The "Obama/Biden" Healthcare Plan?

It's the time in the political season to make way too much of the impact a vice president can have on the presidential contest.

So I hope you don't mind if I extend that amusing parlor sport into the arena of healthcare reform and consider how how Joe Biden's original proposal for healthcare reform compares to Barack Obama's.

If nothing else, it's a good way to parse a few of the issues likely to be magnified when Obama and McCain yammer back and forth about their healthcare plans in the coming weeks.

Biden's plan, unloosed on the public in October 2007 in support of his presidential bid, isn't all that different from Obama's.

Both cover the usual list of Democrat healthcare touchpoints -- making coverage affordable with subsidies to people and businesses, creating new public options to supplement private offerings, preventing insurers from denying coverage to the sick, emphasizing prevention and chronic disease treatment, etc., etc., etc., yada yada and so forth.

Neither plan, significantly, follows the Hillary Clinton proposal for mandating coverage for all people. Neither does the vaporous plank on healthcare reform in the Democrat's party platform draft.

[Note: It's a bit tough to find information on Biden's plan at this point in history. The former presidential campaign website www.joebiden/home is now redirected to a page on Obama's site announcing Biden as VP, effectively airbrushing evidence of the Biden plan from the current debate. We can expect the same from mittromney.com any day now.]

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The key distinctions between the Obama and Biden proposals:

Mandates: Obama requires all kids to have insurance. Biden doesn't require anybody to be insured.

Uninsured: Like Obama, Biden would use a mix of subsidies, tax breaks and expanded options to help people buy into either private or public plans not unlike the one enjoyed by federal employees. Unlike Obama, Biden would give adults 55-64 the option of buying into Medicare, again with subsidies as needed.

Insurance regulation: Obama would prohibit insurers from denying coverage based on pre-existing conditions. Biden would provide incentives to discourage insurers from doing so.

Drug prices: Obama favors changing laws to permit federal price negotiation with drug makers over the cost of drugs for Medicare, reimportation of drugs from other countries, and supporting development of generic drugs. Biden mentions only allowing bargaining for Medicare drug prices.

Health Tech: Both support investments in health information technology in order to make care stronger, safer and better looking. Obama wants to spend $10 billion over 5 years, then make use of certain tech mandatory. Biden wants to spend $1 billion per year.

Total estimated costs: Such estimates are fictional, of course, if not delusional. But Biden costed out his plan at $120 billion per year. Obama, that tightwad, estimates outlays of $60 to $65 million per year. Obama says he'll pay for it by rolling back Bush's tax cuts for people making over $250,000 per year. Biden didn't say how he'd pay the bill.

To the extent this bean-hill of wonkery amounts to much, the public will never hear about it, of course. One of the easiest predictions on healthcare politics over the next many weeks is this:

McCain's plan will be portrayed as an industry-friendly, lobbyist-shaped non-reform boondoggle that leaves millions of people uncovered, undercovered and suffering while the rich and the lucky who own seven houses (they think) enjoy gold-plated, platinum-priced coverage.

Obama's will be dismissed as an act of tax-and-spend FDR-era extravagance that will create a huge new bureaucracy, drive god-fearing businesses out of healthcare entirely, suck the working class dry and lead the country down that slippery slope toward Stalinistic central control.

But back to reality. This is easy to predict too:

Any eventual reform to healthcare, regardless of who wins, is going to become the usual mess based first on ideological inclination and then processed through the machine of money, industry influence, political pandering and either "compromise" or "cooperation," depending on how one views unwillingness to demand absolutes.

And this will occur no matter who the vice president is.

Comments

[klmebane]

strangely i'm more comfortable with the idea of "tax and spend" than i am with the idea of "don't tax, spend anyway."

[GuiltyByStander]

Biden's health care plan may not matter much at this point, but it's worth pointing out two aspects of his policy that were missed.

First, Biden's plan included "catastrophic" insurance for everyone: it should be possible to prevent family bankruptcy in the small percentage of cases where someone suffers a really serious illness that requires a lump of money beyond any ordinary taxpayer's means.

Second, Biden recognizes the obvious: it's going to take more than one term in office for any president to turn around the huge amounts of money that flow into private insurance corporations and no candidate can make the universal promise yet.

Further, any mandated plan that simply compels people to buy insurance from private interests is just silly. There is no need or place for private capital or profit in a public insurance scheme.

I've experienced both Canadian socialism and US capitalism in health care. For someone who is lucky enough to afford expensive insurance and care in the States, the US system works OK. It wastes billions, pays off insurance shareholders who take no risk (risk is born by other premium holders after all), encourages high billings for the uninsured, and allows the drug industry to run amok. But it fixes what ails the upper middle class.

The Canadian system has flaws, but provides similar technology and expertise at far lower costs to everyone. If you have any doubts about that, ask your Canadian friends whether they'd like to see it taken away.

[CroatianCritter]

I agree more than anyone that we need health care reform. But the comparisions to SOCIALISM will continue if the coverage is MANDATED. Take me for example. Due to escalating energy and grocery costs, I am surviving with my partner on a little over 55 K a year. We are barely hanging onto our house. Every year, paying the bills gets more difficult. My job just made my health care plan so TERRIBLE that I dropped my coverage. The plan is so bad that the coverage does not kick in until I spend $5000 of my own money on health care. Since I have never spent more than $600 on health care in one year, this has no benefit to me personally. Now Arizonans and Californians have made auto insurance and home insurance mandatory before you are allowed to purchase either. Since insurance has always been about risk, this is a corporation forcing a government entity to enforce this law on every American. With MANDATORY coverage, that is YET ANOTHER BILL that I can not afford to pay. Plus, the auto and home insurance companies told us that prices would drop if everyone was insured. This turned out to be false. The only POSSIBLE WAY to lower premiums is by creating market conditions that make these companies compete. If the government plan is cheap enough, many Americans will VOLUNTARILY use it anyway. Any MANDATORY coverage is going to turn into another government funded boondoggle that will benefit the corporations only.

[XME]

When it comes to health care, I think it's safe to say that McCain has nothing that even remotely resembles a "plan".

[jmpurser]

No one, individual or party is interested in a health care plan. At most they express a mild interest in propping up the current failed system for one more election cycle with yet more tax payer dollars. Looks like we'll be in the business of killing Americans for profit for at least another 4 years.