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How is the current HCR similar/different from Candidate Clinton's and Edward's plans

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andym Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 02:47 PM
Original message
How is the current HCR similar/different from Candidate Clinton's and Edward's plans
Edited on Tue Mar-30-10 03:18 PM by andym
During the primaries it became clear to me that single-payer was unlikely in the near term, if only because none of the major candidates (Kucinich excluded) were backing it as their plan.

To me, the Obama/Clinton/Edwards plans sounded very similar, and I was curious to see how the current HCR that passed compares to what was proposed by the other major candidates. My take is what we got is pretty much what we could expect, given the starting point. The battle for single-payer was essentially lost in 2008. Since, if single-payer could not be sold during the primary season to Democrats (who are generally more progressive than the entire population), it was not going to be offered later to a more conservative group (the American public).

The progressive aspect of HCR is increased care for everyone and the beginning of national regulation of the insurers.
The conservative aspect of these plans is that they left the insurers intact and provided them with new customers.

Note: I think our best path to single-payer lies in Rep Grayson's bid to allow a Medicare buy-in for everyone. I think that this idea (which was only discussed briefly during the campaign as a buy-in for 55 year olds and above) is the most attainable and I suggest that we put significant effort into attaining it (via activism).

We've already discussed Candidate Obama's plans multiple times. Here are the others:
Clinton's:
http://healthinsurance.about.com/od/healthinsurancebasics/a/clintonreform.htm

If you like your plan, you can keep it.

If you don't like your plan, you have two options:
Choose a new private plan from the menu of federal employee plans available to members of Congress; or
Choose an affordable public plan similar to Medicare.

Individual Mandate and Consumer Protections

This reform proposal requires all Americans to obtain health coverage. Clinton would enact the following consumer protections to help Americans comply with this mandate:

Insurance companies would be required to offer affordable coverage to all Americans, regardless of their health status. This means that individuals with preexisting health conditions would be able to obtain coverage in the private market if they so choose.

Furthermore, Clinton would require that insurers devote a certain percentage of each premium dollar collected specifically towards the payment of claims, rather than towards excessive profits or marketing.

Clinton's plan also proposes to keep premium rates low by promoting quality and efficiency of care.

Affordability of Coverage

Many Americans are concerned about rising health costs. Although Clinton's plan requires most Americans to contribute to the cost of their health care, she vows to keep costs down for the consumer by enacting the following protections:

Clinton would offer families a refundable tax credit as financial assistance with the cost of individual health insurance. Because it is a tax credit (as opposed to a deduction) families would receive these funds regardless of whether they owe any income taxes.

Health insurance premium payments would be limited to a percentage of a family's income.

Large employers would be required to contribute to the cost of their employees' health coverage.

Small employers would received refundable tax credits to encourage them to provide their employees with health coverage.

Safety net programs, like Medicaid and SCHIP, would receive more funding to ensure that all vulnerable populations are reached, including poor adults without children.

Funding

Clinton believes that it will take approximately $110 billion to enact her plan. She hopes to generate this funding through the following means:

Improving health care quality and efficiency
Clinton would require all providers to adopt privacy-protected Health IT. This could improve efficiency by ensuring that all providers can access a single, comprehensive medical record for each individual patient.

Preventive care would be a priority under this proposal. Diseases which are prevented or delayed will not tax the health care system with excess costs.

People with chronic diseases account for a majority of health care spending in the United States. Improvements in chronic care would help contain health care spending.

Research on the comparative effectiveness of various drugs, medical devices, and therapies would be supported and funded. Supporters of comparative effectiveness research believe that it can reduce health care costs and improve efficiency by identifying the most effective treatment for a particular disease or condition. It is likely that payments for "less effective" treatments would be reduced or eliminated.

Eliminating government-authorized overpayments to Medicare private plans

Redirecting funding formerly dedicated towards uncompensated care

Negotiating lower prescription drug costs

Reforming the tax code:
Clinton would discontinue tax breaks available to families with over $250,000 per year in income.
The current system which allows employees to deduct the cost of their health coverage before income tax is applied would be limited. Any amount spent in excess of the premium charged under a standard health plan must be subject to income tax.

---------------------------
Edwards:
Under the Edwards Plan:
http://johnedwards.com/issues/health-care/

Families without insurance will get coverage at an affordable price.

Families with insurance will pay less and get more security and choices.

Businesses and other employers will find it cheaper and easier to insure their workers.
The Edwards Plan achieves universal coverage by:
Requiring businesses and other employers to either cover their employees or help finance their health insurance.

Making insurance affordable by creating new tax credits, expanding Medicaid and SCHIP, reforming insurance laws, and taking innovative steps to contain health care costs.

Creating regional "Health Care Markets" to let every American share the bargaining power to purchase an affordable, high-quality health plan, increase choices among insurance plans, and cut costs for businesses offering insurance.

Once these steps have been taken, requiring all American residents to get insurance.
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xultar Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 02:50 PM
Response to Original message
1. Is the exchange similar to Medicare?
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andym Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 02:54 PM
Response to Reply #1
3. "Choose an affordable public plan similar to Medicare."
Edited on Tue Mar-30-10 02:57 PM by andym
That is the public option which we DID NOT get.
Hilary made this an important part of her plan-- based on Jacob Hacker's work and it stands as a significant difference to what we did get.

This should be the first step in any further reform. Rep Grayson's buy-in is one very good way to do this.
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xultar Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:02 PM
Response to Reply #3
7. So that would answer the OP's question...what the difference is between
Clinton, Edwards, and the current shit we got.

Did Obama really campaign on the PO? I never got a real answer.

I guess what you campaign on and what you are willing to fight for can be different.

I'm not saying that Clinton would have gotten the PO but once burned by the likes of the GOP I don't think she would have lost on that this time.


and the haters land in 3. 2. 1....
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andym Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:15 PM
Response to Reply #7
11. Only part of the answer
Edited on Tue Mar-30-10 03:16 PM by andym
There are other differences-- look at the funding for example.

As to your question: the public option was included in Candidate Obama's published plan (which was almost a clone of Hilary's without the mandates). However, it was de-emphasized during the campaign. Obama emphasized buying insurance similar to that enjoyed by congress (and that is included in the current bill). The public option got little or no airing. This contradiction has created a lot of debate on this site and others.


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karynnj Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:07 PM
Response to Reply #3
10. Like Obama, Hillary would not have had 60 Senators
who would have voted for that. As you saw, in both Houses the numbers were at the bare minimum needed. (I know people suggested that they should try to get the PO through in reconciliation, but from the strict interpretation of the Byrd rule, it is not clear that even if the House put it in - that it would not have been stripped out. )
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phleshdef Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 02:51 PM
Response to Original message
2. I dunno, but didn't Edward's plan offer free EXECUTIVE pelvic exams for those women with child?
Sorry, I couldn't resist?
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DrToast Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 02:58 PM
Response to Reply #2
5. Haircuts were covered for some reason, too
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xultar Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:06 PM
Response to Reply #2
9. Pelvic Exam de Oris?
:hide:
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DevonRex Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 02:54 PM
Response to Original message
4. Wow. Thanks for that info. Pretty similar, huh? nt
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jaxx Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:01 PM
Response to Original message
6. It was passed and is now law.
;-)
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karynnj Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:03 PM
Response to Original message
8. In reality, all three plans were quite similar - with mandates being the biggest difference
Even in 2008, I always thought that in all cases the actual plan would not be the platform, but what could pass Congress. I figured that the House and Kennedy and Baucus would likely put together similar plans whoever was President.

In 2008, I figured that the plan, no matter which President, would NOT have mandates and the CW then - from both Democrats and Republicans was that a mandate would make it DOA. In late 2008, at a Finance committee hearing, I heard Ivan Seidenberg, CEO of Verizon and then head of a business roundtable argue that a mandate was the way to go. I then was convinced that it was likely that the plan would have a mandate - for the reasons explained by everyone from Krugman to Kerry (who in his 2004 plan did not have a mandate, but in his updated 2006 plan (delivered before Edwards or any 2008 candidate) he had a mandate that started some years into the plan.)
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Oregone Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Mar-30-10 03:48 PM
Response to Original message
12. Its different than candidate Obama's plan.
Therefore, its silly to suggest that their plans implemented into reality would of been a shred different than this one. Congress wrote this. Its the consensus reform that industry and the political elite have pushed for for decades
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