Organizing for America | Ludmilla on the Issues: Health Care Reform: Considerations

Health Care Reform: Considerations

By Ludmilla - Nov 7th, 2008 at 12:35 pm EST

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In my current position, in government relations and public policy, we are focusing on Health Care Reform, something we desperately need in this country. Although we work with AIDS organizations we realize that none of the strategies to combat the epidemic have worked because we lacked a "national comprehensive strategy on AIDS", while we do require PEPFAR countries to have a national strategy under the UN legislation.

Healthcare reform should include all chronic illnesses rather than exclusively designing programs for diseases which have been so politized (like HIV/AIDS) and throwing others in groups. Health Care Reform should consider HIV/AIDS funding such as Ryan White to be incorporated into the reform and get rid of the constant fights we have seen during the reauthorization of this particular Act, a fight between groups of different sexual orientation when in fact the face of this crisis is that of those who are economically marginalized, communities of color.

We have to stop creating segregation when we legislate for health care and hopefully the new health care reform team will seriously consider that.

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Discussion on Health Insurance Policy | Report to Admin

By Joy Dec 4th 2008 at 1:33 am EST (Updated Dec 4th 2008 at 1:33 am EST)

It seems differential pricing policy requires to be looked into in the Health Insurance sector to avoid rising cost . Reengineering is essential too as individual procurement percentage seems lesser than private or govt. sponsored & the niche of uninsured seems too lesser to bring uniformity . Please reply back with your comments

health care reform proposal | Report to Admin

By Chris from Evanston, IL Jan 31st 2009 at 1:15 pm EST (Updated Jan 31st 2009 at 1:15 pm EST)

Barack yesterday said "No one bill, no matter how comprehensive, can cure what ails our economy..."

That's probably true...but one comprehensive health care reform proposal, enacted NOW, WOULD be provide genuine stimulus AND dampen the negative impact of all the other economic problems associated with the slowdown: a guaranteed healthcare SYSTEM for 100% of all US citizens.

There is such a proposal, outlined in a book called "Healthcare, Guaranteed" by Dr. Ezekiel Emanuel (2008). The proposal contains ALL the elements of the Obama plan as outlined on this site in "issues," and shows how ALL the reform elements have to act TOGETHER to create an actual SYSTEM -- because, currently, we don't HAVE a system. Highlights of the proposal:

100% guaranteed coverage for all citizens. Everyone gets a voucher for a plan approximately equal to the congressional plan;

Patient choice of doctors and plans;

Fair and broad financing with cost control incentives (dedicated 10% VAT on all goods and services -- raising the VAT % is public and political). Plans are reimbursed with RISK-ADJUSTED premiums, so there's no disincentive to cover sick people;

A National Health Board (a la the Federal Reserve) to collate and publish plan outcome data -- plans compete for patients and providers on quality of coordination and outcomes (this is where electronic records plug in -- but they come from the plans, not the government);

12 regional Health Boards to GATHER plan outcome data, provide regional oversight of health plans and an arbitration mechanism for most dispute resolution;

Tax breaks for health plan premiums are eliminated -- employers no longer incentivized to compensate employees with benefits, so that (ballooning) cost goes into the employment market (or into corporate profits -- the market chooses). Also, people buying extra coverage shop with after-tax $, so they're more cost-conscious;

With incentives to increase quality AND hold down costs, we fix the biggest LONG-TERM, STRUCTURAL economic problem we're currently facing (not counting water shortages and other effects of unsustainable consumption and waste generation).

Also: making this a STIMULUS would be easy and immediate: phase in the VAT over 3 years, thereby printing money to be spent locally on healthcare right away -- a broad, fair stimulus guaranteed to stay in country.

What do we think? Check out this book -- it's the best combination of Guiding and Invisible Hands that I've seen yet applied to this issue.

-cg

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