SEIU's and Presidential Candidates' Visions for Health Care Reform
April 1, 2008
Here are the positions of the two Democratic candidates running for President and how they stack up against what SEIU's vision for health care reform is. Information is not currently available for Republican John McCain.
SEIU: It is time for our nation to guarantee affordable health care coverage for all Americans. Piecemeal reform is not a solution.
Clinton: Addresses universal coverage by requiring all Americans to get health insurance. Provides assistance for those who cannot afford to pay for coverage. Large employers would have to provide health insurance or help to pay for it.
Obama: Expands coverage significantly by requiring employers to cover workers or pay to support new publicly sponsored coverage. Also establishes a National Health Insurance Exchange (purchasing pool) offering competing private options. Expands Medicaid and SCHIP, offers some subsidies, and mandates coverage for children.
SEIU: The current employer-based health care system is not the foundation for 21st century health care reform, particularly given the competitive challenges of a global economy.
Clinton: Reforms the employer-based plan to reduce national health spending. Allows anyone to join alternative pool.
Obama: Reforms and builds on the employer-based system through reinsurance for employers with very high claims. Offers alternatives to employer-based system through a National Health Insurance Exchange allowing Americans to choose a public plan or purchase a private plan. Expands Medicaid and SCHIP for low-income families and adults.
SEIU: A universal health care system must ensure a choice of doctors and health care plans without gaps in coverage or access, and the delivery system must meet the needs of at-risk populations.
Clinton: Choice of plans through alternative pools. Ends discrimination against pre-existing conditions. Focuses on differences in access to health care and quality of health care.
Obama: Offers consumer choice through a National Health Insurance Exchange. Ends discrimination against pre-existing conditions, implements other insurance market reforms. Focuses on differences in quality and access to health care.
SEIU: A universal health care system must include a core health care benefit package similar to one that is available to Federal employees.
Clinton: Offers a comprehensive core benefit plan similar to the Federal core benefit package. Uses state-of-the-art chronic care coordination models.
Obama: Offers a comprehensive core benefit plan similar to plan for federal employees, through National Health Insurance Exchange.
SEIU: Preventive care must be a part of any basic benefit plan to promote health, control costs, and eliminate economic and racial disparities.
Clinton: Establishes a National Prevention initiative requiring insurance companies participating in Federal program to cover preventative care. Coordinates public spending on preventative care. Creates a public-private collaboration. Enlists a prevention workforce. Promotes greater use of generic drugs.
Obama: Requires coverage of preventative care. Promotes preventative care through employers, school systems, Federal, state and local accountability. Addresses differences in disparities for minority populations by promoting prevention and public health.
SEIU: Any plan for health care reform must control costs by providing care that is cost efficient and medically effective.
Clinton: Eliminates co-pays for high priority prevention services. Focuses on preventative care reducing costs. Improves the quality of care by investing in the health care providers.
Obama: Reduces drug costs by allowing Medicare to bargain with drug companies and the re-importation of drugs. Promotes greater use of generic drugs. Invests in research to determine what treatments work.
SEIU: Secure electronic medical records that consumers control are necessary to increase quality and reduce costs.
Clinton: Adopts a health information technology system and develops a “paperless” medical records system. Creates a computerized prescription system.
Obama: Adopts health information technology system that includes electronic health records. Simplifies paperwork for providers.
SEIU: Hospital and physician quality, outcome, and cost data must be available to consumers.
Clinton: Creates a Best Practices Institute to study care and drug options.
Obama: Creates a health care report system requiring hospitals and providers to collect data.
SEIU: A universal health care system must integrate long term care services, reduce out-of-pocket costs and maximize opportunities for individuals to receive assistance in home and community based settings, rather than in hospitals and nursing homes.
Clinton: Reduces health care premiums, supports new long-term and home care options.
Obama: Improves chronic care conditions. Reduces health care premiums. Supports team care and at home care options.
SEIU: Employers, individuals, and government must share responsibility for financing the system.
Clinton: Shares responsibility through individuals continuing to make co-pays and the government expanding public coverage options.
Obama: Shares responsibility by requiring employers to offer comprehensive coverage or contribute to new public insurance. New government subsidies to assist those without access to employer coverage to purchase coverage through Exchange. Requires parents to demonstrate children are covered after reforms in place.
SEIU: Proposal costs and plan to pay for it.
Clinton: Does not cite costs of proposal. Efficiencies offset new costs associated with expanding coverage and upfront costs for Health IT, research.
Obama: Costs $50-65 billion per year when fully phased and $10 billion to achieve electronic health systems. Allows the Bush tax cut to expire for households earning above $250,000.