Thursday, August 28, 2008

A side by side comparison!

From the New England Journal of Medicine

Obama Health Reform Plan:
1. - “Play or pay” employer mandate requiring businesses either to offer workers insurance or to pay a tax (very small businesses would be exempt)

2. - Creation of a new national health plan (similar to Medicare) for the uninsured and small businesses

3. - Establishment of new national health insurance exchange that would offer choice of private insurance options for the uninsured and small businesses

4. - Mandate that all children must have coverage

5. - Subsidies for lower-income Americans to help them afford coverage

6. - Expanded coverage financed through the payroll tax, letting tax cuts for families making over $250,000 expire, and savings from electronic medical records, disease management, and other system reforms

7. - Regulation of all private insurance plans to end risk rating based on health status

8. - Establishment of federal reinsurance program to insure businesses against the costs of workers’ expensive medical episodes

9. - Other proposed measures to control costs and improve quality:
- Reduction in the administrative costs of private insurance
- Accelerated adoption of electronic medical records
- Promotion of disease management
- Emphasis on prevention and public health
- Payment of providers on the basis of performance and outcomes
- Reduction in excessive payments to private plans contracting with Medicare
- Allowing Medicare to negotiate with drug companies
- Establishment of a comparative-effectiveness research institute

McCain’s Health Reform” Plan:
1. - Elimination of current tax exclusion for employer-paid health insurance premiums

2. - Using revenues generated from eliminating tax exclusion, provision of refundable tax credits ($2,500 for individuals, $5,000 for families) for all persons obtaining private health insurance; if insurance costs less than the value of the credit, remaining funds can be deposited into health savings accounts

3. - Creation of guaranteed access plan to provide insurance pool for persons who are medically uninsurable on the individual market

4. - Promotion of individually purchased insurance and less comprehensive insurance policies

5. - Deregulation of insurance markets

6. - Reform of Medicare to make bundled payments for episodes of care and to pay on the basis of outcomes

7. - Other proposed measures to control costs and improve quality:
- Enhanced competition
- Faster introduction of generic drugs
- Emphasis on prevention and better management of chronic conditions
- Greater use of health information technology
- Medical malpractice reform

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