Posted by Jim Lindgren:
Can Obama Keep His Most Emphatic Promises on Health Care?
http://volokh.com/archives/archive_2009_06_14-2009_06_20.shtml#1245089978
In President Obama�s [1]speech to the AMA, he made a firm promise that
I don�t think he can keep, if his plan were to be enacted:
So let me begin by saying this: I know that there are millions of
Americans who are content with their health care coverage - they
like their plan and they value their relationship with their
doctor. And that means that no matter how we reform health care, we
will keep this promise: If you like your doctor, you will be able
to keep your doctor. Period. If you like your health care plan, you
will be able to keep your health care plan. Period. No one will
take it away. No matter what. . . .
If you don�t like your health coverage or don�t have any insurance,
you will have a chance to take part in what we�re calling a Health
Insurance Exchange. This Exchange will allow you to one-stop shop
for a health care plan, compare benefits and prices, and choose a
plan that�s best for you and your family - just as federal
employees can do, from a postal worker to a Member of Congress. You
will have your choice of a number of plans that offer a few
different packages, but every plan would offer an affordable, basic
package. And one of these options needs to be a public option that
will give people a broader range of choices and inject competition
into the health care market so that force waste out of the system
and keep the insurance companies honest.
If this goes through, many employers will do little different than
they are today. But if the Obama plan is enacted, a substantial
portion of employers will cut their health subsidies -- raising their
employees� share of contributions to the company plan � in order to
drive some of the employees into the exchange and the public option.
Other employers may drop their plans altogether � after all, workers
could buy their own coverage in the government exchange -- or simply
fund part of their workers� participation in the exchange. These
changes, which would be the direct results of the implementation of
the Obama plan, would make it virtually impossible for Obama to keep
these promises: �If you like your doctor, you will be able to keep
your doctor. Period. If you like your health care plan, you will be
able to keep your health care plan. Period. No one will take it away.
No matter what.�
One additional point. Obama also promised to end restrictions on
coverage for preexisting conditions:
That is why we need to end the practice of denying coverage on the
basis of preexisting conditions. The days of cherry-picking who to
cover and who to deny - those days are over.
Note that the reason for a preexisting conditions clause is in part to
avoid cherry-picking by the insured. Obama did not give details, but a
simple abolition of such restrictions would lead many rational people
of limited means to avoid buying insurance until they got sick. Forego
insurance and then enter the government-sponsored exchange to buy
coverage when they face major costs. That, of course, would affect the
pricing and cost of coverage for nearly everyone else in the system.
For a guy dedicated to change, President Obama seems to have a fairly
static idea of how people react to reforms.
References
1. http://news.lalate.com/2009/06/15/obama-ama-youtube-and-text/
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