Every presidential election year candidates promise to fix all the problems facing the nation. With the economy pointing toward a recession, oil prices higher, housing prices lower, and inflation showing up everywhere, both Democrats and Republicans are offering voters solutions to these problems. The war in Iraq ranks very high in voter concern also. Both the economy and the war affect a third major issue to voters: the high cost of quality healthcare. It should not be lost in any discussion of healthcare cost that the economy and the war both impact healthcare delivery in this country. Higher unemployment, lower tax revenues, and more uninsured people have a direct bearing on the healthcare problem. The costs associated with the war impacts domestic programs like a new healthcare system. Both the Democrat and the Republican candidates have presented their plans for healthcare reform if elected. Of course each candidate believes that his or her plan will reduce costs, enhance access, and improve the quality of care currently available. The Democratic candidates, senators Barack Obama and Hillary Clinton, both promise mandatory universal coverage for all Americans. They point out that there are nearly 50 million uninsured Americans due to high insurance premiums or coverage denial. Two reasons cited for high healthcare and health insurance costs are administrative costs and inefficiencies in the delivery system. The Democrats say that one quarter of the cost of healthcare goes toward administration of the plans including such things as marketing, underwriting, coverage issues, and claims handling. The inefficiencies cited in the system include duplication of services, medical errors, and defensive medicine practice in response to malpractice concerns. One solution proposed by both Democratic candidates is to enhance medical records technology so that a patients medical history is always available to his or her provider. Malpractice reform to reduce ordering of unnecessary medical testing was also suggested. The Democratic candidates propose universal coverage for all Americans either through existing private plans or through a new or existing government program. Commercial plans will not be permitted to turn down anyone because of pre-existing conditions, and the premium charged must be "fair and reasonable." While the Democrats concede that their program will increase costs, they say those costs would be paid for by reducing inefficiencies in the system, increasing price competition among the commercial insurers, and increasing taxes on high earners. There would also be more transparency in the cost and quality of healthcare so that the consumer can make informed decisions as to where to obtain needed healthcare services. The Republican candidate, Senator John McCain, has also offered a reform plan. He proposes expanding commercial insurance options to drive price competition. He does not propose mandatory universal coverage, but he wants a system that provides tax incentives to individuals to buy health insurance. His national insurance market would permit insurance carriers to sell in any state that they choose. A national market would also be developed for providers. The belief here is that competition among insurers and providers would result in a more efficient system at a lower cost. While McCains plan would create tax incentives for individuals to purchase insurance, it would reduce the incentives for employers to provide insurance for their employees by eliminating tax breaks for employers. There would be less regulation of the healthcare system than proposed by the Democrats, and insurance premiums would be reduced by eliminating waste and encouraging competition. The parties believe that their plans would improve access to care while reducing cost and improving quality. The Democratic candidates believe that drug companies earn too much, and Medicare should be allowed to negotiate drug prices. The Republicans would open up the United States to more foreign import of drugs including generic drugs. The Democratic plan would offer every American health plan options comparable to the plans offered to federal employees. As a healthcare provider or supplier, it is important to carefully monitor what the candidates say about healthcare reform. There will be reform regardless of which candidate wins. Major changes will not take place in the new presidents first year, but it might be anticipated that changes will come about within four years. Competition among insurers means that there will be more competition among providers and suppliers. No candidate proposed a single-payer system or another system similar to some European countries. If changing the existing system was easy, it would have happened a long time ago. Stay tuned. John Latsko is a partner in the health law practice of Schottenstein, Zox & Dunn, Columbus, Ohio. He can be contacted at 614.462.2329; jlatsko@szd.com
Every presidential election year candidates promise to fix all the problems facing the nation. With the economy pointing toward a recession, oil prices higher, housing prices lower, and inflation showing up everywhere, both Democrats and Republicans are offering voters solutions to these problems. The war in Iraq ranks very high in voter concern also. Both the economy and the war affect a third major issue to voters: the high cost of quality healthcare. It should not be lost in any discussion of healthcare cost that the economy and the war both impact healthcare delivery in this country. Higher unemployment, lower tax revenues, and more uninsured people have a direct bearing on the healthcare problem. The costs associated with the war impacts domestic programs like a new healthcare system. Both the Democrat and the Republican candidates have presented their plans for healthcare reform if elected. Of course each candidate believes that his or her plan will reduce costs, enhance access, and improve the quality of care currently available. The Democratic candidates, senators Barack Obama and Hillary Clinton, both promise mandatory universal coverage for all Americans. They point out that there are nearly 50 million uninsured Americans due to high insurance premiums or coverage denial. Two reasons cited for high healthcare and health insurance costs are administrative costs and inefficiencies in the delivery system. The Democrats say that one quarter of the cost of healthcare goes toward administration of the plans including such things as marketing, underwriting, coverage issues, and claims handling. The inefficiencies cited in the system include duplication of services, medical errors, and defensive medicine practice in response to malpractice concerns. One solution proposed by both Democratic candidates is to enhance medical records technology so that a patients medical history is always available to his or her provider. Malpractice reform to reduce ordering of unnecessary medical testing was also suggested. The Democratic candidates propose universal coverage for all Americans either through existing private plans or through a new or existing government program. Commercial plans will not be permitted to turn down anyone because of pre-existing conditions, and the premium charged must be "fair and reasonable." While the Democrats concede that their program will increase costs, they say those costs would be paid for by reducing inefficiencies in the system, increasing price competition among the commercial insurers, and increasing taxes on high earners. There would also be more transparency in the cost and quality of healthcare so that the consumer can make informed decisions as to where to obtain needed healthcare services. The Republican candidate, Senator John McCain, has also offered a reform plan. He proposes expanding commercial insurance options to drive price competition. He does not propose mandatory universal coverage, but he wants a system that provides tax incentives to individuals to buy health insurance. His national insurance market would permit insurance carriers to sell in any state that they choose. A national market would also be developed for providers. The belief here is that competition among insurers and providers would result in a more efficient system at a lower cost. While McCains plan would create tax incentives for individuals to purchase insurance, it would reduce the incentives for employers to provide insurance for their employees by eliminating tax breaks for employers. There would be less regulation of the healthcare system than proposed by the Democrats, and insurance premiums would be reduced by eliminating waste and encouraging competition. The parties believe that their plans would improve access to care while reducing cost and improving quality. The Democratic candidates believe that drug companies earn too much, and Medicare should be allowed to negotiate drug prices. The Republicans would open up the United States to more foreign import of drugs including generic drugs. The Democratic plan would offer every American health plan options comparable to the plans offered to federal employees. As a healthcare provider or supplier, it is important to carefully monitor what the candidates say about healthcare reform. There will be reform regardless of which candidate wins. Major changes will not take place in the new presidents first year, but it might be anticipated that changes will come about within four years. Competition among insurers means that there will be more competition among providers and suppliers. No candidate proposed a single-payer system or another system similar to some European countries. If changing the existing system was easy, it would have happened a long time ago. Stay tuned. John Latsko is a partner in the health law practice of Schottenstein, Zox & Dunn, Columbus, Ohio. He can be contacted at 614.462.2329; jlatsko@szd.com