The cornerstone of Barack Obama’s presidential campaign seemed to be his Health Care Reform. This bill entails the following:

I have Health Insurance –

  • You can keep your existing insurance and doctor if you want
  • Insurance companies will not be allowed to deny coverage due to a pre-existing condition (not for another 4 years)
  • Insurance companies will not be allowed to drop you when you get sick
  • There will no longer be a cap on the amount of coverage you can receive (yearly/lifetime)
  • There will be a limit for “out-of-pocket” expenses
  • Insurance companies will be required to cover check-ups and preventive care (mammograms, etc.)

It looks like he’s a bit peeved at the Insurance Industry – rent out or download The Rainmaker or even get a copy of the book by John Grisham. He tackles the problem of the Insurance Industry and reveals them for being fraudulent and downright evil! The movie has Matt Damon, Danny DeVito and Mickey Rourke. One interesting part in the movie comes when the court learns that this particular insurance company rejects ALL claims for a year!

I don’t have Health Insurance

  • If you change or lose your job or start your own business, you will be covered
  • An Insurance Exchange or Marketplace will come into effect enabling people to “shop” for insurance at competitive prices
  • Tax credits will be provided for small businesses and individuals
  • Low-cost coverage for people with pre-existing medical conditions (Senator John McCain’s idea)
  • Insurance companies kept honest by making a not-for-profit public health insurance option

For everyone:

  • “I will not sign a plan that adds one dime to our deficits – either now or in the future”
  • Plan can be paid for by finding savings within the health care system
  • Independent medical experts employed to identify fraud, waste and abuse
  • Medical malpractice reform project

It sounds like a good plan – here in Ireland we have a system that aids but also hinders. If you are within a certain wage bracket, have a disability or are elderly you are eligible for a Medical Card provided by the Health Service Executive. This card entitles you to free health care regardless of your situation within public services. Unfortunately a lot of people lie on their forms and it’s possible to see someone driving around in a new Range Rover with a medical card! The other alternative is obtaining health insurance from a range of different companies, unfortunately the majority of people who cannot afford the coverage simply go without. A doctor’s visit ranges between 30 and 50 Euro depending on where you go. Any other tests are extra. If you need prescription drugs and you don’t have a medical card, be prepared to pay for it. About a year ago I suffered from a peptic ulcer and I was informed by my doctor (after paying €40) that I need a few tablets – when we got to the Pharmacy we were forced to shell out nigh on €100 for the 6 pills! The problem in this country is that the Pharmacy’s are allowed to get away with theft and charge what seems to agree with them any given day. Over the border in Northern Ireland (part of the UK), there is a flat rate for prescription drugs – roughly £6. It’s about time something happened over in the States.

Of course not everyone likes Obama’s plan. Those who are against the Health Reform are not letting their feelings subside, recently House Minority Leader John Boehner said that the next 24 hours are “armageddon” because the health care bill proposed by Democrats will “ruin our country,” – speaking the day before the bill was voted on. I always thought that Armageddon would spell the end of the world, not pave the way for millions of less-fortunate people to obtain medical care – maybe I’m wrong. On the other side of the coin most of these politicians have their campaigns funded by…Insurance companies – maybe not directly but if the money is traced, it will undoubtedly find its way back to the board rooms of these insurers.

Naturally Obama’s plan is stacked against the odds. In a country with the most expensive health-care system globally, it’s obvious that millions of people cannot afford to see a doctor, let alone have necessary surgery. In the US, on OECD estimates, healthcare expenditure is close to 17% of the GDP. Why is this figure so high?

  • Have you seen Supersize Me? There are high rates of preventable disease among Americans and their supposed love affair with junk food
  • Huge cost of privatised care
  • Health insurance companies run for profit grossly inflate the cost of medical care
  • A study by academics from the Harvard Medical School and the Canadian Institute for Health Information found that almost one third of healthcare spending – 31 per cent – is gobbled up by their administrative overheads and profits.

Obama aims to create millions of new customers for the insurers by subsidising Americans on low and middle incomes to take out policies. But are there loopholes? Already I can see one – US reforms will ban insurers from denying coverage to people with pre-existing medical conditions…but not for another four years. No doubt insurance companies will fight tooth and nail (in 4 years time) to argue that your claim is void because your pre-exiting condition was flagged on their books before the Health Reform came into effect. Take this estimate for example: $350 billion was spent by insurance companies on finding ways to avoid coverage and deny claims – a sum equal to just under 2 per cent of US GDP. Needless to say insurance companies will hike their rates as they seek to rake back the cost of compulsory insurance of the sick by hitting the healthy.

Obama reckons that since you won’t pay any extra “dime[s]” everything will work out. But how can it? The government will have to pick up the tab and how does this help the fiscal burden of the country? Or will there be an extra tax thrown in somewhere – it could  come under the guise of taxing the most expensive insurance policies (Cadillac Plan). Obama states that there is millions of dollars lost in waste and fraud within the system and that unwarranted subsidies in Medicare goes to insurance companies – is he attacking the greed of the insurance companies? the greed of corporate America?

His Health Reform is designed to move more people into private health insurance. But the centrality of private health insurers is part of the problem in the US, not the answer. Is he leading the lambs from, or to the slaughter?


2 responses to this post.

  1. Interesting piece Damien. I think a lot of the debate in the US around HCR centres around fear. About socialism, gov’t over-reach, abortion and it’s clearly been a partisan football. What is clear is the passage of the bill is a landmark event. The Clinton administration w/ Hillary tried and along with Social Security they saw that HCR was like a third rail in US politics. My fear is given the level of vitriol and staunch opposition along with the two party system, it often produces legislation with pork barrel projects and watered down potency. Time will tell but the after-debate is just as fascinating!


    • I still think it is a good plan – from watching ER, the amount of people who cannot obtain medical help just because they can’t afford it is staggering even on a TV show! It’s just funny that those that oppose Obama deem him the Anti-Christ, Boehner called it Armageddon and that’s a direct choice of words – I know being a Republican you are qualified to rhyme off the bible at will but I think poking at the hornets nest of the “we-think-Obama-is-Satan” camp. There are a lot of other factors involved of course, there’s something between Obama and the insurance boys…I’m sure of it!


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