• There would be both public and private exchanges
• The average family will save $2,500 off their premiums
• No mandate for adults to purchase insurance, only children.
• Keep your plan
Those were the main promises made by then Senator Obama as he ran for his first term as president and, as we now know in hindsight, none of the above have come true. Let’s explore how his first campaign season developed.
Prior to his announced candidacy, Senator Obama gave a speech in Washington, DC, “Time Has Come for Universal Health Care.” Some of the key comments in this speech included:
It is “Wrong when businesses have to lay off one employee because they can't afford the health care of another.” It is “Wrong when 46 million Americans have no health care at all.” “Almost half of all small businesses no longer offer health care to their workers, and so many others have responded to rising costs by laying off workers or shutting their doors for good.” “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.” “So where's all that money going? We know that a quarter of it - one out of every four health care dollars - is spent on non-medical costs; mostly bills and paperwork. And we also know that this is completely unnecessary.”
Those points became the foundation of his health care talking points. Then, on February 10, 2007, Senator Obama announced his candidacy in Springfield, Illinois. This paragraph is from that speech, “For the last six years we've been told that our mounting debts don't matter, we've been told that the anxiety Americans feel about rising health care costs and stagnant wages are an illusion, we've been told that climate change is a hoax, and that tough talk and an ill-conceived war can replace diplomacy, and strategy, and foresight. And when all else fails, when Katrina happens, or the death toll in Iraq mounts, we've been told that our crises are somebody else's fault. We're distracted from our real failures, and told to blame the other party, or gay people, or immigrants.”
PROMISE ONE – public and private health plans
As we already know, there are no public plans, only private. This will be discussed further in the next section on the passage of ObamaCare.
PROMISE TWO – The average family will save $2,500 on their premiums
One of the most quoted statements by Senator Obama was, “we will lower your premiums by $2,500 per family per year.” I counted at least twenty times that Obama stated this and several more written fact sheets stating the same. But where did this number come from? In May 2007, three Harvard professors – Mr. Cutler, David Blumenthal and Jeffrey Liebman – produced a memorandum offering their “best guess” that a menu of changes would produce savings of at least $200 billion a year. $77 billion from computerized medical records, $46 billion from reduced insurance administrative costs, and $81 billion from prevention programs and chronic disease management.
This projected $200 billion in savings was divided by the population and averaged for a family of four producing the magical $2,500 number. Even if these numbers were realistic, Senator Obama’s own advisors said not all of the savings would translate into lower premiums as Obama repeatedly stated. They predicted that that the savings to employers would be passed along as higher wages! They also predicted that savings to the government would be passed on as lower taxes or added benefits!
A “final costs memo” from Mr. Cutler claimed a conservative estimate of $120 billion savings and a “best guess” estimate of $200 billion. He also states that his “best-guess” savings to businesses will save $140 billion annually which is equivalent to a “typical family” saving $2,500. This is IF companies and government pass on all savings. Mr. Cutler NEVER said any real families would save $2,500 on premiums.
When Mr. Cutler was asked why there was difference between what Senator Obama was saying and what was actually presented to him, Mr. Cutler stated, “What we’re trying to do is find a way to talk to people in a way they understand.”
Senator Obama, in a speech to the University of Iowa in May 2007, the same month Mr. Cutler presented the above accounting to Senator Obama, stated, “If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less.” “…will save each American family up to $2500 on their premiums.” This same speech was consistently repeated throughout the campaign season.
PROMISE THREE – No mandate
Throughout the primary and election process Senator Obama stated he would have a mandate for children to have insurance, but he repeatedly claimed there was NO mandate for adults. In fact, he chastised Clinton’s plan claiming a mandate would would hurt those who could not afford insurance by penalizing them. He believed that everybody wanted affordable insurance and would jump at the chance to purchase low cost, quality insurance. I have counted no less than 10 speeches and debates in which Senator Obama made these statements. As we all know at this point, there was a mandate on adults imposed after the election.
At the democratic debate in Las Vegas on 11/15/2007, Senator Obama stated, “Well, let's talk about health care right now because the fact of the matter is that I do provide universal health care. The only difference between Senator Clinton's health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated -- forced -- them to get health care.”
In Des Moines, IA on 11/25/2007. "But the reason Americans don't have health insurance isn't because they don't want it, it's because they can't afford it, which is why my plan doesn't have a mandate and goes further in cutting costs than any other proposal offered in this race.”
1/5/08 Democratic Presidential Debate, Manchester, NH “I have no problem, Hillary, with you pointing out areas where you think we have differences. But on health care, for example, the reason that I mandate for children is because children do not have a choice. Adults do, and it's my belief that they will choose to have health care if it is affordable. Now, that's a perfectly legitimate policy difference for us to have.”
1/21/08 Democratic Presidential Debate, Myrtle Beach, SC "Now, if we -- what is happening in Massachusetts right now, there are articles being written about it, which is that folks are having to pay fines and they don't have health care. They'd rather go ahead and take the fine because they can't afford the coverage. My core belief is that people desperately want coverage; they desperately want it. And my plan provides those same subsidies, and if they are provided those subsidies and they have good quality care that's available, then they will purchase it. That is my belief."
2/21/08 Austin Tx, Democratic Presidential debate "Now, Massachusetts has a mandate right now. They have exempted 20 percent of the uninsured because they've concluded that that 20 percent can't afford it. In some cases, there are people who are paying fines and still can't afford it, so now they're worse off than they were. They don't have health insurance and they're paying a fine. (Applause.) But I think that adults are going to be able to see that they can afford it under my plan; they will get it under my plan."
PROMISE FOUR – Transparency
As a candidate for president, Senator Obama repeatedly promised open, televised health care negotiations. Once more, after-the-fact, we know transparency turned into closed door sessions.
• November 2007: "We are going to have a big table, and everybody is going to be invited, labor, employers, doctors, nurses, hospital administrators, patient advocate groups. The drug and insurance companies, they'll all get a seat at the table. ... And we will work on this process publicly. It'll be on C-SPAN. It will be streaming over the Net." (Town hall meeting with Google employees, Mountain View, CA, 11/14/07)
• January 2008: "That's what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are." (Democratic presidential debate, 1/31/08)
• March 2008: "But here's the difference: I'm going to do it all on C-SPAN so that the American people will know what's going on." (Town hall meeting, Lancaster, PA, 3/31/08)
• August 2008: "When I come together around this health care system, I'm going to do it all in the open. I'm going to do it on C-SPAN." (Town hall meeting, Albuquerque, NM, 8/18/08)
• August 2008: "I'm going to have all the negotiations around a big table. ... We'll have the negotiations televised on C-SPAN." (Town hall meeting, Chester, VA, 8/21/08)
PROMISE FIVE – Keep your plan
The “keep your plan” promises really began in earnest after the election, however, even during the election Senator Obama stated it a few times. In all fairness, his written plan says if you have insurance through your employer you can keep it. Unfortunately, even that is not entirely true as we saw after the election.
“If you've got a plan you like, you get to keep it. If you've got a doctor you like, you get to keep your doctor,” he said. [Asheville High stadium, Oct 6, 2008]
So here's what I would do. If you've got health care already, and probably the majority of you do, then you can keep your plan if you are satisfied with it. You can keep your choice of doctor. We're going to work with your employer to lower the cost of your premiums by up to $2,500 a year. (Oct 7, 2008. Nashville TN. The Second Presidential Debate)
So here's what my plan does. If you have health insurance, then you don't have to do anything. If you've got health insurance through your employer, you can keep your health insurance, keep your choice of doctor, keep your plan. (Oct 15, 2008, Hempstead, NY, The Third Presidential Debate)
The Obama Plan in 2008
As written by Senator Obama in Sep/Oct.08, this is his three part plan.
Increase Access to Affordable Health Insurance. This is two part, a “national health plan, similar to the plan available to federal employees and members of Congress” and “a National Health Insurance Exchange for individuals wishing to purchase private insurance.” “For those who cannot afford the new plan…income-related subsidies will be available”. “I will also require that all children have meaningful health coverage”.
Controlling Costs and Improving Quality. “Experts have written that my plan will save the typical American family $2,500 per year on medical expenditures, and save businesses $140 billion per year in reduced premiums.” “I will also implement cost reduction measures that tackle administrative waste and the rising cost of prescription drugs.” “I will allow Americans to buy their medicines from other countries if the drugs are proven safe.” “I will also reduce the excessive subsidies received by private plans participating in the Medicare Advantage program.”
Promoting Prevention and Strengthening Public Health. “I will also increase funding for community-based interventions”, “I will expand and reward worksite health promotion programs”. “I will expand funding…to ensure a strong workforce that will champion prevention and public health activities.”
National Health Plan
This would be made available to anyone without access to employer-sponsored insurance or existing public programs such as Medicare, Medicaid, or SCHIP (State Children's Health Insurance Program). It would also be available to small employers. This plan would be similar to the plan enjoyed by congress. The most popular federal plan had a $600 deductible and $15 copayments with a monthly premium of $1,027.95 for a family. The federal government contributed $713.48.
Health Insurance Exchange
The national Health Insurance Exchange would offer a choice of health plans, including private plans meeting federal regulations and the NHP. All plans have to offer benefits at least equal to NHP and charge the same premium regardless of health.
The government would reimburse employers for some of the costs incurred by catastrophically ill people covered by an employer’s health plan. The employers have to agree to use the money to reduce the cost of workers’ premiums.
Play-or-pay. Employers that do not offer or make a meaningful contribution to the cost of high-quality health coverage would be required to contribute a percentage of payroll toward the costs of the national insurance plan. Small businesses would be exempt but would receive a refundable tax credit of up to 50 percent of the health insurance premiums they pay.
Child mandate. All children have to have health insurance. Parents must pay for private coverage or enroll them in Medicaid or SCHIP.
Cost of the Plan
The campaign says that federal outlays for health care would increase by $50 - $65 billion annually.
Next, passage of ObamaCare