Obama's Concern for Chronics

In a recent New York Times piece, Paul Krugman, one of my favorite columnists, explains how the numbers can't deny that Hillary's health plan is better than Obama's. But what "better" means here is relative even when stats and dollars are an issue. The idea is that Hillary's plan calls for a mandate and will result in more coverage dollars per person. You can't argue the logic of strong economic research. But what excites me about Obama is his less-than-bright-lining look at things. He's got a realistic hold on the healthcare crisis even if his plan is less likely to insure everyone immediately.

More powerful, he's also clearly interested in eliminating waste that contributes to hard-to-explain hardships for sick people. And from the standpoint of someone somewhat young with chronic health problems in the wake of serious cancer, it was damn-near J.F.K.-inspiring to hear him discuss healthcare in the past by leading with talks about insured Americans who had survived cancer but now face secondary problems and an endless onslaught of salary-zapping bills.

To be sure, getting everyone insured is of paramount importance. But so is realistically looking at how one can make that happen over a span of time so that it happens correctly in the nuanced way that it should. Does Obama have specific ideas for how to stop hospital and doctor billing fraud? For how to get cancer survivors better quality of life as they age and new bizarre conditions come their ways because of the toxic chemicals and treatments they were forced to endure to be able to vote in this election? I haven't exactly heard them. But if there's one thing that keeps people going after they've been very sick and now have uncertain futures, it's hope. And Obama gives me, a survivor of an autologous stem-cell transplant for pediatric lymphoma, hope.

Hillary? I just wouldn't trust her looking out for me at the infusion center if there was another chance for her to win some more powerful support from someone across the street. I wouldn't look to her for thoughtful looks at the small problems facing patients double-billed by hospitals, giant corporations, in fact, who often charge $150 facility (or in some cases, emergency room) fees in addition to outrageous doctor fees just because a physician chooses to practice inside a hospital-owned professional building a few blocks from the actual hospital building--what I call the branding-inspired Mayo Clinic model.

What's become evident, however, is that the sufferers and survivors of chronic diseases in America should band together to endorse a candidate based on the specific issues of getting and keeping not-just-OK-but-excellent insurance after a war has been waged against our bodies. Medicare, for instance, recently stopped paying out for some instances of immune deficiency treatments like intravenous immunoglobulins (which is also used to treat auto-immune diseases affecting the nerves, muscles, and joints, to say nothing of its promise for Alzheimer's and other conditions). Someone needs to ask the candidates about this.

Universal health care is vital. But if some of us devoted to it aren't alive--or well enough--to fight for it as the years pass, voting for someone's broad promise of more coverage dollars for everyone when they may not really care about the details for those sick people lucky enough to already have insurance isn't going to help. If there's one thing sick people know, it's that there are a hundred questions to be answered and solved after deciding on a treatment plan.

There's a way to live more healthfully on the left side with insurance - and that doesn't mean just swallowing our severe insurance and medical care issues because the rest of the country isn't insured. Let's look at the problem in a complex, multi-angled manner, and not jump to the flashiest, sexiest solution just yet.

When flight attendants tell you to make sure your air mask is secured before you help others with theirs in the event of an emergency, it's about not being self-interested or conservative. It's about being smart. And while Obama's thoughts about healthcare may seem like an immediately smaller and less comprehensive band-aid for the country's uninsured, they may also be the most realistic and nuanced on the ticket because they come from someone who sees that this problem is a lot larger and more intricate than it seems.

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Comments

[pbarba1969]

This guy is saying that despite the fact that Hilary's plan is better he is going with Obama because he sounds better despite as the author writes that if Obama has any ideas to stop medical fraud or make cancer sufferers lives better " he hasn't heard them" That Obama has hope.

Gee that's great. Hope is very nice. But its not very realistic at times. I want a President to deal with realism. Put Americans's back to work, keep us safe, keep goverment functioning while reducing the dept, get the homeless vets off the steets, and generally make the word better for us.

FDR had hope, JFK had hope but ulike Seantor Obama, they actually had a plan to deasl with the depression and the cold war.

[Doofus]

PK says this, in part:

'An Obama-type plan would also face the problem of healthy people who decide to take their chances or don’t sign up until they develop medical problems, thereby raising premiums for everyone else. Mr. Obama, contradicting his earlier assertions that affordability is the only bar to coverage, is now talking about penalizing those who delay signing up — but it’s not clear how this would work.

So the Obama plan would leave more people uninsured than the Clinton plan. How big is the difference?

To answer this question you need to make a detailed analysis of health care decisions. That’s what Jonathan Gruber of M.I.T., one of America’s leading health care economists, does in a new paper.

Mr. Gruber finds that a plan without mandates, broadly resembling the Obama plan, would cover 23 million of those currently uninsured, at a taxpayer cost of $102 billion per year. An otherwise identical plan with mandates would cover 45 million of the uninsured — essentially everyone — at a taxpayer cost of $124 billion. Over all, the Obama-type plan would cost $4,400 per newly insured person, the Clinton-type plan only $2,700.

That doesn’t look like a trivial difference to me. One plan achieves more or less universal coverage; the other, although it costs more than 80 percent as much, covers only about half of those currently uninsured.'

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Here's what to do: In place of a 'mandate' (which so far involves an unspecified penalty for not obtaining insurance), create an INCENTIVE for getting insured. A tax credit, or a deduction (even for those who don't itemize), or whatever.

Find a way to get healthy people to join the plan, without resorting to punishment. That is essential, and sufficient.

[wmnorton]

I've read this twice and still don't see your point. Is it even though Hillary's plan is better your still going for Obama because his speeches make you feel better? That's what I think you said. I can assure you that the insurance companies would rather you have hope than insurance.