Health Insurance
(Part Two)
Lower Costs by Modernizing the U.S. Health Care System
(1) Reducing Costs of Catastrophic Illnesses for Employers and Their Employees.
Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers’ premiums.(2) Lowering Costs by Ensuring Patients Receive and Providers Deliver Quality Care:
Helping Patients.
Support Disease Management Programs:
Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. This will improve quality of care, give doctors better information and lower costs.Coordinate and Integrate Care:
Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. Obama will improve coordination and integration of care of those with chronic conditions by making sure programs are fully implemented and encouraging team care.Require Full Transparency about Quality and Costs:
Obama will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care. Health plans will also be required to disclose the percentage of premiums that go to patient care as opposed to administrative costs.Ensuring Providers Deliver Quality Care:
Promote Patient Safety
. Obama will require providers to report preventable medical errors and support hospital and physician practice improvement to prevent future occurrences.Align Incentives for Excellence:
Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded based on how effectively they treat patients.Comparative Effectiveness Research:
Obama will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.Tackle Disparities in Health Care:
Obama will tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. He will also challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and making the health workforce more diverse.Reform Medical Malpractice:
Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and will promote new models for addressing errors that improve patient safety, strengthen the doctor-patient relationship and reduce the need for malpractice suits.(3) Lowering Costs Through Investment in Electronic Health Information Technology Systems:
Most medical records are still stored on paper, which makes it hard to coordinate care, measure quality or
reduce medical errors and which costs twice as much as electronic claims. Obama will invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems, including electronic health records, and will phase in requirements for full implementation of health IT. Obama will ensure that patients’ privacy is protected.(4) Lowering Costs by Increasing Competition in the Insurance and Drug Markets:
Increase Competition:
The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. There have been over 400 health care mergers in the last 10 years, and just two companies dominate a full third of the national market. These changes were supposed to make the industry more efficient, but instead premiums have skyrocketed by over 87 percent. Barack Obama will prevent companies from abusing their monopoly power through unjustified price increases. His plan will force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration. His new National Health Exchange will help increase competition by insurers.Lower Prescription Drug Costs:
The second-fastest growing type of health expenses is prescription drugs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Obama will allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama will also repeal the ban that prevents the government from negotiating with drug companies, which could result in savings as high as $30 billion. Finally, Obama will work to increase the use of generic drugs in Medicare, Medicaid, and FEHBP and prohibit big name drug companies from keeping generics out of markets.OBAMA’S RECORD
Health Insurance:
In 2003, Barack Obama sponsored and passed legislation that expanded health care coverage to 70,000 kids and 84,000 adults. In the U.S. Senate, Obama cosponsored the Healthy Kids Act of 2007 and the State Children’s Health Insurance Program (SCHIP) Reauthorization Act of 2007 to ensure that more American children have affordable health care coverage.Women’s Health:
Obama worked to pass a number of laws in Illinois and Washington to improve the health of women. His accomplishments include creating a task force on cervical cancer, providing greater access to breast and cervical cancer screenings, and helping improve prenatal and premature birth services.
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