Obama Campaign Policy and Position Statement on Health Care
June 18, 2007

Creating a Healthcare System that Works

Obama Campaign, June 18, 2007

Quality Affordable Health Care for All by the End of Barack Obama's First Term in Office

Obama's Plan for a Healthy America

Plan Overview
Plan Details
David Cutler Describes Obama Health Plan

"I...believe that every American has the right to affordable health care. I believe that the millions of Americans who can't take their children to a doctor when they get sick have that right...We now face an opportunity - and an obligation - to turn the page on the failed politics of yesterday's health care debates. It's time to bring together businesses, the medical community, and members of both parties around a comprehensive solution to this crisis, and it's time to let the drug and insurance industries know that while they'll get a seat at the table, they don't get to buy every chair."

-Barack Obama, Speech in Iowa City, IA, 5/27/07

The U.S. spends $2 trillion on health care every year, and offers the best medical technology and scientific research in the world. Yet, the benefits of the American health care system come at a price that an increasing number of individuals and families, employers and employees, and public and private providers cannot afford.

Millions of Americans are uninsured or underinsured because of rising medical costs. Nearly 45 million Americans - including 9 million children - lack health insurance.

Health care costs are skyrocketing. Health insurance premiums have risen four times faster than wages over the past six years. Lack of affordable health care is compounded by serious flaws in our health care delivery system. About 100,000 Americans die from medical errors in hospitals every year.

Too little is spent on prevention and public health. The nation faces epidemics of obesity and chronic diseases as well as new threats of pandemic flu and bioterrorism. Yet, despite all of this, less than four cents of every health care dollar is spent on prevention and public health.

Barack Obama's Plan for a Healthy America:

Lowering health care costs and ensuring affordable, high-quality health care for all

Pauline Taylor, 55, a nurse who lives in Iowa City and is a member of SEIU Local 199, a health care workers' union, [said], "He touched on all the highlight"s...(Obama's plan) is wonderful." Taylor said she liked the emphasis on preventative care and getting more generic medications on the market. A nurse for 33 years, Taylor said she has seen what happens when medical conditions go unchecked for years. "People will not put off going to the doctor for so long," she said.

-Iowa City Press Citizen 5/30/07

Barack Obama believes we live in the greatest country in the world and that when it comes to health care, America can and must do better. The Obama plan will save a typical American family up to $2,500 every year on premiums by:

1. Providing affordable, comprehensive and portable health coverage for every American;
2. Modernizing the U.S. health care system to contain spiraling health care costs and improve the quality of patient care; and
3. Promoting prevention and strengthening public health to prevent disease and protect against natural and man-made disasters.

Quality, Affordable & Portable Health Coverage for All

Douglas Davis, an emergency room technician for the University of Iowa hospitals, said he believes Obama's plan gives hope to families. "I believe it's achievable but the most important thing I'm taking from the plan is the security for families," Davis said. "We can't idly sit by and let families take the burden when you have corporations making" billions of dollars.

-Des Moines Register (as reprinted on USAToday.com), 5/29/07

The Obama plan both builds upon and improves our current insurance system, upon which most Americans continue to rely, and leaves Medicare intact for older and disabled Americans.

1. Obama's Plan to Cover the Uninsured. Obama will create a new national health plan to allow individuals without access to affordable insurance coverage to buy coverage similar to that available to members of Congress. The Obama plan will have:

• Guaranteed eligibility. No American will be turned away because of illness or pre-existing conditions.
• Comprehensive benefits. The benefit package will be similar to the Federal Employees Health Benefits Program (FEHBP), and cover all essential medical services, including preventive, maternity and mental health care.
• Affordable premiums, co-pays and deductibles.
• Subsidies. Individuals who do not qualify for Medicaid or SCHIP but still need assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
• Simplifying paperwork and reining in health costs.
• Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.
• Portability and choice. Participants in the new public plan and the National Health Insurance Exchange (see below) will be able to move from job to job without changing their health care coverage.
• Quality and efficiency. Participating insurance companies will be required to collect and report data to ensure that standards for quality, health information technology and administration are being met.

2. National Health Insurance Exchange. Obama will create a National Health Insurance Exchange to help individuals who wish to purchase private insurance. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums. The Exchange will require benefits comparable to those offered in the new public plan. Insurers would be required to justify an above-average premium increase. The Exchange would evaluate plans and provide information about differences between them.

3. Employer Contribution. Employers that do not offer or make a meaningful contribution to the cost of quality health coverage for their employees will be required to contribute a percentage of payroll toward the costs of the national plan. Small employers that meet certain revenue thresholds will be exempt.

4. Mandatory Coverage of Children. Obama will require that all children have health care coverage.

5. Expansion of Medicaid and SCHIP. Obama will expand eligibility for Medicaid and the State Children's Health Insurance Program.

6. Flexibility for State Plans. Obama's plan allows states to continue innovating on health care reform.

Achieving universal coverage has long been a goal of Democratic presidential hopefuls. But Obama's emphasis on cost savings is bound to appeal to people who have insurance but still have seen their costs skyrocket... If Obama's plan helped a little it would mean a lot to her family and many others, Amy . . . said. "There are lots of factors that play into our success or failure, but in our case, the high cost of health insurance premiums is really dragging our family down," said [Amy]... "The month-to-month cost of the premiums is out of balance with the reality of our income. If we could have just a little help, if it could be reduced just a little, it would really help."

-Quad City Times, 5/29/07

1. Reducing Costs of Catastrophic Illnesses for Employers and their Employees. Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums.

2. Lowering Costs by Ensuring Patients Receive and Providers Delivery Quality Care.

Helping Patients

• Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease, and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs.
• Coordinate and integrate care. Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. More than half of Americans with serious chronic conditions have multiple physicians, leading to duplicate testing and conflicting treatments. Obama will support greater integration and coordination of care for those with chronic conditions.
• Require full transparency about quality and costs. Obama will build on his efforts in the U.S. Senate and Illinois State Senate to ensure that patients receive accurate information about hospital and provider quality. Obama will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care.

Ensuring Providers Delivery Quality Care

• Promoting patient safety. Obama will require providers to report preventable medical errors, and support hospital and physician practice improvement to prevent future occurrences.
• Aligning incentives for excellence. Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded for achieving performance thresholds on outcome measures.
• Comparative effectiveness research. Obama will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.
• Harnessing the power of genetic medicine. Genomics has the potential to revolutionize the practice of medicine, but despite significant scientific advances, very few genomics-based tests or treatments have reached consumers. As President, Obama has a plan to overcome the scientific barriers, adverse market pressures, and outdated federal regulations that have stood in the way of better medicine.
• Tackling disparities in health care. As a United States Senator, Barack Obama has fought to maintain funding for the Centers of Excellence in Women's Health at the Department of Health and Human Services and helped spearhead legislative efforts to address gender and ethnic health disparities. As President, Obama will continue to challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.
• Reforming medical malpractice. Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance, and will promote new models for addressing physician errors that improve patient safety, strengthen the doctor-patient relationship, and reduce the need for malpractice suits.

3. Lowering Costs through Investment in Electronic Health Information Technology Systems. Obama will invest $10 billion over five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems. Obama will ensure that patients' privacy is protected.

4. Lowering Costs by Increasing Competition in the Insurance and Drug Markets

• Increasing competition. The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. Obama will prevent companies from abusing their monopoly power through unjustified price increases and force insurers to spend more funds on patient care instead of keeping exorbitant amounts for profits and administration.
• Lowering prescription drug costs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Obama will allow Americans to buy cheaper medicines from other developed countries if the drugs are safe. Obama will also repeal the ban that prevents the government from negotiating with drug companies for the Medicare prescription drug benefit, which could result in savings as high as $30 billion. Finally, Obama will work to increase the use of generic drugs in federal benefits programs and prohibit drug companies from keeping generics out of markets.

On Tuesday in Iowa City, U.S. Sen. Barack Obama of Illinois, a Democrat, announced his [health care plan]... one aspect is particularly noteworthy: It includes limits on the profits of private-sector health-care businesses. He believes that's the right move for consumers, but it risks offending some powerful interests. He did it anyway. That tells voters something important about him.

-Editorial, Des Moines Register, 6/1/07

Barack Obama believes that protecting and promoting health and wellness in this nation is a shared responsibility among individuals and families, school systems, employers, the medical and public health workforce, and federal, state, and local governments.

1. Employers. An increasing number of employers are offering worksite health promotion programs and insurance plans that cover preventive services. Obama will support and expand these important efforts.

2. School Systems. Obama will work with schools to create more healthful environments for children. He will work to get junk food out of vending machines in schools and improve nutritional content of lunches through financial incentives, increase grant support for physical education, expand federal reimbursement for school-based health services, and provide grants for health educational programs for students.

3. Workforce. Obama will expand funding - including loan repayment, adequate reimbursement, grants for training curricula, and infrastructure support to improve working conditions - to ensure a strong workforce that will champion prevention and public health activities.

4. Individuals and Families. The way Americans live, eat, work, and play have real implications for their health and wellness. The Obama health plan will require coverage of essential clinical preventive services such as cancer screenings and smoking cessation programs in all federally supported health plans. Obama will also increase funding to expand proven community-based preventive interventions.

5. Federal, State and Local Governments. Governments at all levels should develop a national and regional strategy for public health that includes funding mechanisms for implementation. Senator Obama also supports greater organization of the 3,000 health departments in this nation and supports collaborative arrangements between government and the private sector. The Obama plan will also force government to examine its own policies, including agricultural, educational, and environmental policies, to assess and improve their effect on public health in this nation. As president, Barack Obama will prioritize these activities to strengthen prevention and public health, as well as fight for the following initiatives:

• Fight AIDS Worldwide. There are 40 million people across the planet infected with HIV/AIDS. As president, Obama will continue to be a global leader in the fight against AIDS. Obama believes in working across party lines to combat this epidemic and recently joined Senator Sam Brownback (R-KS) at a large California evangelical church to promote greater investment in the global AIDS battle.
• Improve Mental Health Care. Mental illness affects approximately one in five American families. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As president, Obama will support mental health parity so that coverage for serious mental illnesses are provided on the same terms and conditions as other illnesses and diseases.
• Protect Our Children from Lead Poisoning. More than 430,000 American children have dangerously high levels of lead in their blood. Lead can cause irreversible brain damage, learning disabilities, behavioral problems, and, at very high levels, seizures, coma and death. As president, Obama will protect children from lead poisoning by requiring that child care facilities be lead-safe within five years.
• Reduce Risks of Mercury Pollution. More than five million women of childbearing age have high levels of toxic mercury in their blood, and approximately 630,000 newborns are born at risk every year. Barack Obama has a plan to significantly reduce the amount of mercury that is deposited in oceans, lakes, and rivers, which in turn would reduce the amount of mercury in fish.
• Help Americans Affected by Autism. Autism is a serious and growing problem for American families. Affecting over one million Americans, autism is a complex neurobiological disorder that causes extreme impairment in thinking, feeling, language, and the ability to relate to others. Fortunately, federal support for autism research has grown tremendously in recent years. But Barack Obama believes that we can do more to help autistic Americans and their families. He has been a strong supporter of over $1 billion in federal funding for autism research and treatment, and he believes that we should increase funding for the Individuals with Disabilities Education Act to truly ensure that no child is left behind.

More than anything, autism remains a profound mystery with serious consequences for autistic individuals, their families, loved ones, the community, and education and health care systems. Obama believes that the government and our communities should work together to provide a helping hand to those affected by this growing epidemic.

Share your voice on these issues by using our MyPolicy tools. With the help of your insight, Barack will further develop his health care plan to take into account our common experiences and build the political momentum to enact real reform.