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Raising the Bar in Rehab

Presidential Candidates and Health Care

Published September 2, 2008 12:56 PM by Lisa Catenacci

Election year means a time of change. Change can be a great thing, especially in terms of health care, health insurance and many other factors impacting the PT field. One of my professors brought this topic up, so I thought a blog forum is a great opportunity to discuss the leading candidates and their stance on health care issues. (Got a lot of free time? Flip through the book Redefining Health Care by Michael Porter and Elizabeth Olmsted.)

Barack Obama's Plan

Obama has laid out an outline for a new national health plan, which includes: guaranteed eligibility, comprehensive benefits, simplified paperwork, easy enrollment, choice, quality and efficiency. Furthermore, Obama's plan includes a National Health Insurance Exchange for people who wish to purchase a private insurance plan.

Obama's Website says he plans to "lower costs by modernizing the U.S. Health Care System." This includes reducing costs of illnesses, helping patients (there are many details here), ensuring providers deliver quality care, lowering costs by increasing competition in the insurance and drug markets, etc.

John McCain's Plan

John McCain believes the key to health care reform is to restore control to the patients themselves, making it easier for individuals and families to obtain insurance. His reforms include the tax code to offer more choices beyond employer-based health insurance coverage and making insurance more portable (from job-to-job).  John McCain encourages expanding the benefits of health savings accounts (HSAs) for families. 

In terms of lowering health care costs, McCain lists these details: lowering drug prices, providing quality/cheaper care for chronic disease, promoting coordinated care, expanding access to health care, greater use of IT to reduce costs, etc. 

My take on this: I like the idea of HSA in McCain's plan, something Michael Porter also supported in his book.  It's interesting that Obama remarks on lowering costs by increasing competition, but he doesn't include competition between health care providers-which is where the high cost problems were initiated!  (Michael Porter's book discusses competition between providers to lower costs.) Obama's national health care plan scares me a bit, because I don't want to see our country's health care plan turn into a universal health care nightmare, although I do like his plan to simplify paperwork and make enrollments easier.

What do you think?  How will this change how you vote? 


Just for sake of arguement...what exactly do you mean by a universal healthcare nightmare?? I have been doing alot of research regarding the statistics of healthcare systems around the globe and to date:

The United States of America is the ONLY industrialized nation that does not offer universal healthcare

YET is : 25th in life expectancy compared to ALL other Countries

GRANTED we are rank FIRST in  Health care spending

How could this be?  Perhaps is it the fact that we are not legally given the right to Health Care........

though you might be saying but we have Medicare!!- however people in America- that qualify often will refuse job offers because they might make too much money and over-qualify for Medicare but still make to little to afford health insurance

..and those that are able to receive Medicare still aren't covered for prescription drugs, routine eye exams, and functional equipment that they in the end there's no use in diagnosing a problem if one can address it or treat it right??

michelle christina, physical therapy student October 2, 2008 3:22 PM

When the government cuts costs and funding for healthcare they aren't just cutting your paycheck.  You should read some of the current legistlation involving the government wanting to put medicare caps on treatment. Luckly the caps were not implemented. The caps would have put limits on how much time a patient could get treatment. The big question in this campaign is how do we create an affordable health care system with only incremental cost containment. The options are personal choice and responsibility or government control.  History will show that increasing taxes and goverment control does not improve cost containment or create incentives to improve the quality of health care.

Vanessa, pt - mspt, outpatient September 23, 2008 10:48 PM
alva FL


Thank you for the insight into Obama's proposals.  I didn't know all of the details you brought forth!  I will have to read into each candidates plan before November, haha!

Thanks again.


Lisa Catenacci September 9, 2008 11:50 PM

Hey Lisa,%0d%0a%0d%0aGreat post!  I love that you provided ideas about both candidates.  I'm guessing you have read both candidates websites, however, I doubt you have actually read the proposed health care plan (the detailed plan, not just the highlights).  I have -- go figure!  The plan doesn't call for any sort of universal health care plan in the way that most people understand universal health care.  In those Scandenavian countries that have universal health care, where the government provides one health care plan that every citizen participates in, we see what most believe to be universal health care.  What Obama proposes is quite different.  He proposes that the government create a new insurance company that is owned and operated by the federal government.  This plan would be available to everyone, regardless of your social status, family income, etc.  Much like Medicare does now, this program would set a new fee schedule, that would be of lower cost to the consumer.  If you look at the current system, most 3rd party payers base their fee schedule on Medicare.  If the new government sponsored insurance company sets lower costs, it would be expected that other 3rd party payers would follow suit.  %0d%0a%0d%0aNow, you are probably wondering why this is a good thing.  Step outside your role as a health care provider.  Imagine you are just an average joe.  If someone told you that your health care costs would be lower, wouldn't you think it'd be a good thing.  I understand that the lower the cost to the patient, the less we get paid.  Now, I know everyone might not agree with me, but I think that there are definately those physicians who make WAY too much money.  I really think that if they take a pay cut, it wouldn't cause the economy to come crashing down.  %0d%0a%0d%0aMy problem with the McCain plan is this:  Putting health care back in the hands of the consumer sounds like a good idea in theory.  Now I'm in a DPT program.  I've had an entire 3 credit class, and heaps of guest lectures on how the health care system works, and I still don't think I understand it totally.  I have faith in the intelligence of the American people, but I don't know that everyone has the time or patience to sit down and go through the American health care system as it currently exists and try to untangle the mess that has been created over the past decade.  %0d%0a%0d%0aThe other response mentioned something about how Obama's plan would cause the quality of care to plummit.  My view, I didn't get into this field to make money.  I got into this field to help people.  If I don't get paid as much as I used too, I would NEVER consider giving any less quality of care.  The ethical dillema this presents... a post for another day.

Mike Kelley September 9, 2008 8:55 PM
Milwaukee WI

Hi Monika-

Thanks for the comment- I think you raise some good points.  I don't consider myself a part of either political party, I guess I just vote for whichever candidate seems to be the right person for the job.  You raise an interesting point with other countries with socialized medical systems!


Lisa Catenacci September 5, 2008 10:18 PM

I have also read the book Redefining Healthcare (by Michael Porter and Elizabeth Olmsted) and found it to provide useful insight into the problems with the healthcare system and how it would be more beneficial for both the consumer and the provider to have more competition and choices.  

I do believe that John McCain has a much better idea on how to improve this system and not turn it into some universal healthcare plan that could bring the quality down to the lowest possible standards.  Can you name a country that has a socialized medical system with care that is superior to the United States?  I can not.

Furthermore, I do not believe that Barack Obama can reduce the cost of anything.  He makes a lot of promises many of which will raise taxes and increase the size of government.  I do not trust anything that comes out of his mouth to be genuine or good for the United States.

Monika, Physical Therapy - Student , Marquette University September 4, 2008 8:22 PM
Milwaukee WI

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