Obama's Health Care Plan Arouses Fierce Debate

2009-06-09 13:11:25  

    by Matthew Rusling

    WASHINGTON, June 8 (Xinhua) --

Opponents are gearing up for a battle against U.S. President Barack Obama's health care plan.

    Conservatives for Patients' Rights, an advocacy group, has been running television ads saying Washington wants to create a system similar to that of the United Kingdom and Canada, where, the ads claim, patients are subjected to long waits for care and have difficulty obtaining prescription medicine.

    Another organization, Americans for Prosperity Foundation, also began a new campaign called Patients United Now, seeking to "educate citizens about the threat of government controlled health care."

    For its part, the Obama administration sought over the weekend to influence legislation when advisers David Axelrod and Austan Goolsbee appeared on CNN to address the issue.

    The president "made a very strong case for the proposal that he put on the table," Axelrod said.

    This is just the start of a bitter debate that will heat up as Congress nears the completion of a bill to overhaul the health care system -- Obama's No. 1 domestic priority, experts said.

    In a recent letter to the heads of congressional committees charged with writing the bill, Obama outlined what he believes the legislation should contain.

    Provisions included a government insurance plan that individuals can buy into and a "health insurance exchange" that would bring individuals and insurers together and allow people to choose a plan to fit their budget.

    A draft bill released Friday by Sen. Edward M. Kennedy's health committee would require employers to cover workers or pay a fine. The bill would also provide subsidies to help the poor pay for health care, assure patients the right to choose their own doctor and require all Americans to purchase insurance, except those who can not afford it.

    Insurers would not be permitted to deny coverage based on pre-existing conditions and there would be caps on their profits. They would also compete with a new government sponsored "affordable access" plan that would offer care to those not eligible for Medicaid or Medicare.

    While the bill is not yet finalized, opponents argue it could spell the end for small insurers. Companies could opt to pay the proposed penalty instead of providing expensive insurance for employees, said Robert Moffit, director of the Center for Health Policy Studies at the Heritage Foundation, a Washington, D.C. think tank.

    Smaller insurers could lose customers and close their doors, depriving Americans of choice and quality in seeking health care insurance, he said.

    Another problem is that the plan will be a creation of Congress, which means the government will play a larger role in people's lives and it could leave patients with few contractual rights, he said.

    "You can't take the government to court in most cases," he said.

    Patients could also find themselves mired in red tape just to see a specialist, some have argued.

    Ellen-Marie Whelan, senior health policy analyst at the Center for American Progress, noted, however, that Obama's proposed "health care exchange" is a market-based approach that does not represent a government takeover.

    Most workers are already covered by their employees, an arrangement that is unlikely to change, she added.

    Larry Kocot, deputy director of the Engelberg Center for Health Care Reform at the Brookings Institution, a Washington, D.C. think tank, said he sees no evidence that Obama's plan would diminish the quality of the health care system.

    Apprehension, he contended, could stem from special interest groups afraid of losing out as a result of any change in the status quo.

    "When you have that much money involved, any thought of changing the system and squeezing out inefficiencies is going to (cause concern)," Kocot said.

    Indeed, cutting costs is among the goals topping reformers' agenda. "The amount we spend on health care it is growing out of control," Kocot said.

    The cost of health care -- paid by individuals, businesses and the government -- is expected to climb from nearly 18 percent of GDP in 2009 to around 20 percent, or 4.4 trillion , by 2018. It is expected to outstrip GDP growth by around 2 percent per year, according to government figures.

    If the United States can curb those numbers by 1.5 percent a year, the nation could save 2 trillion dollars over the next decade, Kocot said.

    But allowing current spending trends to continue would be more expensive than any new system, he said.

    Whelan said patients receive a myriad of unneeded and expensive high-tech services that insurance companies are covering and doctors are ordering. Part of the reason is that neither party knows what works and what does not, she said.

    But other experts said cutting such services to save money could slow progress in medical innovation.

    U.S. pharmaceutical firms are the world's leaders in research and development and their research is a costly endeavor, said Tevi Troy, former deputy secretary of the Department of Health and Human Services and visiting senior fellow at the Hudson Institute, a Washington, D.C. think tank.

    If Congress tries to limit costs by discouraging the development of expensive new technologies, "that could contribute to the drying up of investments in critical (research and development) and thus harm innovation," he said.

    "Some of these cost-cutting measures, if they reduce the development of new life-saving technologies, could therefore end up costing us more in the long run," he said.

    Hospitals could also lose out, as a large portion of their income comes from private insurers, he said.

    Troy also said that while access to health care remains an issue, it is somewhat miscast in the public debate.

    While proponents of Obama's outlook often cite the nearly 50 million uninsured Americans, not all of them are needy, Troy said. About 25 percent of those are "healthy and wealthy" and another 20 percent are already eligible for some sort of government health care assistance but are not taking advantage of it, he said.

Editor: Zhang Xiang