Obama's Healthcare Agenda

The Obama modus operandi is very simple: pronounce broad themes, have Congress draft the expensive, government-growing implementation, and then slam it through before anyone has the chance to read or analyze it.

It’s worked so far: on the bailouts, the State Childrens Health Insurance Program (SCHIP), and the so-called “stimulus.” Congress is now going down that path on the budget. Next up: healthcare.

Healthcare was a hot topic during the campaign, but little has been done about it in the first 100 days except for a brief White House health “summit” in early March.

Right now Obama has set aside $634 billion over the next 10 years to pay for an “overhaul” of the healthcare system.

But what is that “overhaul” likely to do? The official White House website outlines some of the details of the Obama-Biden Healthcare Plan.

According to the website this plan will provide “affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors, and plans. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.”

They also say that this plan allows you to keep your current insurance if you like it and “your costs will go down by as much as $2,500 per year.” For those that don’t have health insurance then they “will have a choice of new, affordable health insurance options.”

Many public policy experts and researchers on the left are weighing in on the president’s plan. The one conclusion that they can’t avoid is that it will be awesomely expensive. The Obama plan is aimed at providing more access to more medical services. And you can’t provide more care without more cost.

An article by Henry J. Aaron, a senior fellow for The Brookings Institute, discusses some of the aspects of the president’s plan. He starts off by saying that the reserve fund “would not have to cover the costs of some important healthcare reforms already enacted and paid for. These include the extension of health insurance to about four million children, the introduction of health information technology to hospitals and physicians’ offices and the expansion of studies of the cost and effectiveness of alternative ways of treating various illnesses.”

So we know what it may not cover, but what exactly will the money cover? Aaron says that is still to be determined. He believes that it is too soon to know for sure and says that some in Congress, especially Sen. Ted Kennedy (D-MA) “would like to see one large bill that sets in motion solutions to the three major problems of US healthcare: a lack of insurance coverage (17% of the non-elderly population is without health insurance); mediocre quality of care (many Americans think US healthcare is the best in the world, but hard evidence on medical errors and failure to deliver standard care contradicts this belief); and staggeringly high expenditures.”

At the Center for American Progress, Robert A. Berenson and Ellen-Marie Whelan have identified what they call the “core elements of the emerging health reform package.”
The first is “Insurance coverage expansion,” which means that health care insurance coverage will be provided for all Americans. How this will happen and who will provide it were not specified.

The next tenet is “Delivery system reform and payment innovation.” This vague name is followed by a vague description in which it is describes as “Integrated delivery systems, in which physicians play a leadership role, can promote collaborative team-based care to better serve patients’ complex care needs, especially in the area of primary care and chronic care management.”

The next two elements include “prevention and wellness” and “chronic care management.” The last element they identified was “comparative effectiveness,” and is described as permitting “patients and their health professionals to make better decisions about care based on evidence.”

As this is written, news reports say that one of the worst parts of the liberal approach – establishing a “single-payer” government-run healthcare system – may not be part of the legislation. Because there is considerable opposition to this approach on Capitol Hill, the administration may – not “will” – back away from it. Which is not to say either Congress or the White House won’t insist on it before the bill passes, or in other legislation before year’s end.

So far there has been no publication of an actual health care plan, or concrete definition of what Obama’s healthcare plan involves and will do to change the way Americans pay for medical services. When it comes out, we’ll be watching.