Obama’s Poor Judgment on Healthcare
Expert guest post by Sophia Yen, MD, MPH
Originally posted at Asian Americans & Pacific Islanders for Hillary
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| Sophia Yen, MD, MPH |
As a physician and patient advocate, I know the problems with healthcare. Universal
healthcare in which everyone is covered and we get rid of the middle-man (the
insurance companies) is the solution. But the 2nd best solution is at least
“everyone is in the system.” The 3rd best solution is “everyone
has the option to be in the system.” The least optimal is what we have
now. Barack chose the 3rd best solution. Edwards and Hillary chose the 2nd best.
The key question is whether to let people opt out. Scholars in the field and
physicians who study the problem know that in order to do good, you cannot let
people opt out. Otherwise, it increases the cost to the taxpayer via people
going to the ER and we having to bail them out of bankruptcy when that happens,
and those with insurance sucking up the cost of their ER visits.
Obama makes a
great case for universal healthcare in 2007 and then fails to deliver as
a presidential candidate. He said:
Every time an American without health insurance walks into an emergency
room, we pay even more. Our family’s premiums are $922 higher because of the
cost of care for the uninsured. We pay $15 billion more in taxes because of
the cost of care for the uninsured. And it’s trapped us in a vicious cycle.
As the uninsured cause premiums to rise, more employers drop coverage. As
more employers drop coverage, more people become uninsured, and premiums rise
even further.It is not in our character to sit idly by as victims of fate or circumstance,
for we are a people of action and innovation, forever pushing the boundaries
of what’s possible. … The time has come for universal health care in America.
Obama says that people don’t have insurance because it is too expensive. Not
true.
One study estimates that about 25% of the country’s uninsured, or roughly 11
million people, are eligible for government health care programs but unenrolled.
Research also suggests that subsidies alone are unlikely to solve the uninsured
problem in the U.S. (source: Subsidies
and the Demand for Individual Health Insurance in California).
In 2007, Obama said about healthcare, “We must act. And we must act boldly.
… Washington no longer has an excuse for caution. Leaders no longer have a
reason to be timid.” Yet his is the wimpiest plan of the 3 top candidates
and does not achieve universal healthcare/coverage. (Some estimate 9-15 million
people would not be covered under his plan because they would not opt in.)
This is flip floppy… (wait until the Republicans get a hold of this!)
Here is a great
article by economist Paul Krugman on the subject.
The difference between the plans could well be the difference between achieving
universal health coverage — a key progressive goal — and falling
far short.… A plan without mandates, broadly resembling the Obama plan, would cover
23 million of those currently uninsured, at a taxpayer cost of $102 billion
per year. An otherwise identical plan with mandates would cover 45 million
of the uninsured — essentially everyone — at a taxpayer cost of
$124 billion. Over all, the Obama-type plan would cost $4,400 per newly insured
person, the Clinton-type plan only $2,700.That doesn’t look like a trivial difference to me. One plan achieves more
or less universal coverage; the other, although it costs more than 80 percent
as much, covers only about half of those currently uninsured.
According to the Urban institute, “it is not possible to achieve universal
coverage without an individual mandate.” (Source: Do
Individual Mandates Matter? ).
In a recent Healthcast
from the Kaiser Network, Len Nichols, Ph.D., the Director of the Health Policy
Program of the New America Foundation said:
If you go pure voluntary even if you have fairly generous subsidies you are
not going cover more than half of the uninsured. So basically the reason to
do a mandate is not because we like it, I mean I would think the mandates
are kind of like booster shots, they are vaccinations that sometimes hurt
a little bit, but they protect you from the rest of us and they protect the
rest of us from far worse illnesses down the road. They actually make markets
work better to make sure everyone pays their fair share.
For such a brilliant man, I am shocked that Senator Obama missed such a fundamental
part of the solution to the problem of healthcare or isn’t willing to take the
bold changes that he advocates for. I worry that this may be indicative of his
judgment regarding other issues.
P.S. I never dreamed of becoming an MD until my mother introduced me to her
female MD friend and I realized that women could be MDs. It would be truly inspiring
to young women in the US and women everywhere to see a woman lead the most powerful
nation in the world.
Kaiser foundation sponsored a candidate
forum on healthcare. (Interestingly, Obama refused to participate in this
forum! Everyone in healthcare knows when the Kaiser Family Foundation calls,
you answer! It’s like refusing to talk to NPR! So, obviously Obama has poor
healthcare advisors on his healthcare, probably non-MDs and more like economists/lawyers?)
Sophia Yen MD, MPH is a Taiwanese-American pediatrician who specializes
in Adolescents (patients aged 12 through college). She currently works at Stanford’s
Lucile Packard Children’s Hospital in the Teen and Young Adult clinic in Mountain
View. Dr. Yen is also a member of the Blue Cross Childhood Obesity Physician
Advisory Committee. Dr. Yen along with other members of the committee has been
instrumental in shaping the current and emerging Childhood Obesity Initiative
activities by providing input into the development of the programs and reviewing
medical content.
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