Hillary's Plan Will Be Affordable & It Is Markedly Different From Obama's
Submitted by Nick Kelly on February 28, 2008 - 10:02pm.
Barack Obama | Hillary Clinton | Mainstream Media | Health Care
Health insurance is quite expensive in America, but the rates Federal Employees pay are very reasonable in comparison to most. Indeed, they are even quite affordable for most working Americans. The rates paid by Federal Employees are also quite affordable for American employers, the largest of which Hillary's plan expects to either provide health insurance to their employees, or to contribute to the costs of their employees being enrolled in the Federal plan.
For 2008 the Federal Employees Health Benefits Program offers 14 health insurance plans to current and former federal employees such as your retired Senator and the staff at your local VA Hospital. The 2008 monthly premiums for those plans range from a low of $72.10 per month to a high of $580.28 per month. In between those extremes are the most popular plans (which happen to be administered by BlueCross/BlueShield) for which the monthly premiums are $84.79 for an individual to get "basic" coverage, $134.66 for an individual to get "standard" coverage, $198.61 for a family to get "basic" coverage, and $314.47 for a family to get "standard" coverage. These are the sorts of health insurance plans and rates that Hillary Clinton's American Health Choices Plan would make available to all Americans and all American employers.
Barack Obama's Plan for a Healthy America, may or may not offer similar monthly premiums on his proposed "new national health plan which will give individuals the choice to buy affordable health coverage that is similar to [n.b. but not the same as – ed. note] the plan available to federal employees." Furthermore, instead of being open to all Americans and all American employers, as Hillary's will be, his
new public plan will be open to individuals without access to group coverage through their workplace or current public programs. It will also be available to people who are self-employed and small businesses that want to offer insurance to their employees.
In other words, Obama’s new public plan may or may not be as affordable as the current Federal Employees Health Program, and it most definitely will not be available to all Americans or all American employers.
Therein rests the first huge difference between the two plans. Hillary’s plan offers everyone the chance to buy into the existing and very affordable Federal Employees Health Benefits Program (without the creation of any new Federal bureaucracy), and Obama’s plan does not.
The second enormous difference between the two plans is that Obama’s plan merely offers new subsidies to
Individuals and families who do not qualify for Medicaid or SCHIP but still need assistance
to buy health insurance from either existing health insurance companies or from his proposed new plan that he says will be “similar to” the existing Federal Employees Health Benefits Program.
Hillary’s plan instead provides that
If you’re one of the tens of millions of Americans without coverage or if you don’t like the coverage you have, you will have a choice of plans to pick from and you’ll get tax credits to help pay for it.
Those will be
premium affordability tax credit(s) that ensure… that
health premiums never rise above a certain percentage of family income
Hillary’s plan further promises to strengthen
Medicaid and the State Children’s Health Insurance Program to serve all low-income Individuals
(which she describes as those under 200% of the Federal poverty guidelines). She also plans to ensure that “public hospitals and community health centers… continue to receive support to serve vulnerable populations.”
In other words, Hillary’s plan protects all Americans from excessive health insurance premiums, and injects new strength and ease of entry into existing programs for the poor, while Obama’s plan will help some of the poor to buy health insurance from over 1500 health insurance companies, but do nothing to strengthen existing programs for the poor.
The third extremely significant difference between Obama’s plan and Hillary’s plan is that his plan has the potential to enrich a great many of the 1500 existing health insurance companies while her plan will reward only the few that are able to demonstrate both high quality service and low administrative costs. Thus, Hillary's plan is a brilliant step towards single-payer, and Obama's plan is nothing of the sort. I have discussed this in two previous diaries, and here is the link to the second of those for anyone who’s not yet read them.
A fourth difference lies not in the plans themselves, but rather the commitment (or lack thereof) to get them implemented in a timely manner. Obama says that his (already health insurance industry influenced) plan will be discussed and debated by all on CSPAN, and that some four years into his Presidency, he will implement whatever is left of it. Hillary, by contrast, is itching to implement her health care plan as quickly as possible. She says:
"We can have universal health-care because doctors and nurses and health care professionals and business and labor will finally say to the health insurance companies "ENOUGH"! You cannot run health-care in America any longer! Not one more day!"
She is obviously more than ready to take on the enemies of Universal Health Care, and she has an extremely well thought-out strategy to prevent them from denying the American people the health care that we deserve. Check out the end of this video: http://youtube.com/watch?v=oZYjp_onj14
There are other differences as well, some of which I mentioned in my previous diaries. Therefore, I find it completely reprehensible that most of the media are either too ignorant or too craven to point out these major differences. The notion that the only important difference is about mandates is completely misleading the American people.
Finally, it should be clear from the data and facts presented in this diary that the Obama campaign's slick mailers concerning Hillary's plan are outrageous distortions of the truth. It is far worse than a shame that Obama himself continues to support those distortions. Since Americans without health insurance are more likely to die than Americans with health insurance, it seems to me that distorting the truth about Hillary's excellent plan is an immorality every bit as deadly as the lies that convinced so many Americans that we had to invade Iraq.
I will never forgive George W. Bush for his distortions of the truth about Iraq, and if Obama persists in distorting the truth about Hillary's health care plan, I will never forgive him either. As for the media, they were complicit, to say the very least, in persuading the American people to believe Bush's lies. And they are so far doing exactly the same thing in persuading the American people to believe the Obama campaign's slick lies about Hillary's health care plan.
"experts" to pontificate about the weirdest things, and some genuine military experts like Wes to advise them regarding issues of warfare, but when it comes to the health care system (or most any other complex system, for that matter), they don't often seem to realize the need for expert systems advice. It's far easier for them to just over-simplify the situation in a way that appeals to their biases, whatever those may be. Of course the other problem is that it's very tough to make the differences I'm noting interesting to the average television viewer.
Still, it does seem like some reporter (in addition to the ever-valiant Paul Krugman) ought to try. Our Rube Goldberg health insurance system is costing people their lives.
Anyway, thanks again for your comment. All we can do is keep on blogging about this until someone with a big audience picks up on it. Or, better yet, until Hillary gets elected, and we can actually do something about it!
Nick Kelly
Wes Clark still could be the national security candidate.
reminded us on Wednesday that Hillary's plan is more affordable. Because everyone participates, it spreads the risk out over everyone, rather than the smaller pool of individuals who participate in Obama's plan.
Wes Clark Democrats...let the Clinton campaign know who sent you
Two groups are likely to opt out -- the poor if not properly subsidized, and the young and healthy. The assumption behind any insurance plan is that more people who don't draw benefits share the costs for those who do. If the young and healthy opt out, they're not helping their own futures when they WILL need benefits.
Stan Davis
Lakewood, CO
Wes Clark -- Make America All It Can Be!
number of insurance companies, by allowing the poor to use their new O proposed subsidies to buy health insurance from any health insurance company. That means that roughly 20 million poor people would be divided amongst at least the 1500 existing insurance companies. That is no sort of consolidated risk pool, and those insurance companies would all continue to need to charge their other enrollees high enough premiums to pay for the higher up-side average risk inherent in a smaller risk pool. It also means that there would be no savings in administrative costs, because all of those 1500 companies would continue to have to duplicate one another's administrative staffing, including collections, sales, etc.
In addition, it means that doctors offices and hospitals and pharmacies would continue to have to deal with some 17,000 different insurance plans. That is a very significant administrative nightmare for them, which they have to charge back to us through our health insurance premiums.
Hillary's plan, by contrast, would very likely consolidate all 47 million of the currently uninsured into one of roughly a dozen risk pools (e.g. the same insurance companies that currently administer the FEHP). That vastly reduces all of the above administrative costs and it also decreases the average up-side risk for the insurance companies involved. Hence, premiums can be much lower under Hillary's plan.
Nick Kelly
Wes Clark still could be the national security candidate.
People just don't realize how much health insurance cost until they have to start paying the premiums themselves. I have done that for almost 20 years. I know a couple (not yet on medicare) who are paying $1500.00 a month. Folks, that is $18,000.00 a year! Millions of people don't even make that much a year.
I equate Obama's plan of being voluntary to having a union shop and not requiring all the employees to join the union. How does that work?
as described in Hillary's proposed new plan:
The average family premium for
employer-based coverage (including employer and employee contributions) is over $12,000. For half
of Americans, this total premium accounts for at least one-fourth of their annual income.
Does anyone know what the average American family currently pays in Federal income taxes - the traditional boogie man of the Republican Party? I'll bet it's not much, if any, more than $12,000 per year. In other words, on the average, our health care premiums alone now cost us as much as do our Federal income taxes. And that doesn't take into account all the deductibles and co-pays, etc.
So, it's no wonder that some healthy individuals want to opt out of paying health insurance. They'd probably also like to opt out of paying Federal income taxes as well. But, clearly, if they did the latter, the rest of us would have to pay higher taxes to make up the difference. That's a significant part of what happens now with our health insurance premiums. We pay higher premiums because so many individuals opt out.
So the trouble with O's plan can indeed be compared to "having a union shop without requiring all the employees to join the union". First of all, that simply raises the dues of those who do join the union. Furthermore, it does not fully empower the union to offset the power of capital and management, just as O's plan does nothing to empower the people's Federal government to offset the financial power and management decisions of the health insurance industry corporations.
Nick Kelly
Wes Clark still could be the national security candidate.
"Health insurance is quite expensive in America, but the rates Federal Employees pay are very reasonable in comparison to most. Indeed, they are even quite affordable for most working Americans"
====
If you look up the costs of this program, you'll see that current premium costs for the Federal Program are around $10,000 per year for a family of 4 with most of it being paid by the Feds (I think employee pays something like around $200/month). This really isn't much different than working for other large companies that pay most of the premiums.
and thanks for the evidence that supports my point. The amounts charged Federal employees are not significantly different from the amounts currently charged working Americans in large corporations.
However, the majority of Americans do not now work for large corporations "that pay most of the premiums". Most working Americans now work either for small companies or for themselves. And those who work for large corporations are watching their benefits erode, including their health insurance benefits. That's the reality working Americans face, and Hillary's plan offers an affordable solution. A solution that ultimately relieves American businesses of a cost that most foreign businesses do not directly incur, which places our businesses at a distinct competitive disadvantage.
Nick Kelly
Wes Clark still could be the national security candidate.
Socialist healthcare horror story by Jerome a Paris Sat Dec 22, 2007
Today seems like an appropriate day to repost the text below, first posted on DKos last April. I can't help crying each time I read stories like Nataline's, or any other brought up by nyceve, because it does not need to be that way - just lives wasted for no good reason: money is not a good reason. In this case, Nataline's death is so appallingly unfair that one can only scream. Consider this my contribution to the outrage.
:: ::
I have not written a lot about my son since then because all seems to be going well, with quarterly exams showing nothing, and his having an almost normal life at school. No news is good news. He's very much looking forward to Christmas!
<!-- polls come after this -->
- Jerome a Paris's diary :: ::
As a reminder, my (then 4 years old) son was diagnosed 2 and a half years [ed - now 3+ years] ago with a brain tumor. He underwent surgery, then chemiotherapy for a year and a half. Early last year, he appeared to have been cured, but the tumor reappeared last autumn, and he underwent radiotherapy this winter. Next week we'll know how that is working. [ed - the news (back in May) were positive]
In the meantime, as a consequence of surgery, he is handicapped and only very partial use of one arm.
:: ::
He was first diagnosed by our pediatrician, a private sector doctor, who sent us to the (public) specialised pediatric hospital in Paris for additional exams. We did a scan and a MRI the same day, and that brought the diagnosis we know. He was hospitalised the same day, with surgery immediately scheduled for two days later. At that point, we only had to provide our social security number.
Surgery - an act that the doctor that performed it (one of the world's top specialists in his field) told us he would not have done it five years before - actually took place the next week, because emergency cases came up in the meantime. After a few days at the hospital, we went home. At that point, we had spent no money, and done little more than filling up a simple form with name and social security number.
Meetings with the doctor in charge of his long term treatment, and with a specialised re-education hospital, were immediately set up, and chemiotherapy and physical therapy were scheduled for the next full year.
Physical therapy included a few hours each day in a specialised hospital, with a varied team of specialists (kinesitherapy, ergotherapy, phychologist, orthophonist) and, had we needed it, schooling. As we lived not too far away, we tried to keep our son at his pre-school for half the day, and at the hospital the other half. Again, apart from filling up a few forms, we had nothing to do.
My wife pretty much stopped working to take my son to the hospital every day (either for reeducation or treatment) - and was allocated a stipend by the government as caregiver, for a full year (equal to just under the minimum wage). Had we needed it, transport by ambulance would have been taken care of, free of charge for us (as it were, car commutes to the hospital could also be reimbursed).
During the chemiotherapy, if he had any side effects (his immune system being weakened, any normal children's disease basically required him to be hospitalised to be given full anti-biotic treatment), we'd call up the hospital and just come around. Either of us could spend the night with him as needed. We never spent a dime.
After a year at the specialised hospital, ongoing re-education was moved to another institution specialised in home and school interventions. In practice, a full team of 5 doctors or specialists come to see him over the week, either at home or at school, to continue his treatment (such follow up, possibly less intense than at the beginning, will be needed until he reaches his adult size). Of course, they manufacture braces and other specialised equipment for him and provide it free of charge to us.
Check up exams take place every 3 months, with all the appropriate exams (usually including a MRI), and we've never had to wait for the appointments. Again, no cost for us, no funds to be fronted.
When he relapsed, our doctors considered all available options. In the end, the most promising technology was in another Paris hospital. Such technology, linked to nuclear research, exists only in 3 places in the world, one in Boston and one in Switzerland, so the French system itself was able to provide a cutting edge option. But had we needed to go to Germany, the UK or even the USA for treatment because that's where the best hope was, the costs of that would have been covered too by French social security.
Now that our son is in first grade, he has the right to special help for handicapped children at school (a fairly recent law), and he now benefits from part time help - a person who is around about 20 hours per week to help him do his work and catch up when he is absent for his therapy. This is paid by the city of Paris and the ministry of education.
Oh, and as he is officially handicapped, I recently discovered that we actually benefit from an additional tax break (in France, the taxes you pay are roughly divided by the number of people in the family; the handicap counts as an additional person for that purpose).
So, we did not have to spend a single cent. We got support to be available for him. He gets top notch treatment. We never had to wait for anything. And this is available to absolutely everybody in France, irrespective of your job, age or family situation. If you are badly sick or injured, you simply do not have to worry about money at any time, nor about lack of care.
An interesting twist to that story is that we do have private healthcare insurance in France. Basic healthcare is covered by social security, but only partly: except for the poor (under a certain income level), there are co-payments for most expenses like medecine and doctor visits, and doctors are also allowed to charge you more than the official tariff (and you have to pay the difference, in addition to the co-payment on the official price). Thus many people buy private (or mutual) insurance to cover that difference partly or fully. Such insurance is often provided by your employer. But whenever you have "major" expenses, you switch to 100% coverage of expenses by the public system - except that, if you had a private insurer, it has to pay to the public entity a portion of the costs. In my case, as I had a good insurance via my bank, this is what's happening, and thus the private sector bears a portion of "catastrophic risk." (And they have no say in what care is provided. They just pay an agreed fraction of it.)
Thus there is solidarity across the sytem.
:: ::
This is not to say that all is well in French healthcare. As in other countries, costs are barely under control, spending increases every year, and there are many ways the system could be improved for doctors, nurses and patients. But the fact remains that if you are badly ill, you will be taken care of; you will not need to give up your job (or if you do, you're helped); you will not need to sell your house; and you will not be denied healthcare (see my second comment below).
It's been tough enough to deal with a sick child; I simply do not want to imagine what it would have been like if I had to beg for care or to scurry around for money in addition. It's just inconceivable. And thus, I was happy to pay taxes before, and I'm really, really happy to pay taxes now to provide that level of care for those that really need it.
synthetic environment Republican Health Care Plan : Be Rich or Die
I have a niece who years ago married a Frenchman who was living and working here in America. They both wanted to stay here, but moved to France because they needed very expensive health care services in order to have a child. Today they have a wonderful and brilliant son whom they never could have afforded to have if they had remained in America.
Perhaps one day their son will find the cure for cancer, or lead the world to peace.
It's a terrible shame and a great waste of potential talent that America allows so many of her sons and daughters to suffer and die and even not to be born because of our lack of a universal health care system.
Nick Kelly
Wes Clark still could be the national security candidate.
environmental toxic burden we all carry; and if you have read the toxic burden every child carries in the womb before even born it will make you cry to think of it;
synthetic environment Republican Health Care Plan : Be Rich or Die
Thanks Nick, for all the work you've done with these posts on health care. I've benefitted greatly from your sharing of your experience in this arena. You're right, these are very significant differences that haven't been discussed by the media, but discussing issues of substance doesn't really seem to be a big interest of theirs, does it?