it’s actually health insurance reform. Another common fear is that the Democrat-proposed bill would infringe on individuals’ freedom to choose their doctor or their health insurance. “We should have a choice,” said Arlene of Bensonhurst. “Countries like England have a nice system, but they don’t really have many choices. We should have a choice.” Actually, the proposed legislation allows for private insurance to be available in addition to the new option of public health insurance. It’s a key reason why the American Medical Association, previously a strong opponent to health insurance reform – has come out in support of Obama’s plan. The president has said on many occasions, “If you like your doctor, you’ll be able to keep your doctor. If you like your healthcare plan, you’ll be able to keep your healthcare plan.” Saying that the new plan would “pull the plug on grandma” is another fear-laden misinterpretation of the plan. This misinterpretation was widely proclaimed by Republican Senator Charles Grassley. “We should not have a government-run plan to decide when to pull the plug on grandma,” Grassley told an audience in Iowa. All that the bill actually proposes is merely to ensure that a patient’s wishes under his or her “living will” – whether to prolong the patient’s life with advanced equipment – is clearly communicated and accurately followed by health care providers. Grassley later retracted his statement. Recently, there has been much speculation that President Obama intends to eliminate the option for government-provided insurance as a compromise to gain some Republican support in Congress, offering instead an option to get insurance from a co-op organization, essentially a non-profit insurance company. Health and Human Services Secretary Kathleen Sebelius said that a government alternative to private health insurance is “not the essential element” of the administration’s health care overhaul. The White House would be open to co-ops, she said Under a proposal by Democratic Sen. Kent Conrad of North Dakota, consumerowned nonprofit cooperatives would sell insurance in competition with the private companies, similar to the way electric and agriculture co-ops operate, especially in ruVisit us at: www.BayCurrents.net

ral states such as his own. With $3 billion to $4 billion in initial support from the government, the co-ops would operate under a national structure with state affiliates, but independent of the government. They would be required to maintain the type of financial reserves that private companies are required to keep in case of unexpectedly high claims. “I think there will be a competitor to private insurers,” Sebelius said. “That’s really the essential part, is you don’t turn over the whole new marketplace to private insurance companies and trust them to do the right thing.” “A co-op system doesn’t sound much different from a public option, but I think we need government involvement in order for any kind of meaningful reform to take place,” said Tibby, a former Brooklyn resident. Many Democrats in Congress are furious at the hint of potentially eliminating the public option. In response, the Obama administration sternly holds to the public option in several statements. “The president is committed to the public option,” Melody Barnes, the White House director of domestic policy, said in an Aug. 19 conference call with the National Council of Jewish Women. An Obama administration memo states, “The bottom line is this: Nothing has changed.”

Provisions of Obama’s Healthcare Reform

also be an expansion and improvement of graduate medical education and medical training.

• Employer-Provided Insurance Large companies would be required to choose one of two options: 1. Provide health coverage for employees, or 2. Contribute to their employees’ health coverage (whichever plans the employees choose.) Employers who fail to do so would have to pay a penalty of up to 8% of their payroll. Small employers (with a payroll of less than $250,000) are exempt from this requirement.

• The Costs bursement rates for primary care services. The Medicare “donut hole” – the coverage gap by which Medicare recipients have to pay for their medication for a brief period – would be eliminated.

• Investing in the Medical Workforce To prevent a shortage of doctors and health care professionals due to an increased number of Americans being covered, more scholarships and loans would be made available for people entering various medical professions. There would

There has been much discussion over how the costs of the health plan would be covered. The Obama administration and Democrats in Congress have not clarified exactly where the money would come from, but have suggested that premiums could be a key source. They’ve also hinted that bonds could provide much of the funding, but that option has been criticized by Republicans saying this would be like taking out a mortgage to pay for groceries. At this point, little is certain about how the reforms would be paid for.

• Public Health Insurance This government-run health insurance (funded by premiums) would be available to compete with existing private health insurance companies. Affordability credits will be available on a sliding scale system. (Affordability credits financially help those who can’t afford to pay for health insurance. The lower your income, the more affordability credits you would have.)

• Health Insurance Exchange This would be a marketplace for individuals and small businesses to compare and shop for health insurance. There would be mechanisms here for consumer protection and fraud prevention. This is also where affordability credits would be administered.

• Elimination of Discriminatory Practices Based on Health Condition It would be illegal for insurance companies to exclude anyone from starting or renewing coverage because of a pre-existing condition.

• Prevention of Bankruptcy from Medical Expenses for Individuals Insurers would no longer be allowed to put a cap on the amount of benefits received by an individual. However, there would be a cap on out-of-pocket medical expenses by an individual.

• Improving Medicaid and Medicare Health care provider participation in Medicaid and Medicare would be increased, improving access to care for low-income families, the disabled, and the mentally ill. To do so, there would be increases in reim-

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August 24  September 10

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Volume 6 Issue 02  

Brooklyn, NY community newspaper

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