Barack Obama has officially become the 44th president of the United States and the first Black president in history.
His campaign promised many changes, but the ill economy has taken priority over all.
Many observers believe Obama’s health care plan, however, is a close second in providing affordable health care to all Americans, particularly Blacks who face considerable health disparities.
Obama, when he was a candidate running for the office of president, spoke with the Recorder and other Black media outlets across the country to discuss his viewpoints on health care in the African-American community. Following are his statements:
Obama: Over the last several years, health care costs have increased dramatically. The average premium’s gone up by 100 percent, the average deductible has gone up 30 percent just this year, but obviously the African-American community continues to have poor health and receives lower quality health care than other Americans and is more likely to be uninsured.
The death rate for cancer is a third higher for African-Americans than it is for whites, and the community suffers from higher rates of chronic illnesses like heart disease and diabetes. Health care is universally important and we’ve got to do something about it, especially in the African-American community.
Here’s what I’m proposing. If you already have health care, which the majority of Americans do through their employer, then we’re going to work to lower your premiums, your expenditures by up to $2,500 each year by investing in electronic health records and investing in chronic care management prevention.
If you don’t have health insurance, then you’re going to be able to buy into a similar health care plan as the one that I have as a member of Congress. If you can’t afford it, we’ll subsidize you.
That means we’re going to make sure AIDS education programs are in the communities where we’ve seen the highest growth in AIDS; that we’re making regular exams for things like prostate cancer and breast cancer, which occur at higher rates in the African-American community — that all those are adequately funded at the front end so we can save money on the back end.
We also want to expand health care for all children immediately through the FCHIP program. We are going to have a mandate when it comes to children.
How much is this health plan going to cost and how are you going to pay for it?
Obama: The net cost would be about $65 billion. The way we’re going to pay for it is, we’re going to roll back the Bush tax cuts for the top 1 or 2 percent of Americans so that they’re paying the same amount when we were under Bill Clinton. They’d continue to stay in the upper echelons on the income ladder, but we’d be able to pay for the health care plan. We’d also be eliminating programs like the Medicare Advantage program, which basically is a subsidy to insurance companies under the Medicare Plan. It was pushed through by George Bush; it hasn’t saved any money or improved quality of care.
Workers who have health insurance, but barely make ends meet may avoid getting the tests and medical attention they need because of things like co-pays. How does your health plan address that?
We’re going to provide strong incentives to make sure prevention is covered. It’s one of the biggest problems in our health care system. People go to the emergency room for treatable illnesses or they put off visiting their doctor because they can’t afford co-payments and deductibles. If we do what we need to do, we should reverse that kind of incentives. We should make it free to go get screenings from the doctor, make sure those are reimbursed because the more we do that, the more the system as a whole’s going to save.
In eliminating inequalities in health care, would there be a penalty if found that hospitals and health plans aren’t analyzing data to reduce disparities?
I think a lot of the disparities that occur right now have to do with not necessarily explicit efforts to discriminate against African-Americans, but has to do with the fact that the system as a whole isn’t treating folks with the same degree of care. What we need to do is get that information then start teaching hospitals and others how to improve their performance on these fronts.
With respect to having more doctors and nurses that are African-Americans or Hispanic, the biggest barrier there is funding medical school, which can be expensive, setting up career tracks as early as elementary school so that young African-Americans and Latinos are getting the kinds of AP courses and science courses they need in order to be able to enter medical school.
Is there something in your proposal to help small Black businesses offer health care to their employees?
Yes, what we’re going to do is give you a 50 percent credit for any health care plan that you offer employees. There are going to be some businesses that still can’t afford to do it because their margins are just too low and in those situations we’re going to have the employees join the federal health care plan. It’ll be a group plan and cheaper for them. Those that still can’t afford it; we’ll give subsidies to so they can afford it.
Would there be a penalty for parents who don’t ensure their children and businesses that don’t ensure their employees?
We would not impose a penalty until we’ve ensured the FCHIP program and other programs have made it absolutely affordable for every child to be covered. My belief is that you’ve got to make sure people have an option before you start fining them. Once we’ve got the options in place, we’d impose a fine in the ballpark of what it’d cost to provide insurance for their child.
Children are relatively cheap to insure. We’re going to be providing subsidies to make sure people can afford them, but we’re also going to expect our parents showing some responsibility in signing up their kids.
We’ll exempt small businesses from the pay or play provision. Large, or medium sized businesses, we will say to them, “if you’re not providing health insurance to your employees, then it’s only fair you pitch into the pool to help us cover them.”
How would you handle the disabled and handicapped in Medicaid? Would there be changes to those programs?
Medicare is a huge problem and we’re going to rationalize and reform the system. One of the reasons we need health care reform in the employer based and private sectors is because if people aren’t getting screenings early, what happens is by the time they get into the Medicare system they are much worse off. We can trim from the Medicare costs, thereby giving better benefits to folks like the disabled, but we can only do it if we’re reducing the costs in the health care system overall.
Final thoughts?
We’re long overdue for a health care system that works for all Americans.
