We have chosen Barack Obama as our next President! This means that his proposal for how to reform health care will certainly set the tone for our discussion about how to improve quality, cut rising costs and extend medical coverage to about 45 million additional Americans.
Since any proposal must be submited to Congress, it is reasonable to assume that elements of Obama's proposal may well be modified, but at the core of his proposal are principles that would change health care delivery and coverage in the U.S.
The cornerstones of Obama's plan are:
- Expand Medicaid eligibility to include greater numbers of the uninsured
- Mandate coverage for children
- Create a national exchange where uninsured folks can purchase a public or private policy;
- Provide subsidies to lower-income individuals and small businesses to help defray the cost of purchasing insurance; and,
- Tax medium and large-size employers that decline to provide their employees with health insurance.
We have discussed the specific benfits of the personal medical home previously, and it is important to remember in a time of scarce resources, that by supporting the provision of primary care first, we are supporting the only thing that has ever been shown to be associated with both improved quality and decreased cost of medical care! Although well intentioned, throwing more money at our current health care mess will be bound to dissapoint us, by making more people eligable for the dysfunctional, and unorganized type of care that is currently bankrupting us.