Barack Obama and the Health Care Issue in the US

Dear Fellow Americans, Sick and Well,

My question, when I think about the issue of health care in the United States, is a simple one.

Should the richest country on earth allow it's 47 million poorest citizens to be without health insurance? The statistics on this come from Income, Poverty, and Health Insurance Coverage in the United States: 2004. That 47 million is 15.7 percent of the total population and includes, probably, most of the 12.7 percent of the population that lives in poverty.

I think that another critical question is whether or not being without health insurance is the same thing as being without health care. That distinction is subtle but important, because my concern isn't about insurance. Insurance is paperwork and, in a way, a straw man. What is important is that people can get health care when they need it and are not discriminated against when they do not have health insurance. Perhaps as we try to think through the problems related to health care in the U.S., a solution might be found outside of the insurance box.

Obama says:

• Reduce costs for employers and businesses by having the government pay for certain high ticket health care items.


• Build a system of health risk prevention.


• Improve quality of care.


• Move to a system based on information technology, computerizing record keeping.


• Break the stranglehold of insurance and drug companies.


• In the process of setting up a new system, get all concerned parties "around the table" to draft the program.

This is a nice video. It is both personal and filled with ideas. They are good ideas, but even Obama admits that they are not the only ideas and that other ideas will play a part in building a new health care provision network. He does promise that he will redo the system by the end of his first term in office. Hm.m.m. Have I heard that before? It is an enormous task. He'll have to work really hard to do that.

Obama says, insurance companies and drug companies should have a seat at the table but they shouldn't be able to buy every chair. Click this link to see a long but casual and informative video that ends with a little discussion on how Obama will build a coalition of groups to plan health care changes.

I guess there is another big question related to all of this. How do we pay the bill? That is the hard part of all of this. I think that many countries that have a socialized form of medical care for its citizens have faced these hard questions. I am in favor of limits to coverage. I don't think any politician likes to talk about that. There is much waste and inefficiency in the way we go about treating the sick. Certainly we have made great advances in the treatment of disease, but some of those advances are so over the top that people have to make living wills in order to avoid heroic and unnecessary treatments.

We need a systemic overhaul of our systems, health care and health care insurance. Barack Obama wants to do an overhaul.

• Obama's goal is to expand government-provided health care and create a form of “managed competition".


• Obama supports expanding SCHIP and Medicaid eligibility.


• Although Obama does not support a health insurance mandate for adults, he does support a mandate for children and young adults (any one 25 or under).


• Obama’s goal is to increase health care access, he would support a “pay-or-play” mandate.


• All but the smallest employers would be required to provide health insurance; those who didn’t would be compelled to pay into a national fund covering these uninsured workers.


• The mandate would likely require a minimum benefits package.
• Overall, Obama is pushing towards more government provided health care and more regulation.

BRD