VOTE' ' ' For Kids Health

1
VOTE. . . For Kids Health

• A Brief Overview of the Health Platforms of the
  Presidential Candidates
• Childrens Hospital and Research Center- Oakland
• Lucile Packard Childrens Hospital at Stanford

2
Introduction

• Our intent help us be well informed voters on
  health care issues
• Review health policy platforms of all major
  Presidential candidates from both parties
• Not an endorsement of any one candidate, simply a
  non-biased educational piece

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Why this is Important

• It impacts our patients!
• It impacts our ability as health care providers
  to understand how we care for all patients within
  the broader system
• We have a strong voice and need to use it wisely
• A 2007 Commonwealth Fund survey of adults age 19
  and older regardless of political
  affiliation/income level ? candidates' views on
  health care reform will be very important or
  somewhat important in their voting decision

4
Super Tuesday!

• Make sure you vote!!!
• You can find your polling place online
• Anyone want to watch the results come in over
  happy hour?

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Its in the Scientific News!

• Recent journal article from NEJM
• Health Care in the 2008 Presidential Primaries
• Harvard School of Public Health, Boston
• John F. Kennedy School of Government, Cambridge
• Kaiser Family Foundation, Menlo Park

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The Results

• Democrats
• Expand health insurance coverage, even if it
  increases spending
• Control health care costs
• Expanding employer-based coverage and public
  programs
• Comprehensive plans in terms of benefits
  coverage

• Republicans
• Control health care costs
• Minority want expansion of coverage
• Making coverage more available in the marketplace
• Tax incentives for affordibility issues
• High-deductible, catastrophic coverage combined
  with HAS to provide tax savings

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Buzzwords to know

• Mandates Refers to candidates support or
  opposition to the idea of all Americans being
  required to have health insurance
• HIT health information technology largely used
  to describe a paperless system
• EMR electronic medical record
• Connectors or exchanges group insurance
  market arrangement providing people with a choice
  of public or private insurance
• USPSTF United States Preventive Services Task
  Force
• HSA A Health Savings Account is a special
  account owned by an individual used to pay for
  current and future medical expenses. It is used
  in conjunction with a High Deductible Health
  Plan.

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Buzzwords to Know

• Portability Term that refers to ability to
  protect health insurance coverage for insured
  people and their dependents when there is change
  in the insurer or change in job.
• Single Payer Health Care System A government run
  organization that collects all health care feeds
  and pays out all health care costs. Canada and
  many European countries follow this health care
  model
• Universal coverage Health insurance coverage for
  all persons in a state or country
• FEHBP Federal Employee Health Benefits Program
  same health benefits members of congress get

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Candidate Hillary Clinton

• Stated goal Affordable and high-quality
  universal coverage through a mix of public and
  private insurance
• American Health Choices Plan
• Pool of private plans operated by FEHBP ? same
  benefits as members of congress
• One public plan similar to Medicare
• You can keep your Medicare or Employer plan if
  you choose
• Subsidies
• Large employers
• Based on size and average wages
• Government
• Expand Medicare SCHIP (decrease gaps in
  coverage)
• Tax credits to small businesses that provide
  insurance
• Refundable tax credits for working families set
  premium based on percentage of income level

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Candidate Hillary Clinton

• Mandates Supports
• Private Insurance Changes Ins. companies
  required to offer coverage to anyone who applies
  and requires coverage of prevention services
  based on USPSTF recommendations (cannot deny for
  preexisting conditions)
• Improving quality Incentivize by increasing
  federal funding for excellence in care
• Financing Cost estimated at 110 billion
  annually
• Rolling back tax cuts for households earning more
  than 250,000
• Reduces waste/inefficiencies in current system

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Candidate Hillary Clinton

• Seven-point plan to control cost
• Ensure better preventative care
• Modernize record-keeping
• Streamline care for the chronically ill
• Create large insurance pools
• Start a "Best Practices Institute" to finance
  research
• Control prescription drug costs
• Revise medical malpractice system
• Lower spending by 120 billion/yr
• 2200 in health savings for typical family
  (Business Roundtable)

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Candidate Mike Gravel

• Stated goal Universal coverage through an
  annual health-care voucher program
• Permitting choice of provider
• Based on projected needs (risk for individuals
  not a collective one fits all)
• Modest co-pay, modest deductible
• Pay for more if you want more than the standard
• Phase out Medicaid/Medicare over time
• No employer contribution
• Free up business so its more competitive
• Mandates Not applicable everyone covered

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Candidate Mike Gravel

• Changes to Private Insurance Phased out
• Financing Anticipates savings from voucher
  program can finance universal coverage without
  additional costs
• Anticipate 30 reduction in costs due to
  single-payer
• Retail sales tax
• Modernize records
• Additional Would provide financial aid to new
  doctors and nurses

14
Candidate Mike Huckabee

• Stated goal A complete overhaul of our health
  care system to create a health system favoring
  market-based, consumer-based policies
• Health insurance costs tax deductible for
  individuals
• Move from employer-based ? consumer based to keep
  business competitive
• Invest in prevention to cut costs, instead of
  chasing chronic diseases
• States as laboratories
• Subsidies
• Tax credits for low-income households
• Mandates Opposes
• Expansion of Medicaid and SCHIP No provision

15
Candidate Mike Huckabee

• Private Insurance Changes Make health insurance
  portable from one job to another expand HSAs.
• Improving quality Increase attention to
  preventive health care reduce premiums for those
  living a healthy lifestyle.
• Financing Not specified
• Cost control
• Reform medical liability
• Adopting EMR
• Making health insurance portable
• Expanding HAS (incentive to stay healthy)
• Making health care tax deductible for individuals
  as well as businesses

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Candidate John McCain

• Stated goal Provide access to affordable health
  care for all by paying only for quality health
  care, having insurance choices that are diverse,
  encouraging personal responsibility, and cost
  containment
• Tax credit of 2500 for individuals or 5000 for
  families for purchase of insurance
• Revise tax code to "eliminate the bias toward
  employer-sponsored health insurance
• Mandates Opposes
• Expansion of Public Programs
• More timely and high quality VA benefits
• Require any state receiving Medicaid to develop a
  financial "risk adjustment" bonus for high-cost
  and low-income families to supplement tax credits
  and Medicaid funds

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Candidate John McCain

• Private Insurance Changes Allow insurance to be
  sold across state lines allow small businesses
  and self-employed to purchase insurance through
  any organization portable
• Improving quality
• Change provider payments (single bill for heart
  care v. individual bills)
• Medicare payments for diagnosis, prevention and
  care coordination
• Bar payments for preventable medical errors or
  mismanagement
• National standards for measuring and recording
  treatments and outcomes
• Innovative ways to improve access Telemedicine
  in rural and underserved areas (clinics in retail
  outlets)
• Promote competition among providers
• Promote public health and education of children
  surrounding health topics
• Financing Not yet specified, although indicates
  cost containment measures would make insurance
  more affordable

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Candidate John McCain

• Cost Containment
• Medical malpractice reform
• Promote HIT
• Competition among providers based on
  performance/quality
• Invest in preventative and chronic care
• Permit sale of nationwide insurance for private
  insurance companies to reduce admin costs
• Greater competition to drug markets, safe
  reimportation and streamlining the process for
  introducing generic drugs
• Increase provider transparency
• Expand HSA

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Candidate Barack Obama

• Stated goal Affordable and high-quality
  universal coverage through a mix of private and
  expanded public insurance
• National Health Insurance Exchange
• Small business and individuals who do not have
  access to public insurance or employer-based
  coverage can enroll in new public plan (similar
  to FEHBP) or purchase in competitive pool of
  private plans
• One public plan based on Medicare
• Requiring employers to pay for coverage or
  contribute to new public plan (exempts small
  businesses)
• Reimbursement to employers for catastrophic
  events, if premium savings are used for reduction
  in premium cost
• Mandates Supports for children aims for
  universal coverage
• Subsidies
• Expand Medicaid/SCHIP
• Income-related subsidies

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Candidate Barack Obama

• Private Insurance Changes Prohibits denial of
  coverage based on pre-existing conditions
  requires health plans to disclose percentage of
  premiums that go to patient care
• Improving quality Reward provider performance
  address health disparities reform medical
  malpractice system promote and strengthen public
  health and prevention
• Financing Cost estimated at 50-65 billion paid
  for by
• Elimination of the Bush tax cuts for those
  earning over 250,000
• Control costs

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Candidate Barack Obama

• Cost containment
• EMR HIT funding
• Promote insurer competition
• Improve preventative and chronic care services
• Drug reform promote generics, reimportation, ban
  on direct price negotiation between Medicare
  drug companies
• Hospitals providers to publicly report costs
  quality
• Reform medical malpractice

22
Candidate Ron Paul

• Stated goal Take steps to encourage more free
  market competition among providers
• Eliminate federal regulations discouraging small
  businesses from providing health insurance
• Reduce reliance on third-party payers (HMOs)
• 500/child tax credit for drugs and care not
  covered by insurance
• Personal liberty, minimal government (decrease
  involvement of FDA)
• Mandates No provision
• Expansion of Medicaid and SCHIP No provision

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Candidate Ron Paul

• Income-Related Tax Subsidies/Credits Allow
  individuals to fully deduct non-reimbursed health
  care costs, including premiums, from their taxes
• Private Insurance Changes No provision
• Improving quality No provision
• Financing Not specified (opposes raising taxes
  for health care)

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Candidate Mitt Romney

• Stated goal Provide access to affordable
  quality health insurance for every American and
  slow the rate of inflation in health care
  spending, give power to the States
• Make all health care expenses deductible
• Tax credits for insurance not provided by
  employers
• Expand and deregulate private insurance market
• Personal choice, personal responsiblity
• Mandates No provision (although as Governor
  signed into law mandate of coverage)
• Expansion of Medicaid and SCHIP No expansion,
  but would provide block-grants to states and
  allow states full flexibility to restructure
  Medicaid
• Income-Related Tax Subsidies/Credits Redirect
  current subsidies for uncompensated care to
  provide subsidies for low-income families states
  would design eligibility requirements

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Candidate Mitt Romney

• Private Insurance Changes Provide federal
  incentives to states to deregulate and reform
  health insurance markets to lower costs
• Improving quality Bring market dynamics to
  health care with federal incentives for EMR, cost
  transparency, and expand provider options
• Financing Redirect existing subsidies for care
  of the uninsured does not support raising taxes
  to fund health care
• Cost Control Supports medical liability reform
  through federal caps and state reform

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Resources for voters

• www.health08.org
• http//www.voterguide.sos.ca.gov
• http//politics.nytimes.com/election-guide/2008/is
  sues/index.html/contextindex/issuehealth
• Individual websites!

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References

• http//www.health08.org The Kaiser Family
  Foundation- January 10, 2008
• http//www.cnn.com/Election/2008/issues/issues.hea
  lthcare.html- January 16, 2008
• http//www.commonwealthfund.org/publications/publi
  cations_show.htm?doc_id647708- January 15, 2008
• http//politics.nytimes.com/election-guide/2008/is
  sues/index.html/contextindex/issuehealth
• Individual campaign websites