the diff: Health Care

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  • GOP in the Oval Office: barely break out the first aid kit
  • Dem in the Oval Office: a patchwork of mild reforms highly likely, with a small possibility of moderate-to-major reform

(BIG disclaimer alert: In guessing the impact a president will have in the next two years, we’re assuming the Dems will keep at least a slim majority in Congress. That’s, of course, a big assumption to make, but one safe enough to bank on.)

Democratic and GOP candidates aim to solve the twin problems of high healthcare costs (16% of GDP and rising) and high numbers of un-insured (15% of Americans) coming from almost opposite tacks. Obama wants more Uncle Sam (in terms of paying for and regulating health insurance); McCain wants less.

But while would-be executives have ambitious – diverging – plans for shaking up healthcare, a Republican president is sure to be stonewalled by an unsympathetic Congress and a Democrat might find that America, for all its healthcare groaning, is still not ready for large-scale reform.

The full chart

GOP in Da House: With a Republican in office, the next two years will look a lot like the last two years; with the prez playing defense, vetoing offensive plays from a Democratic congress hot to expand federal heath care programs.

The one ray of progress would be in shifting the nation’s health records from filing cabinets to electronic databases, a move designed to avoid double treatment and shed light on best medical practices – which both parties are keen on. If McCain gets the number one spot, Congress could also finally okay buying drugs back from Canada.

But GOP hopes to deregulate the health insurance industry (letting plans cross state borders and choose their own standards of care) and give families more direct purchasing power (with tax credits to buy independent and high-deductible plans as well as health savings accounts) won’t get very far. Republican’s fetish for capping medical malpractice awards won’t get much more indulgement.

Dem in Da House: Depending on how sweeping of a healthcare mandate a Democratic president rides into DC with, we could see mild-to-medium-hot health reform.

As a no brainer, Congress will be able to push through the SCHIP bill that President Bush has swatted down twice, adding 2-4 million low income kids onto state health plans. Dems will also be able to give a one-two to big pharma by telling Medicare to bargain for cheaper drugs and letting Grandpa buy his lipitor from overseas.

But those are small fry reforms. The big question is how far a Democratic president can bring his/her mega-plans to cover all Americans while keeping costs down.

Obama would set up a “menu” or “exchange” of private and public health care plans that individuals, families and businesses could buy into; families would get tax credits and discounts to help them buy in; and (all or many) employers who don’t cover their workers would have to pony up to pay for the new system. The $60 - $110 billion yearly price tag would be covered by cutting off subsidies for families making more than $250G and by a host of untried cost-saving initiatives.

While the Dem candidate is aiming to avoid the pitfalls of Hillarycare – by, for one, making “choice” key – and while US business is aching to toss off the albatross of healthcare, one should never estimate the power of Capitol Hill inertia and that real bogeyman, the “special interest.” Getting the American people and the Chamber of Commerce to swing for change is half the battle. Without Pharma, the medical profession and HMOs on board, DC will either need a minor revolution or another ten years before it sees solid reform.

For more on the candidate’s health plans, see Kaiser Family Foundation’s choice breakdown.

Health care is really a big

Health care is really a big issue in this country. Good luck for those dealing with it :)

Viagra and Healthcare

Why do we see all the buzz about generic ed pills? Also, how come generic Viagra is not included in non prescription ed drug catalogs like Cialis is.
For more than 10 years people could find a good online Viagra buy for around $10 USD per Viagra tablet which is more affordable than brand Cialis.

Keesh | August 13, 2008 - 6:08am

great information, great

great information, great site i like that you have both sides. this really helped me understand why health care is such a tricky issue.

how is it possible to add 2-4 million more kids to state health care plans? it definitely sounds like a good idea, but if it were possible to do that without causing more rising costs in health care, wouldn't it have been already done?

and how can it be fair if families earning over $250g are shouldering much of the cost? just because they earn more doesn't mean they dont deserve to keep what they just sounds a little anti-democratic.

confused (not verified) | August 7, 2008 - 9:12am

how biased is this

how biased is this article?

a random Joe (not verified) | April 9, 2008 - 12:34am
talker's picture

you tell us

Really. If you see any part of this article you think is biased, please let us know so we can correct it. Thanks!

talker | April 9, 2008 - 8:49am

Insurance premiums vs. actual health care expenditures

Cited here is 16% of GDP (and rising) as costs for health care.

What is the $ amount of health care insurance premiums paid in U.S. per annum?


a random Joe (not verified) | March 16, 2008 - 6:22pm
talker's picture

$723 billion

The Center for Medicaid and Medicare Services puts together the best charts on health care expenditures (pdf).

According to CMS, Americans spent $1.1 trillion on health care in 2006 through the private sector: $723 on insurance premiums (which include what their employers pay); $256 billion on out of pocket expenses and $155 billion through "other funds."

The government spent an additional $1 trillion on health care, primarily for Medicare and Medicaid.

talker | April 9, 2008 - 8:46am