Barack Obama
In response to CWA's questionnaire, Barack Obama said the following about health care:
I believe that every American has the right to affordable, comprehensive and portable health coverage. My plan will guarantee coverage for every American through partnerships among employers, private health plans, the federal government, and the states. My plan both builds on and improves our current insurance system, which most Americans continue to rely upon, and leaves Medicare intact for older and disabled Americans. Under my plan, Americans will be able to maintain their current coverage if they choose to, and will see the quality of their health care improve and their costs go down. My plan also addresses the large gaps in coverage that leave 45 million Americans uninsured. Specifically, my plan will: (1) establish a new public insurance program, available to Americans who neither qualify for Medicaid or SCHIP nor have access to insurance through their employers, as well as to small businesses that want to offer insurance to their employees; (2) create a National Health Insurance Exchange to help Americans and businesses that want to purchase private health insurance directly; (3) require all employers to contribute towards health coverage for their employees or towards the cost of the public plan ; (4) mandate that all children have health care coverage; (5) expand eligibility for the Medicaid and SCHIP programs; and (6) allow flexibility for state health reform plans.
Under my plan, the medical system as a whole will save money; we will realize tremendous savings within the health care system from improving efficiency and quality and reducing wasted expenditures system-wide. Specifically, these savings will result from investments in health information technology, improvements in prevention and management of chronic conditions, increased insurance industry competition and reduced industry overhead, the provision of federal reinsurance for catastrophic coverage, and reduced spending on uncompensated care.
For example, today administrative costs in private insurance average 14 percent of benefits. I will considerably reduce insurance industry overhead by instituting the National Health Insurance Exchange, which will provide purchasing pools, standardize insurance packages, reduce marketing expenses, and promote competition. It has been estimated that this innovation will save upwards of $46 billion per year.
Moreover, there is significant room for savings by investing in health information technology. Even by conservative estimates, it has been predicted that such investments could save $77 billion per year long-term. I propose we spend $10 billion per year, for five years, to accelerate adoption of health IT so that we can harness these much greater savings more quickly.
Finally, better care management has the potential to save significant amounts of money as well. A RAND study has predicted that roughly $120 billion can be saved by improving our efforts regarding prevention and disease management. My plan commits to promoting healthier lifestyles in schools, the workplace, and the home, as well as preventive services, disease management, care coordination, and other efforts.
Under my plan, we can expect to save roughly $200 billion. And these are only conservative estimates. This translates into savings of up to $2,500 for the typical family. Other researchers estimate substantially larger possible savings.
In addition to using these savings from within the healthcare system, the additional federal costs of the subsidies would be paid for by allowing the Bush tax cuts to expire for people making more than $250,000 per year, as they are scheduled to do.
Finally, my plan will help, not hurt, U.S. businesses. All but the smallest businesses will be asked to contribute to the larger health care system, either through participation in an employee health plan or contribution to my national plan. So if employers are already currently providing quality coverage to their employees, they will not have to make a contribution; if they are not, they will have to contribute unless they are especially small in size. Moreover, under my health care plan, federal reinsurance will be offered to employer health plans to help ensure that unexpected or catastrophic illnesses do not price health insurance out of reach for businesses and their employees. For many small businesses in particular, having a single employee with catastrophic expenditures can make insurance unaffordable for all of the workers in the firm. My plan will reimburse employer health plans for a portion of the catastrophic costs they incur above a certain threshold – if they guarantee that such savings will be used to reduce the cost of workers’ premiums. Providing reinsurance for catastrophic coverage will also reduce premiums.