| Obama's Health-Care Plan: Pros and Cons Debate |
In 2009, we asked two doctors to debate the pros and cons of President Barack Obama's health-care plan. Back then, the plan was an idea. Now, it's a law, the Affordable Care Act. (Opponents derisively call it Obamacare.) Some of the details of Obama's health-care plan have changed since 2009, but the overall goals remain similar. For example, as planned back then, insurance companies will soon not be allowed to deny coverage to people with pre-existing conditions. And small businesses now get a tax credit to help them provide health insurance. You can see more highlights of the current Affordable Care Act at Obama's website. (Of course, given the source, they're highlighted with a positive spin.) We asked our debators, if the United States does adope a universal health-care plan, is Obama's headed in the right direction? Here's their take. You can share your opinion in the comments section below the debate. Get expert-written articles like this every month in our free health newsletter.
Debator
The Obama health-care plan is headed in a positive direction by all historic indicators. It began with February’s expansion [2009] of the State Children’s Health Insurance Program after years of failure, providing insurance to millions of additional vulnerable children. Then, the passage of the economic stimulus bill helped states maintain current levels of care for their poorest citizens. Now, a new secretary, Gov. Kathleen Sebelius, with a dedicated commitment to the common good has been nominated. [Sebelius was sworn in as health secretary in 2009.] The administration has undertaken a summit [in 2009] at the White House to explore all the possibilities, with four particularly key objectives. The first is finding ways to insure every American. At a time of foreclosures and job losses, the last worry anyone needs is whether they can get thoughtful care with appropriate follow-up if an emergency befalls them. Current law provides for continued insurance under COBRA if a job is lost, but this is incredibly expensive for families—particularly if someone has no job. But SCHIP expansion aside, more than 40 million people still have no insurance. A second objective has been transparency, so the remarkably expensive enterprise of medical care doesn’t become a new pork barrel of inefficiency. This leads to the third goal: cost efficiency. Tremendous efficiencies are possible because they are currently being achieved by our economic competitors around the world. Increased health-care efficiencies were probably the leading engine for the economic expansion during the 1990s. The United States currently has the developed world’s most inefficient system, costing more than twice as much as other systems while performing poorly on many health indices. Thus, a fourth goal is heightened quality, like that supported by the significantly expanded medical research in the stimulus bill. Better health, after all, is a goal shared by everyone, and Obama has moved us a giant step closer by forcefully articulating these four objectives.
Debator
President Barack Obama’s health-care plan at best is not reform at all, and at worst will expand the poorest performing segments of our health-care system and further erode what little choice currently exists at the individual patient and provider level. “Universal health-care coverage,” according to the president’s plan, would be largely driven by enrollment in public programs, such as Medicaid and SCHIP, in which the government sets benefit levels and provider reimbursement rates. Being nominally “covered” in a public health insurance program is of little value if prohibitively low reimbursement rates and administrative hassles prevent physicians from accepting you as a patient. Although the patient is the central figure and the key decision maker in the health-care system, the president’s plan unfortunately appears to continue the paternalistic view that government, not the individual patient, should decide the value of health-care services. Individual patients, regardless of income level, are capable of making appropriate decisions about their own health care, given the proper incentives. Giving patients ownership of their health-care resources and choice over how those resources will be spent will also increase the demand for transparency about the cost and quality of services.
Ultimately, the goal of real reform should be for the government to stop trying to design and operate public health-insurance plans and instead focus on providing disadvantaged individuals with the necessary funds to buy into the same system that everyone else uses.
 Comments (91)
  written by joe moma , May 05, 2012 I'm sick but irrisponsible. Thanks for the money everyone  report abuse
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 written by H. A. Stowe , April 04, 2012 Frankly I am surprised at the posts that suppose that some haven't read the bill (because they disagree with it). I am for the mandate and against subsidizing folks who earn as much as $92,000 a year for a family of four. I am against the expansion of Medicaid without specific limits,, and definitely against the Independent Payment Advisory Board (IPAB). This is the part that some have labeled "death panels", not the "end-life-counseling-services" that Sarah Palin decried. IPAB is in charge of limited Medicare funds (the bill caps Medicare spending though congress of course can raise the limit). Still, this board can and will have the power to decide on healthcare services based not on quality or need, but rather strictly on costs. Using comparative effectiveness (which the ACA directs) will also reduce options and choice to patients. What works best for most will be good enough for all. I am also against the pre-existing condition clause. Those who haven't bothered to participate in paying for insurance shouldn't expect to receive the same benefits as those that have been paying in all along. I propose portability of healthcare, that no new employer or insurer can refuse coverage or payment for pre-existing conditions as long as insurance coverage has been on-going and continuous. I am also against the 40% tax on "Cadillac" healthcare plans. Why "punish" someone because they chose the highest level of coverage they can afford and then expect them pay even more for it? report abuse
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Votes: +4
 written by gilbert , March 28, 2012 dont believe the hype most country have higher education with less coast better doctors that want to help sick not buy more cars the last person you see in the hospital is the doctor on your way out not good guys even cuba does a better job with care its sad america is hurting i travel and see what i see it is sad !!!! most of us dont step out we are far from the best report abuse
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 written by Lolz , February 09, 2012 If they cant afford it, then they dont deserve it. report abuse
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Votes: -23
 written by Patrice , January 26, 2012 Has anyone whose commented negatively against the Affordable Care Act actually read the thing. I've read it and most of the things you people are complaining about simply are not there. Where are you getting your information? This is part of the problem with this country. Too many of us are willing to allow talking heads tell us whats what and form our opinions for us when we can easily go find the truth and form our opinions for ourselves. This is too critical a moment in our history to be asleep at the wheel while others drive (and if they have their way, right into a ditch). I'm 23 years old. I've spent 12 years of my life being tought how great this country is supposed to be. But, with this level of willful ignorance I'm not so sure. Wake up America! report abuse
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 written by Dr. Don Mungerhoff , January 10, 2012 Read the Bill and make your own decisions. Don report abuse
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 written by paircoyote , January 02, 2012 So....it's okay for the poor to be cared for under a state's medicaid program; or the elderly cared for under Medicare; and Vets cared for under the VA. But for those who don't have an existing health issue and who believe they are immune from getting sick or injured, and who CAN afford to buy private insurance but choose not to....well that's okay. You just need to go to an emergency room and the rest of us will pay so that you will be taken care of. Personal responsibility should prevailbut if those who choose not to take personal responsibility, there needs to be a mandate. Look at it this way: would we ALL buy automobile liability insurance if we didn't have to? The argument against the Affordable Health Care Act is simply that we don't like being told what to do even if it's the right thing. report abuse
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Votes: +3
 written by carole , December 25, 2011 I think everyone should read everything on Obama's Health care plan. Don't believe what republicans are telling you or what you read on Fox news. It is a good plan. Its not a government takeover, it doesn't kill jobs, it doesn't fine you if you don't get it. It doesn't have death panels. It doesn't cut medicare. Go on and read what pertains to you personally and get the correct information. It also says if you have to pay more than .08 of your income, you will not have to pay. Not only that but what your main insurance companies won't this does. Please research yourselves. report abuse
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Votes: +2
 written by olaitan sunday , December 05, 2011 i need help to do my born back surgery i dont have money to do it now i need help to do it is pain me too much i can scan and show all guys here? report abuse
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Votes: -10
 written by Janet S. , November 17, 2011 As a middle aged American with pre-existing diseases, I do not believe Obama should force anyone to have insurance. The poor have medicaid. Those who are in the country illegally are without insurance. There are already clinics for the needy, so he needs to study what America has before trying to shove this health care act down out throats. He wants those without insurance to be fined, and the last I heard it was a substantial amount. Not just $500, but thousands. If a legal American cannot afford health insurance, and is disqualified from receiving Medicaid, how does Obama propose to get these people to pay? They already have not money. His plan is ludicrous. What if they can't pay the fine? The prison system is already strained. Leave the prisons for those who committed true crimes - like those in Congress supporting the health care act! report abuse
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Votes: +7
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