Issues 08: Health Care

[maycocksean]

So I woke up the other morning thinking about health care. I know that makes me sound like wonk, but I'm really not.

The key difference between Obama and Clinton's plans, as I understand it, is that Clinton would make health insurance mandatory (or more postively, universal) similar to the way that car insurance is required for all drivers. Obama, on the other hand would provide "access" to health insurance for all but not require everyone to get it.

Which plan do you like better personally? Or, if you're a Republican, what do you see as the better solution for helping uninsured Americans? Which of the two plans do you think would be likely to make it through Congress, close to the form the president intended?

I can see arguments for both plans. Clinton's point of view is that people might not buy health insurance even though they need it. Obama seems to think that if the costs are low enough just about everyone will buy insurance, and those that don't WANT to buy shouldn't be forced to. Clinton's argument is that her plan will be so affordable that the mandatory aspect of what wouldn't be burdensome. (I can see the right freaking out about Americans being required to by gov. health insurance though).

I'm not certain which approach is better, but I do think Obama's plan would more likley make it through Congress in a recognizable form. One thing I am certain of is that both programs will be more expensive than either of the candidates are willing to admitt and things like streamlining costs is not going to be enough to cover the cost of such a large extension of government-funded health care. An increase of taxes, would of course, be the best way to fund it but Americans aren't really friendly with tax increase for any reasons so I don't see either candidate selling that point before the election.

 

[Vincent Vega]

What about the working poor? Some people work three jobs and still aren't able to afford a decent living. There is not one spare cent to pay for health isurance. So if that becomes mandatory, what is the plan to make it affordable for those?

On the other hand, the opportunity cost argument that comes with Obama's approach is very reasonable. Even people that could afford the cheaper health care might take the risk to avoid that insurance in order to have more money in the pocket.

What is the candidates' plan to organise the insurance system? Are they setting up the guidelines and telling the existing insurances to take all citizens to that cost and providing this basic insurance model? Or are they going to set up public health insurances and the existing ones may stay privatized (a system similar to that in Germany)?

And finally, if you just take into consideration how hostile some Americans have become towards smokers or people that eat evil transfats etc. (or was it another kind of fat?), I'm afraid a mandatory health insurance system would just worsen the situation.
Now some would go after anyone who is in any way living a unhealthy lifestyle and harass those to do more for their health because otherwise they are costing 'my' money.

So, how likely is it that Americans accept a mandatory health insurance system in any way, shape or form?

 

[BonosSaint]

THE BASICS:

Hillary's Health Care Plan (from her website)


Hillary Clinton unveiled the third part of her plan to ensure that all Americans have affordable, quality health insurance. Building on her proposals to rein in costs and to insist on value and quality, her American Health Choices Plan will secure, simplify and ensure choice in health coverage for all Americans. This Plan covers every American - finally addressing the needs of the 47 million uninsured and the tens of millions of workers with coverage who fear they could be one pink slip away from losing their health coverage - with no overall increase in health spending or taxes. For those with health insurance, the plan builds on the current system to give businesses and their employees greater choice of health plans - including keeping the one they have - while lowering cost and improving quality. Specifically, the American Health Choices Plan will:



The American Health Choices Plan gives Americans the choice to preserve their existing coverage, while offering new choices to those with insurance, to the 47 million people in the United States without insurance, and the tens of millions more at risk of losing coverage.



The Same Choice of Health Plan Options that Members of Congress Receive: Americans can keep their existing coverage or access the same menu of quality private insurance options that their Members of Congress receive through a new Health Choices Menu, established without any new bureaucracy as part of the Federal Employee Health Benefit Program (FEHBP). In addition to the broad array of private options that Americans can choose from, they will be offered the choice of a public plan option similar to Medicare.


A Guarantee of Quality Coverage: The new array of choices offered in the Menu will provide benefits at least as good as the typical plan offered to Members of Congress, which includes mental health parity and usually dental coverage.


Americans who are satisfied with the coverage they have today can keep it, while benefiting from lower premiums and higher quality.



Reducing Costs: By removing hidden taxes, stressing prevention and a focus on efficiency and modernization, the plan will improve quality and lower costs.


Strengthening Security: The plan ensures that job loss or family illnesses will never lead to a loss of coverage or exorbitant costs.


End to Unfair Health Insurance Discrimination: By creating a level-playing field of insurance rules across states and markets, the plan ensures that no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums.


Relying on consumers or the government alone to fix the system has unintended consequences, like scaled-back coverage or limited choices. This plan ensures that all who benefit from the system share in the responsibility to fix its shortcomings.



Insurance and Drug Companies: insurance companies will end discrimination based on pre-existing conditions or expectations of illness and ensure high value for every premium dollar; while drug companies will offer fair prices and accurate information.


Individuals: will be required to get and keep insurance in a system where insurance is affordable and accessible.


Providers: will work collaboratively with patients and businesses to deliver high-quality, affordable care.


Employers: will help financing the system; large employers will be expected to provide health insurance or contribute to the cost of coverage: small businesses will receive a tax credit to continue or begin to offer coverage.


Government: will ensure that health insurance is always affordable and never a crushing burden on any family and will implement reforms to improve quality and lower cost.


Senator Clinton’s plan will:



Provide Tax Relief to Ensure Affordability: Working families will receive a refundable tax credit to help them afford high-quality health coverage.


Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans.


Create a New Small Business Tax Credit: To make it easier-not harder-for small businesses to create new jobs with health coverage, a new health care tax credit for small businesses will provide an incentive for job-based coverage.


Strengthen Medicaid and CHIP: The Plan will fix the holes in the safety net to ensure that the most vulnerable populations receive affordable, quality care.


Launch a Retiree Health Legacy Initiative: A new tax credit for qualifying private and public retiree health plans will offset a significant portion of catastrophic expenditures, so long as savings are dedicated to workers and competitiveness.





Most Savings Come Through Lowering Spending Due to Quality and Modernization: Over half the savings come from the public savings generated from Senator Clinton’s broader agenda to modernize the heath systems and reduce wasteful health spending.


A Net Tax Cut for American Taxpayers: The plan offers tens of millions of Americans a new tax credit to make premiums affordable-which more than offsets the increased revenues from the Plan’s provisions to limit the employer tax exclusion for health care and discontinue portions of the Bush tax cuts for those making over $250,000. Thus, the plan provides a net tax cut for American taxpayers.


Making the Employer Tax Exclusion for Health Care Fairer: The plan protects the current exclusion from taxes of employer-provided health premiums, but limits the exclusion for the high-end portion of very generous plans for those making over $250,000.

 

[BonosSaint]

Obama's Health Care Plan:

Barack Obama's Plan
Quality, Affordable and Portable Coverage for All
Obama's Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress. The Obama plan will have the following features:
Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.
Comprehensive benefits. The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have. The plan will cover all essential medical services, including preventive, maternity and mental health care.
Affordable premiums, co-pays and deductibles.
Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
Simplified paperwork and reined in health costs.
Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.
Portability and choice. Participants in the new public plan and the National Health Insurance Exchange (see below) will be able to move from job to job without changing or jeopardizing their health care coverage.
Quality and efficiency. Participating insurance companies in the new public program will be required to report data to ensure that standards for quality, health information technology and administration are being met.
National Health Insurance Exchange: The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public.
Employer Contribution: Employers that do not offer or make a meaningful contribution to the cost of quality health coverage for their employees will be required to contribute a percentage of payroll toward the costs of the national plan. Small employers that meet certain revenue thresholds will be exempt.
Mandatory Coverage of Children: Obama will require that all children have health care coverage. Obama will expand the number of options for young adults to get coverage, including allowing young people up to age 25 to continue coverage through their parents' plans.
Expansion Of Medicaid and SCHIP: Obama will expand eligibility for the Medicaid and SCHIP programs and ensure that these programs continue to serve their critical safety net function.
Flexibility for State Plans: Due to federal inaction, some states have taken the lead in health care reform. The Obama plan builds on these efforts and does not replace what states are doing. States can continue to experiment, provided they meet the minimum standards of the national plan.
Lower Costs by Modernizing The U.S. Health Care System
Reducing Costs of Catastrophic Illnesses for Employers and Their Employees: Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums.
Helping Patients:
Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. This will improve quality of care, give doctors better information and lower costs.
Coordinate and integrate care. Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. Obama will support implementation of programs and encourage team care that will improve coordination and integration of care of those with chronic conditions.
Require full transparency about quality and costs. Obama will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care. Health plans will also be required to disclose the percentage of premiums that go to patient care as opposed to administrative costs.
Ensuring Providers Deliver Quality Care:
Promote patient safety. Obama will require providers to report preventable medical errors and support hospital and physician practice improvement to prevent future occurrences.
Align incentives for excellence. Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded for achieving performance thresholds on outcome measures.
Comparative effectiveness research. Obama will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.
Tackle disparities in health care. Obama will tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. He will also challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.
Insurance reform. Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and will promote new models for addressing errors that improve patient safety, strengthen the doctor-patient relationship and reduce the need for malpractice suits.
Lowering Costs Through Investment in Electronic Health Information Technology Systems: Most medical records are still stored on paper, which makes it hard to coordinate care, measure quality or reduce medical errors and which costs twice as much as electronic claims. Obama will invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems, including electronic health records, and will phase in requirements for full implementation of health IT. Obama will ensure that patients' privacy is protected.
Lowering Costs by Increasing Competition in the Insurance and Drug Markets: The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. There have been over 400 health care mergers in the last 10 years, and just two companies dominate a full third of the national market. These changes were supposed to make the industry more efficient, but instead premiums have skyrocketed by over 87 percent.
Barack Obama will prevent companies from abusing their monopoly power through unjustified price increases. His plan will force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration. His new National Health Exchange will help increase competition by insurers.
Lower prescription drug costs. The second-fastest growing type of health expenses is prescription drugs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Obama will allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama will also repeal the ban that prevents the government from negotiating with drug companies, which could result in savings as high as $30 billion. Finally, Obama will work to increase the use of generic drugs in Medicare, Medicaid, and FEHBP and prohibit big name drug companies from keeping generics out of markets.
Fight for New Initiatives
Advance the Biomedical Research Field: As a result of biomedical research the prevention, early detection and treatment of diseases such as cancer and heart disease is better today than any other time in history. Barack Obama has consistently supported funding for the national institutes of health and the national science foundation. Obama strongly supports investments in biomedical research, as well as medical education and training in health-related fields, because it provides the foundation for new therapies and diagnostics. Obama has been a champion of research in cancer, mental health, health disparities, global health, women and children's health, and veterans' health. As president, Obama will strengthen funding for biomedical research, and better improve the efficiency of that research by improving coordination both within government and across government/private/non-profit partnerships. An Obama administration will ensure that we translate scientific progress into improved approaches to disease prevention, early detection and therapy that is available for all Americans.
Fight AIDS Worldwide. There are 40 million people across the planet infected with HIV/AIDS. As president, Obama will continue to be a global leader in the fight against AIDS. Obama believes in working across party lines to combat this epidemic and recently joined Senator Sam Brownback (R-KS) at a large California evangelical church to promote greater investment in the global AIDS battle.
Support Americans with Disabilities: As a former civil rights lawyer, Barack Obama knows firsthand the importance of strong protections for minority communities in our society. Obama is committed to strengthening and better enforcing the Americans with Disabilities Act (ADA) so that future generations of Americans with disabilities have equal rights and opportunities. Obama believes we must restore the original legislative intent of the ADA in the wake of court decisions that have restricted the interpretation of this landmark legislation.

Barack Obama is also committed to ensuring that disabled Americans receive Medicaid and Medicare benefits in a low-cost, effective and timely manner. Recognizing that many individuals with disabilities rely on Medicare, Obama worked with Senator Ken Salazar (D-CO) to urge the department of health and human services to provide clear and reliable information on the Medicare prescription drug benefit and to ensure that the Medicare recipients were protected from fraudulent claims by marketers and drug plan agents.
Improve Mental Health Care. Mental illness affects approximately one in five American families. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As president, Obama will support mental health parity so that coverage for serious mental illnesses are provided on the same terms and conditions as other illnesses and diseases.
Protect Our Children from Lead Poisoning. More than 430,000 American children have dangerously high levels of lead in their blood. Lead can cause irreversible brain damage, learning disabilities, behavioral problems, and, at very high levels, seizures, coma and death. As president, Obama will protect children from lead poisoning by requiring that child care facilities be lead-safe within five years.
Reduce Risks of Mercury Pollution. More than five million women of childbearing age have high levels of toxic mercury in their blood, and approximately 630,000 newborns are born at risk every year. Barack Obama has a plan to significantly reduce the amount of mercury that is deposited in oceans, lakes, and rivers, which in turn would reduce the amount of mercury in fish.
Support Americans with Autism. More than one million Americans have autism, a complex neurobiological condition that has a range of impacts on thinking, feeling, language, and the ability to relate to others. As diagnostic criteria broaden and awareness increases, more cases of autism have been recognized across the country. Barack Obama believes that we can do more to help autistic Americans and their families understand and live with autism. He has been a strong supporter of more than $1 billion in federal funding for autism research on the root causes and treatments, and he believes that we should increase funding for the Individuals with Disabilities Education Act to truly ensure that no child is left behind.

More than anything, autism remains a profound mystery with a broad spectrum of effects on autistic individuals, their families, loved ones, the community, and education and health care systems. Obama believes that the government and our communities should work together to provide a helping hand to autistic individuals and their families.

 

[maycocksean]

Thanks for posting this information, BonosSaint.

So which plan do you think is better and why?

 

[BonosSaint]

I see things I like in both, things I don't like. I think in some ways they are difficult to judge, because "affordable" is a vague term that doesn't specify the dollars and cents amounts to the consumer.

I have no trouble with mandatory universal coverage because in the end somebody will be paying for the catastrophic illnesses of the uninsured and it won't be the uninsured. Of course, Hillary's plan doesn't address what percentage of a consumer's income will be used to determine the cost of the premiums which concerns me and a tax credit would come after the fact, perhaps making it difficult for the upfront payment for insurance for individuals and families that live paycheck to paycheck.

Obama's plan is ambitious, which I like, but neither plan really addresses the consequence to the insurance companies for price gouging--merely a monitoring.

Obama's plan addresses an issue Hillary's does not seem to, which is the quality of healthcare (in addition to the cost). So I appreciate his full transperancy from hospitals as well as insurers.
And definitely his allowing of citizens to purchase drugs outside of country and promoting government negotiation on drug prices.

I haven't seen the dollar amounts obviously, but based on the programs, I think premiums would be cheaper on Hillary's plan--based on it being spread out universally.

Based on website policies--Edge: Obama

I obviously have concerns with the makeup of the Congress (watching a few troubling developments down my way). Healthcare policy is not an executive order as Hillary learned to her lasting embarassment. Until Congress enacts it, it's a wishlist.
I expect any plan to be watered down once it gets to its final form. Now how watered down will it be is the question. I suspect Hillary has structured hers to have the least opposing interests. I'm not sure whether that is a virtue or not. In short, I think Obama has a better plan, but I think that Hillary's has a better chance of passing.

 

[Vincent Vega]

Ok, when I have two or so spare hours I will read the basics.

 

[Vincent Vega]

OK, finished.

Hm, might be because Obama's is a bit longer, but I would agree that in principle his has some advantages over Clinton's.
His focus on transparency and prevention is very commendable.

I also doubt Hillary's claim that her program could be "established without any new bureaucracy as part of the Federal Employee Health Benefit Program", as health insurances then will have to deal with such a heterogeneous field of customers, risks etc.

As having a chronic disease myself, but not really affected by US health insurance, I'm happy that Obama is taking those diseases into consideration.
What I'm missing with both is a real calculation of costs and savings.
Here, both are just saying they will save here and there, and their programs won't cost much, and won't generate much extra cost, if any. Obama is throwing in some figures here and there, but nothing one could really use for a serious calculation. The only sum I've seen is what he will pay over the next five years for medical IT, but for the rest he is only mentioning some of the current yearly costs he is aiming to decrease, without indicating by how much he will decrease those.
Both are very vague on the modernisation part. OK, IT is a modernisation, but what else?

Generics is indeed a great source for savings. I've also read recently that a study found that pharmaceutical companies are spending more for advertising their medicine than for research and development.

Both plans sound good, and promise only the best, but without any real figures it's not more than nice sounding.

And I still see the acceptance as a problem. Such plans are based on soidarity, but solidarity also means that you can't dictate others lifestyles in order to stay healthy and generate as little cost as possible. Also, many people have a rather broad definition of socialism, something both candidate's will have to deal with when trying to implement the reform.

 

[anitram]

Hillary's plan is better.

Unfortunately statistics show that there is a segment of the population who can afford a plan and will refuse to enrol, because they have other ideas for their $160/month or whatever it is. I saw one study that indicated a lot of these people would rather keep leasing a new vehicle every 4 years than pay for health insurance. I think there is something mentally off with these folks to be honest, but that is what we are dealing with.

Obama is right though, that I think the numbers of such people are exaggerated, so that his plan would actually cover more people than the pundits say. But I've never really gotten a clear answer out of him about how it is that we will penalize people who refuse to subscribe.

The thing about Hillary's plan is that it's going to cost some $50-60 billion more than Obama's (I'm sorry I can't remember the exact numbers off the top of my head). His plan can essentially be financed fully simply by rolling back Bush's tax cut to those making over $200K. Hillary's will come up short and so she'll have to fish around elsewhere for the remainder. Given the lame Congress and how much the GOP hates her, I'm not so sure it'll be easy to find that money.

Neither has the perfect plan, neither plan is bad either. Hillary's is just the only one that will actually insure everyone.

(But this is a good example of why it is very intellectually lazy to say that Obama only talks about hope and change and nothing concrete. I've watched almost all the debates and many of his speeches and I know exactly what his plan consists of. When somebody says he has no platform, usually it means they haven't bothered to get informed.)

 

[Liesje]

The health care plans are the one main issue I still need to study up on. Since MI didn't have a Dem primary, I put it off. It's something that's becoming increasingly important to me, now that I'm married to someone who has a lifelong health problem that our insurance doesn't usually cover, at least not enough to really help us. The problem with our current HMO is that we never reach the premium and we can't afford the premium. Even with Phil taking special medications and having to have yearly tests and see referral doctors, we don't reach the premium and still have to pay. I use student loans to pay medical bills! My parents have always had the same problem. My brother broke his arm and it took my mom years to pay it off. I think she finally cashed in our life insurance policy to get the collections people off her back.

I think health care really became an important issue to me a few years back when I was on a road trip with my parents. We stopped at some gas station in rural Tennessee and on the message board was a flyer for a bake sale. A local family had a newborn that needed heart surgery and they could not afford it because they were not insured. My mom and I were both floored. We live in a wealthy, developed nation and families are forced to have bake sales to save their babies' lives?

Anyway, I'll come back later and study up on the platforms...

 

[ntalwar]

Obama's plan is better: "Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. "

Hillary's plan does not mention premiums being tied (or not) to preexisting health conditions.

 

[randhail]

I think that people with certain pre-existing conditions should be charged more, not for congenital conditions such as type 1 diabetes, but for the acquired conditions that result from the person not taking of themself (the smoking, alcoholic, type II diabetic that refuses that comply with treatment). It works for car insurance so why should it be any different for health insurance? You utilize more resources, therefore you should be expected to pay more. Now, the differences shouldn't be astronomical, but's only fair. If you're compliant with your treatment then you would be charged a lower rate.

 

[ntalwar]

I think that people with certain pre-existing conditions should be charged more, not for congenital conditions such as type 1 diabetes, but for the acquired conditions that result from the person not taking of themself (the smoking, alcoholic, type II diabetic that refuses that comply with treatment).

That seems like it could lead to genetic discrimination at some point. It could also get insurance companies off the hook because there is not always a clear cause and effect relationship between a given behavior and a medical condition.

 

[randhail]

You're right that there isn't always a clear link between behavior and health and it does seem like most everything does have at least some, even if minor, genetic component to it. That's why I would have compliance to treatment be a factor in how much someone pays. The patient has to take an active interest in their own care. Why should the smoking diabetic patient that sits at home eating crap pay the same amount as the smoking diabetic who quits smoking and is actively controlling there glucose levels? It doesn't seem fair at all and you would think that the prospect of paying more money would encourage people to be compliant to treatment.

 

[Liesje]

I think that people with certain pre-existing conditions should be charged more, not for congenital conditions such as type 1 diabetes, but for the acquired conditions that result from the person not taking of themself (the smoking, alcoholic, type II diabetic that refuses that comply with treatment). It works for car insurance so why should it be any different for health insurance? You utilize more resources, therefore you should be expected to pay more. Now, the differences shouldn't be astronomical, but's only fair. If you're compliant with your treatment then you would be charged a lower rate.

I actually agree, but I don't really see how this would be fairly determined and enforced. However I'm not in a medical profession so maybe it's not as hard as I think. But I agree it sucks that someone like my grandma who is grossly unhealthy and gave herself a heart attack and diabetes gets everything paid for on a silver platter meanwhile I cannot afford for Phil to have an EEG test to help determine the cause of his epilepsy.

At work, we actually do get cash incentives for being healthy. It is done through our health insurance provider, but unfortunately does not effect our actual HMO. For 2008, you have to do three different health incentives per quarter and if you complete them you get $75 cash per quarter. The "health incentives" are things like taking fitness, dance, or nutrition classes offered, keeping a log of working out 5-7 times a week, quit smoking, get a flu shot, join a pedometer contest team, get an annual physical...that sort of thing. Also if you have a certain disease where exercise is important but more difficult (MS, heart conditions, neurological conditions, etc), you can get paired for free with an exercise science senior and meet with them several times a week for personal training. So there are some nice things my employer arranges and offers for free or at a discounted rate, but again it never actually affects our HMO (which went up this year at a much higher percentage than our cost of living salary increase).

 

[maycocksean]

Here, both are just saying they will save here and there, and their programs won't cost much, and won't generate much extra cost, if any.

Yeah, that's the part of both plans that I think is a bunch of crap. I think both programs will be very expensive but I don't think either candidate wants to cop to that.

 

[maycocksean]

(But this is a good example of why it is very intellectually lazy to say that Obama only talks about hope and change and nothing concrete. I've watched almost all the debates and many of his speeches and I know exactly what his plan consists of. When somebody says he has no platform, usually it means they haven't bothered to get informed.)

Thank you for that.

That's all I've been trying to say for a very long time.