Tuesday, April 29, 2008

Obama vs Clinton Health Care Plans

As I said that I would do in my last post, I have studied and compared the high-level information on the health insurance plans of both Clinton and Obama. Just as I was finishing this post, I read the following:

Regardless of the Presidential campaign and proposals, it is important to have strong better options coming out of Congress.

Here are the four simple questions to ask of any health care proposal:

1. Is it Universal (covers all people)... but just that is not enough, you must also find out how the proposal deals with items 2, 3 & 4:

2. Is it Comprehensive (does it cover all needed conditions, prevention, treatment)?

3. How much is it going to Cost Individuals; is it affordable year-in and year-out and can you afford to get sick (their total cost in taxes, premiums, deductibles, copays, uncovered conditions/expenses, total out of pocket...)?

4. How much is it going to Cost Overall, total cost of the system to the country (and yes, we do need overall cost-control); and how is it paid for, and who is paying, all the pieces, direct and indirect?
As it turns out, these are also the concerns that I had in mind and that shaped my analysis. For that analysis, I used the side-by-side comparison found here. The comparison breaks out the provisions of each plan in 13 categories.

I think the merits of each plan can best be assessed by digging deep into the details to a greater degree than is presented at the link above. However, I have based my comparison on the information at this link, and it still took me a fair amount of time to do so. So of course, there are questions that I have that would require still more detailed information to answer (the devil is in the details, as they say). But I will use what I have, which I think is more than most voters would stop to consider.

I copied the table at the link into a Word document and appended an extra column in which I entered my comments. I also inserted some of my questions in the text as I was reading through the document, using the Insert, Comment menu function. These can be viewed by selecting the View, Markup menu function or the Show, Reviewing Pane function on the Reviewing Toolbar.

I used yellow highlighting for provisions that I considered most noteworthy. I used other highlight colors to point out some important provisions in both plans that are similar or identical to each other.

Based on my comparison, there are four important categories in which I judge that Clinton’s plan has an advantage over Obama’s plan, based solely on the information in the document. These are:
  • Expanding access to coverage
  • Premium subsidies to individuals
  • Premium subsidies to employers
  • Changes to private insurance
On the other hand, I am concerned about the effect of each plan on the national deficit. The estimated cost of Clinton’s plan when fully phased in is $110 billion per year. At that level, I wonder how we will prevent the deficit from ballooning even further out-of-control. My hope is that we as a nation would have the political will to re-set our national priorities to emphasize health care for all over war and dubious, unnecessary, multi-billion dollar weapons programs.

Obama’s plan is estimated to cost about half of Clinton’s plan. If economists and accountants agree that it actually would cost that amount, then that fact could make it more politically palatable in order to get it passed. I am still skittish about the 1994 collapse of national health care. The best plan in the world isn’t worth anything if we can’t get it passed into law.

Is Clinton’s plan far-and-away better than Obama’s? I don’t think so. However, based on what I now know, I do judge Clinton’s plan overall to be the better plan.