Leading up to the November election, the health reform proposals of presumptive presidential candidates John McCain and Barack Obama will be analyzed, compared and critiqued until absolutely nothing original is left to say about them.
The team of strategists corralled to draft the proposals are now defending and promoting them. Both sides have put Harvard professors and U.S. Representatives to work, but the similarities end there.
Here’s a brief look each candidates’ health wonk roster:
is McCain’s policy director. The economist is the former director of the
Congressional Budget Office and economic advisor to both Presidents
Bush. "The key to real reform is to restore control over our
health-care system to the patients themselves," he has said. While not on McCain’s Straight Talk Express campaign bus , Holtz-Eakin is Senior Fellow at the Peterson Institute for International Economics and President of DHE Consulting, LLC. Holtz-Eakin staunchly supports limiting national spending to clearly defined priorities and reforming entitlement programs to keep taxes low.
Thomas P. Miller is a resident fellow at the American Enterprise Institute for Public Policy Research. He is a former senior health economist for the Joint Economic Committee of the U.S. Congress and former Director of Health Policy Studies at the Cato Institute. Miller believes that health care is over-regulated, over-subsidized, and over-politicized.
Stephen T. Parente is a finance professor at the University of Minnesota and former director of the HIT Institute there. Here’s his resume. Parente earned his PhD in health care finance from Johns Hopkins. He has published frequently on health care consumerism and value-based purchasing.
Regina E. Herzlinger is a professor at Harvard Business School who has been dubbed the "grandmother of consumer-driven health care." Her books include Consumer-Driven Health Care: Implications for Providers, Payers, and Policymakers and Who Killed Health Care? Herzlinger has a long history of mentions on THCB here, here and here.
U.S. Rep. Michael Burgess is a doctor who represents the 26th district in Texas. He sits on the House Energy and Commerce Committee, which is responsible for health care, the safety of food and drugs, energy and power legislation. Burgess blogged recently for Health Affairs on doctor-owned specialty hospitals.
Jay Khosla worked as Health Policy Counsel for the former U.S. Senate
Majority Leader, Bill Frist, before joining McCain’s health policy
advising team. Khosla has also worked as the health counsel for the
U.S. Senate Budget Committee, focusing on Medicare, the uninsured and
insurance market reforms.
David Blumenthal is a physician and professor of
medicine and professor of health policy at Harvard
Medical School. His work has focused on the costs of health information
technology and different strategies for health reform. This is his fourth time advising a presidential candidate on health care.
David Cutler is a professor of economics at Harvard University. He is the author of Your Money Or Your Life: Strong Medicine for America’s Health Care System. Cutler helped develop the Clintons’ failed universal health care proposal in
the early 1990s and worked on health care blueprints for
Democratic presidential candidates Bill Bradley in 2000 and John Kerry in 2004. He has worked with the National Institutes of Health and the
National Academy of Sciences. Currently, he is a research associate at the National Bureau of Economic Research and a member of
the Institute of Medicine.
U.S. Rep. Jim Cooper from Tennessee has been working on health reform in the House since 1992. He played an antagonistic role during the Clintons’ attempt at reform in the 1990s. Cooper blogged recently at Health Affairs on health spending.
Jeffrey Liebman is a professor of public policy at Harvard University and an expert on federal budgeting and program costs. Along with Cutler and Blumenthal, Liebman authored an economic review of Obama’s health plan, finding that it could be implemented without raising taxes.
For long term care
As a non-nurse provider, I’m still waiting for the nurses to come up with a differnt mantra other than “there are 3 million nurses” and we have all the answers but no one is listening because we’re nurses.
As if to say “stop listening to the doctors and listen to use because we’re delivering all the care”… This “moantra” sounds like the cry of the abused spouse!
Well…it comes down to this. Nurses aren’t providing care unless a physician orders it. Care doesn’t get paid for unless a physician orders it. If you wanted to be a physician, you should have gone to medical school.
In assessing Obama’s health care strataegies, it’s important to also understand his more fundamental views on the US economy. Dave Leonhardt wrote a nice piece which appeared in The New York Times on August 24th on this topic.
My sense of where Obama is coming from is that he tries to balance a conservative economist’s view of the value of well functioning markets with an understanding of the need for appropriate government guidance and regulation to help markets work.
Health care is sorely in need of well functioning markets. Obama and McCain will both be challenged to try to get past the strongly funded health care special interest groups to address the misalignment of economic incentives inherent in the present US health care system.
As everyone knows, Health Care Reform is a major issue during this Presidential Election. The Health Care Reform Proposals from each Presidential Candidate have
been analyzed by the experts in which the pros and cons have been exposed. While Americans will review the proposals and the analytical reports, there is one unresolved issue which proves Health Care Reform will not be enacted by Congress. Until this issue is resolved, Health Care Reform is nothing more than an attention getter for the candidates, not a reality for Americans. The issue I speak of regards a law enacted by Congress in 1972 that is not being enforced and violations of this law continue.
How can we honestly think there will be a National Health Care System when our own government won’t even pay the medical costs for 6,000 living donors whom society deems as heros but they are treated as though they are citizens living in a third world country without access or financial resources for medical care? The greed of our government towards the citizens of this great country is most exemplified through living organ donors in which our own government entities, such as HHS, not only violate US Code of Law but actually take monies from the living donors. We have presented numerous issues before Congressional Representatives, the Secretary of Health and Human Services, Centers for Medicare and Medicaid Services/CMS and other organizations involved with transplant. Senator Grassley has been given the information and his office continues to ignore enforcing the US Code of Law which
is being violated.
The law I speak of is The US Code, Sec. 1881. [42 U.S.C. 1395rr], enacted in 1972, subsection (a) gives transplant recipients their own Medicare benefit. Subsection(d)states living donors will receive their own Medicare benefit in which medical expenses related to the living donation will be fully paid. Under THE MEDICARE COVERAGE FOR END STAGE RENAL DISEASE PATIENTS, HHS through CMS has honored part of the law by giving transplant recipients their own Medicare benefit and establishing the ESRD Network, but they refuse to honor the part in which living donors are to receive their own Medicare Benefit related to the living donation.
We know living organ donors save the government millions of dollars through their generous gift of life. CMS has requested living citizens be used to acquire organs before deceased citizens due to the financial gains since CMS has less dialysis expenses from decreased time on the transplant wait list and better graft survival from living donors. To add insult to injury, the government has become so greedy,
it not only refuses to honor the US Code of Law but they require living donors to submit their own private insurance information. This is done so CMS can co-ordinate and apply the living donor’s insurance policy towards the the transplant recipients Medicare benefit. In addition, living donors are required to use their own monies for co-pays and deductibles in their insurance policy, which can amount to thousands
of dollars when the donor’s surgery is not covered by Medicare. We have brought the issues before CMS and those at CMS have been sympathetic towards living donors
but CMS must abide by the rulings and budget from HHS. Living donors are now facing lack of future medical care due to the caps on their insurance in addition to co-pays and deductibles from their organ donation. The finanicial benefits are given to the government, private insurance companies and transplant recipients while many living donors pay to donate an organ.
Granted CMS has paid for some living donors surgeries but there are many living donors who are receiving medical bills for donating a kidney. These living donors
were told their medical expenses related to the donation would be paid but they are not being paid. There is a myth in the transplant community being relayed to living donors that their medical expenses will be paid. The only reason I am aware of this issue is because I am a Living Kidney Donor and Registered Nurse. As a Registered Nurse who works full-time in dialysis, I am well aware of the plight of Chronic Kidney Disease which affects 1 in 9 Americans. I also work part-time in a Level 1 Trauma ER where patients come to the ER for medical care due to the lack of insurance. I also work as a Sexual Assault Nurse Examiner so I am well aware of crime and how it affects the citizens of this country. While my experience as a Registered Nurse has taught me the problems in health care and crime, my experience as a living kidney donor has been the greatest teacher of all. In 2001 I donated a kidney to my nephew when he was 2 years old. After donating I found many living donors with physical,
emotional and financial problems due to donating so I began the Living Organ Donor Advocate Program-LODAP. LODAP was founded because government and transplant organizations stated there were no monies available to help living donors with problems. I have been contacted by numerous donors who are financially devasted due to donating a kidney.
It’s a sad day in America when I hear a living person state they would have been better off dying during the donation surgery than suffering the physical complications and financial devastation they live with daily due to donating an organ. Maybe even more tragic and perhaps even criminal, is the fact our government knows there is a law that would provide the medical coverage for living donation but they allow the violation of the law to continue and seek more monies from the living donors.
If the government thinks paying for 6,000 living donor surgeries that save them money is too much, do we really think they will pay for health care for Americans? Until current health policies such as this with living donors is are honored, Americans will have no hope for Health Care Reform.
#1.-Universal Healthcare & that means everybody covered is an absolute necessity to protect us all. With the cost of family coverage exceeding $12,000/year in many jurisdictions, it is entirely unreasonable to think that “making it more affordable” & reducing the average family’s cost by $2500 within 4 years will solve our national common problem. We must devise a method that will almost automatically cover every man, woman & child in USA for reasonable medical treatment.
#2.-As we have a very well-developed system of employer -based coverage, It is least disruptive to retain it, requiring ALL employers of any size to provide health coverage, but require the insurance carrier to provide it at a common %of payroll price. Thereby, no employer is required to pay the equivalent of an ee’s salary to cover him/her & family. The insurance industry has long known that high income folks have long used more & more costly care than poor folks. They used to rate for income. I believe the industry can easily rise to the challenge. Hopefully, McCain & Obama can too!
This is arguably the most important health policy post.
The paucity of professionals who provide care in the stables of advisors is disturbing, as is the absolute absence of a registered nurse anywhere.
It’s the almost three million nurses in the US providing about 95% of all reimbursed health services, that earn, control or manage a large percentage of healthcare dollars and resources. Surely, these professionals, charged via statute and ethics to safeguard patients across all treatment settings, should be at the health policy and agenda tables of the presidential candidates.
As Hillary supporters would say, it’s time to put 3 million cracks in the glass ceiling.
Great info, thanks.
Healthcare is a very expensive issue- both in dollars and political capital- if you actually want to change anything. Tracking polls show it plummeting in political saliency as the economy has weakened. KFF’s data shows it has been eclipsed by the economy (jobs, gas and food prices, etc.) and you see candidates scrambling to be relevant here. With the prospect of a $500 billion FY08 federal deficit looming, expect a lot of mumbling about the uninsured, and a lot more non-specific talk about costs
(you don’t want to blame anyone and wake the dragon). Sad to say, given all the unfinished business, but health reform will be a second tier topic this fall and next year.