Exhibit A – “Universal” Health Care

[johnkarls]

.
We all remember what happened to President Clinton after he was elected as the “Change” candidate!!!

He proposed “single payer” Universal Health Care!!!

“Single Payer” means that there are no insurance companies which, of course, seem to be in the business of refusing coverage and, when coverage is granted, disallowing claims.

“Universal” means everyone is covered!!!

President Clinton put Hillary in charge of leading the effort.

Their effort was defeated by “campaign contributions” to Senators and Congresspersons.

As we saw in Michael Moore’s “Sicko” last August 2nd, all of the Democratic presidential candidates are merely proposing to make insurance available everyone so that the insurance companies don’t once again sabotage the effort – except Dennis Kucinich whom Michael Moore endorsed in addition to endorsing Kucinich’s “single payer” legislation introduced in Congress.

Michael Moore’s “Sicko” also listed some of the Senators and Congresspersons who have recently accepted sizable “campaign contributions” from health-insurance companies, including Hillary Clinton.

Nevertheless, the health-insurance proposals of Barack Obama, Hillary Clinton and John Edwards are virtually identical – except that Tim Russert of Meet the Press accused Barack Obama of a lack of “candor” by claiming in his campaign ads that his proposal “covers everyone” even though, unlike Clinton and Edwards, he refuses to include a “mandate” requiring everyone to purchase the new health insurance.

On this point of Tim Russert’s accusation of a lack of “candor” by Barack Obama are the following two postings I appended on Jan 4th to the Proposed Topic of “‘Face The Nation’ – NYC Mayor Bloomberg for President.”


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“Meet the Press” - Obama’s Lack of a Health-Care Mandate
I’ve been wrestling for four days (it is now Thurs evening, Jan 3rd) with the issue of whether to say anything regarding Barack Obama’s most recent stance with respect to his refusal to include in his health-care proposal a “mandate” that everyone purchase the health-care insurance that would be provided under his proposal.

The reason for wrestling is that Obama’s most recent stance is a relatively minor point with respect to the foregoing proposal of studying the benefits of an independent candidacy of Michael Bloomberg.

However, after thinking “long and hard” about whether to include any comments, it became obvious that the issue of Barack Obama’s naïveté or disingenuousness or lack of comprehension on such an important issue as whether his health-care proposal would be universal as he continues to assert – does speak to the issue of whether we need an independent candidate who will understand the problem and will not duck it.

As can be seen from the official “Meet the Press” transcript from last Sunday (Dec. 30), Tim Russert asks Barack Obama “in terms of candor” how he can be running a campaign ad in Iowa that claims his health-care proposal “covers everyone” when there is no “mandate” that everyone purchase the health-care insurance that would be available under his proposal.

Although Barack Obama has been under attack on this point for an extended period, he still flailed around on Sunday morning while providing no realistic answer, saying (as can be seen from the transcript below) –

“…My belief is that the real problem is people can't afford healthcare, and that if we could make it affordable, they will purchase it… If it turns out that there are still people left over who are not purchasing healthcare, one way of avoiding them waiting till they get sick is to charge a penalty if they try to sign up later so that they have an incentive to sign up immediately… what happens then is we are not going around trying to fine people who can't afford healthcare, and that's what's happening in Massachusetts right now. They've already had to exempt 20 percent of the uninsured, and you're reading stories about people who didn't have healthcare, still can't afford the premiums on the subsidized healthcare, but now are also paying a fine. That I don't think is providing a relief to the American people. We need to make health care affordable…”

As a viewer of “Meet the Press” since long before Tim Russert took over the program, I have never seen Russert “pull his punches” as he did by not pinning down Barack Obama on this point. Presumably out of pity that Barack Obama would further embarrass himself.

After all, Barack Obama’s first argument is a naïve assertion that everyone will buy the health insurance without a “mandate”!!! Even though he had been defending himself against attacks from Clinton and Edwards that his failure to include a “mandate” meant coverage would NOT be universal by arguing that the reason for his failure to include a mandate is that mandates by the states for drivers to purchase auto insurance had NOT been very effective so the Clinton and Edwards proposals would NOT be universal either!!!

Then Barack Obama appears to contradict himself by saying (as quoted above): “…one way of avoiding them waiting till they get sick (to purchase health insurance) is to charge a penalty if they try to sign up later”!!!

Why is he only appearing to contradict himself???

Because he doesn’t say whether he would impose such fines!!! Appearing to back off quickly when Russert called the fines a “quasi-mandate.”

At that point, a jumble of words spilled out of Barack Obama’s mouth which didn’t explain what he is going to do about people who do not purchase his health insurance.

Is he going to impose fines??? Or is he not going to impose fines??? Or is there yet some other “rabbit” lurking in his hat???

Since Barack Obama has not inkled that there may be another “rabbit” lurking in his hat, it is interesting to examine his quandary over whether or not to impose fines in terms of “Elementary Game Theory” which is universally employed by experts in such situations.

If no fine is imposed, then everyone that Barack Obama is naively hoping will purchase his proposed health insurance will refrain from doing so until they need it. A “rough cut” analysis of how much such health “insurance” would cost if nobody purchases it until it is needed would mean that its initial premium would equal the average cost of the first illness that finally prompts each citizen to purchase that “insurance.”

This would mean that if an individual encounters an illness that costs less the average cost of the first illness that finally prompts others to purchase the “insurance” then it would make more sense for that individual to simply pay the smaller cost of her/his illness and wait for an illness whose cost does exceed the average cost of the first illness that finally prompts others to purchase the “insurance.”

Unless there is a government subsidy to anchor this whole “insurance” scheme, it can readily be seen that no such insurance, in theory, will ever be purchased unless some poor chump “starts the ball rolling” by being the first to make the irrational decision to purchase the “insurance” at a price that exceeds the cost of her/his illness (in order to cover insurance-company administrative expenses and profit as well as the cost of the illness)!!!

And once such a chump appears, the cost of the “insurance” will rapidly escalate because nobody whose first illness costs less than that amount will purchase it (choosing instead to simply pay the smaller cost of the illness). Obviously, purchases of such “insurance” by only those whose first illness exceeds the cost of that “insurance” will mean the price of such “insurance” will rapidly escalate to cover the claims, all of which exceed that price.

And this does not even consider how the fines would “dig a hole” that is much deeper in terms of “game theory”!!!

No wonder Tim Russert let poor Barack Obama “off the hook” before he embarrassed himself further.

At least Hillary Clinton and John Edwards are smart and honest enough to admit that a “mandate” is required, and then to grapple with Obama’s original criticism that “mandates” to purchase health insurance will probably be no more effective than have been the “mandates” of the various states to purchase auto insurance.

Though now we have “warped around” to the original subject – whether there is needed an independent candidate who will scrap the whole idea of involving the insurance industry because of their so-called “campaign contributions” and, instead, provide truly universal health care.

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Meet the Press Transcript – 30 Dec 2007 – Excerpt comprising the last half of page 5, the last page of the Official Transcript


MR. RUSSERT: In terms of candor, you're running a political ad in Iowa and elsewhere about healthcare. And this is what the ad says. Here's the Obama ad. Let's watch.

(Videotape)

SEN. OBAMA: I've got a plan to cut costs and cover everyone.

(End videotape)

MR. RUSSERT: "Cover everyone." Every analysis of your healthcare plan says there are 15 million Americans who would not be automatically covered because you don't call for a mandate.

SEN. OBAMA: But, but, Tim...

MR. RUSSERT: Let me just give you a chance to respond. Ron Brownstein, who's objective on this, wrote this for the National Journal, and then we'll come back and talk about it. He says this: "Obama faces his own contortions. He commendably calls for building a broad healthcare consensus that includes the insurance industry. But in the states, the individual mandate has been critical in persuading insurers to accept reform, including the requirement" "they no longer reject applicants with pre-existing health problems. If such a requirement isn't tied to a mandate, insurers correctly note, the uninsured can wait until they are sick to buy coverage, which" would "inflate costs for everyone else. By seeking guaranteed access without an individual mandate, Obama is virtually ensuring war with the insurance companies that he's pledged to engage."

SEN. OBAMA: Well, Tim, here's the philosophical debate that's going on. First of all, every objective observer says Edwards, Clinton, myself, we basically have the same plan. We do have a philosophical difference. They both believe the problem is the government is not forcing adults to get healthcare. My belief is that the real problem is people can't afford healthcare, and that if we could make it affordable, they will purchase it. Now, they assert that there're going to be all these people left out who are avoiding buying healthcare. My attitude is, we are going to make sure that we reduce costs for families who don't have health care, but also people who do have healthcare and are desperately needing some price relief. And we are going to reduce costs by about $2500 per family. If it turns out that there are still people left over who are not purchasing healthcare, one way of avoiding them waiting till they get sick is to charge a penalty if they try to sign up later so that they have an incentive to sign up immediately.

MR. RUSSERT: Which is a quasi-mandate.

SEN. OBAMA: But--well, no, it's not a quasi-mandate because what happens then is we are not going around trying to fine people who can't afford healthcare, and that's what's happening in Massachusetts right now. They've already had to exempt 20 percent of the uninsured, and you're reading stories about people who didn't have healthcare, still can't afford the premiums on the subsidized healthcare, but now are also paying a fine. That I don't think is providing a relief to the American people. We need to make health care affordable. That's what my plan does. And The Washington Post itself said, for the Clinton campaign to try to find an individual who wanted healthcare and could not get it under the Obama administration would be very difficult because that person probably does not exist. If you want healthcare under my plan, you will be able to get it, it will be affordable, and it will be of the high quality.

MR. RUSSERT: Before you go, you related a conversation that you had with your wife, Michelle, that if you didn't run--win this time for president, you wouldn't run again.

SEN. OBAMA: Well, no, what my wife said is, "We're not doing this again." And...

MR. RUSSERT: Is she right?

SEN. OBAMA: Well, the point she was making, I think, was an interesting one, which is, she said, one of the things that we bring to this race is we're not that far away from normal. You know, it wasn't that long ago that we were living in a small condo and it was getting too small for our kids, that we were trying to figure out how to save money for our children's college education and paying off student loans. That, I think, gives us some insight into what ordinary Americans are going through right now. Eight years from now, she isn't so sure that we won't be in a different orbit, and we won't have that same feeling for what people are going through.

MR. RUSSERT: But if you don't win this time, would you run again?

SEN. OBAMA: Oh, Tim, we haven't even cast the--we haven't even had the first caucus in Iowa.

MR. RUSSERT: Keeping that door open, huh?

SEN. OBAMA: I, I intend to win this time, that's why I'm running.

MR. RUSSERT: Senator Obama, thanks very much for joining us and sharing your views.

SEN. OBAMA: Thank you.

MR. RUSSERT: And we'll be right back.

(Announcements)

MR. RUSSERT: Continuing coverage from Iowa all week on MSNBC, the "Today" show and "NBC Nightly News." We'll be back live next week from New Hampshire, two days before the New Hampshire primary. New Year's Day, watch those Buffalo Sabres, world's largest outdoor hockey game, on here on NBC. If it's Sunday, it's MEET THE PRESS. Happy new year, everyone, and thanks to our friends here at WHO in Iowa.


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Further Thoughts - Obama’s “Meet the Press” Performance
Since I “bit the bullet” and commented on Barack Obama’s refusal to include in his health-care plan a “mandate” that all of the 47 million uninsured purchase the health-care insurance that will be offered, it appears necessary to provide a few additional comments on the devastating “elementary game theory” implications of this failure.

From a reading of Barack Obama’s current proposal, including both the description from his official web site that appears below and from the actual text of the proposal which can be accessed via the link at the end of the description (but is not reproduced below for the sake of brevity), economies would come from several sources:

FIRST, he would reverse the Bush Administration policy of saddling Americans with 100% of research & development expenditures, which is reflected in permitting drug companies to sell outside the U.S. at reduced prices that do not include a research cost element. Barack Obama would permit Americans to obtain their drugs abroad (think purchasing via the internet) whenever drug companies attempt to discount elsewhere. (Interesting Question – to the extent that drugs are made available to poor countries at reduced prices that do not reflect research costs, does Barack Obama appreciate the full implications of this elimination of “foreign aid for poor countries” that this policy represents, or would he sort out the countries and have a list of countries from which Americans would be permitted to purchase drugs???)

SECOND, he would reduce the costs associated with health care (hospitals, doctors, etc.), in effect claiming that his experts are better than the existing insurance-company experts in reducing or controlling such costs. However, when it comes to imposing a national requirement that hospital and physician records be computerized and that they be computerized in a uniform manner, he does have a point that the federal government can impose such a law while the insurance companies would be prevented by anti-trust law from colluding with each other to impose such a requirement.

THIRD, he would reduce the administrative costs and profits of health-insurance companies by increased competition.

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In terms of the “elementary game theory” analysis set forth in the preceding posting, the first two items will have no impact because those cost reductions will benefit both the insured and the uninsured. Leaving intact the “elementary game theory” problems of nobody purchasing the health insurance until an illness is encountered whose cost exceeds the premium – and the quickly sky-rocketing premium level as the insurance is purchased only when illnesses are encountered whose cost exceeds the premium.

The third item would also have no impact on the “elementary game theory” analysis despite the fact that it does reduce a cost for individuals opting for coverage at the outset, but has no cost-savings for individuals correctly opting to wait to purchase coverage until an illness is encountered whose cost exceeds the premium.

This probably explains why both Tim Russert and Barack Obama “stepped back from the brink” and Russert let Barack Obama “off the hook.”

Because the only way out of the problem (unless one “assumes it away” by assuming massive ignorance or stupidity on the part of the public) is to provide a massive subsidy.

Indeed, that is what is done in the Medicare Program for which “senior citizens” are charged premiums approaching $2 thousand/year/person for non-drug medical expenses (and premiums of approx. $600/year/person for drug expenses). These expenses greatly exceed the premiums with the difference funded from current social security & medicare taxes (aka “self-employment tax” in the case of business owners) – since the social security (and medicare) taxes have been used since social security was enacted under Franklin Roosevelt to subsidize current benefits rather than fund the future benefits of the current workers paying the taxes (WITH THE CURRENT EXCESS OF SUCH TAXES OVER CURRENT BENEFITS USED TO REDUCE THE GENERAL DEFICIT RATHER THAN BEING INVESTED IN A CONVENTIONAL-STYLE PENSION PLAN – THE POLS CALL THE CUMULATIVE TOTAL OF EXCESS SOCIAL SECURITY TAXES THE “SOCIAL SECURITY TRUST FUND” BECAUSE THEY HAVE ISSUED TO THEMSELVES FEDERAL GOVERNMENT BONDS IN THE AMOUNT OF THE CUMULATIVE EXCESS – BUT THIS IS A MERE “FIG LEAF” BECAUSE ISSUING TO YOURSELF YOUR OWN I.O.U.’s IS NOT, REPEAT NOT, A REAL “TRUST FUND”!!!).

In the mass of words Barack Obama utters after Tim Russert lets him “off the hook” on whether he would impose fines for failure to purchase the insurance, Barack Obama admits that under Massachusetts’ “universal” plan, 20% of the uninsured had to be exempted and there are still many citizens who cannot afford the premiums and are being fined!!! And he opines that exempting 20% is unacceptable and imposing fines on even more citizens is not “universal” coverage.

So what is the magnitude of the “elephant in the room” that Barack Obama does NOT want to discuss??? The amount of the governmental subsidy that would be required to make his plan work!!!

One can only guess.

But let’s, for the fun of it, make some educated guesses.

The text of Barack Obama’s own health care plan begins with the statement: “The U.S. spends over $2 trillion on medical care every year…”

The 47 million uninsured are 15.61% of the total U.S. population estimated by the C.I.A. as 301 million as of last July (https://www.cia.gov/library/publication ... nt/us.html - Google’s number 1 item for searching “U.S. population”).

If more than $2 trillion/year is spent on 301 million Americans, then on a pro-rata basis more than $312 billion/year is the share of the 47 million uninsured.

Which means that covering nationally the 20% that had to be exempted in Massachusetts would “ball park” at $62.4 billion/year, PLUS AN UNDISCLOSED ADDITIONAL AMOUNT FOR THE ADDITIONAL NATIONAL CITIZENRY THAT BARACK OBAMA ADMITS IS BEING FINED ON THE MASSACHUSETTS LEVEL.

THOUGH THIS IGNORES THE “ELEMENTARY GAME THEORY” PRINCIPLE THAT IF BARACK OBAMA FAILS TO EVEN IMPOSE ANY FINES, THE OTHER 80% OF THE 47 MILLION UNINSURED WILL MAKE THE RATIONAL DECISION TO REFUSE TO PURCHASE MEDICAL INSURANCE UNTIL THEY ENCOUNTER AN ILLNESS THAT EXCEEDS THE PROHIBITIVELY-HIGH COST OF THE INSURANCE.

UNLESS, OF COURSE, BARACK OBAMA SUBSIDIZES THAT COST BY PAYING MUCH IF NOT VIRTUALLY ALL OF THE $312 BILLION/YEAR OF HEALTH-CARE COSTS ATTRIBUTABLE TO THE 47 MILLION UNINSURED.

AND THIS DOES NOT EVEN TAKE INTO ACCOUNT THE POLITICAL PRESSURE (THINK “CAMPAIGN CONTRIBUTIONS”) AS EMPLOYERS TRY TO SHIFT THE REMAINDER OF THE “MORE THAN $2 TRILLION/YEAR” OF MEDICAL COSTS TO THE FEDERAL GOVERNMENT.

Perhaps Tim Russert and Barack Obama are smarter than I give them credit for, because they may indeed see this coming and don’t want to alarm us. But wouldn’t it be nicer if they treated us with some respect that we are also smart enough that we don’t have to be tricked into a process that will ultimately result in universal health care??? And, if they trusted us and we made the right decision, could be achieved much sooner with much less silliness!!!

Though I doubt that Tim Russert and Barack Obama deserve such credit. After all, if Barack Obama achieves the nomination, all of the above will come out anyway in the course of the general election campaign between him and the Republican candidate (and, perhaps, Michael Bloomberg). When that happens, Democrats will be saddled with a candidate who looks foolish despite the fact that he might have thought he was being smart.


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From “www.barackobama.com/issues/healthcare/” as of January 4, 2008
PLAN FOR A HEALTHY AMERICA

“We now face an opportunity — and an obligation — to turn the page on the failed politics of yesterday's health care debates… My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness.”

— Barack Obama, Speech in Iowa City, IA, May 29, 2007

At a Glance

· Quality, Affordable and Portable Coverage for All

· Lower Costs by Modernizing The U.S. Health Care System

· Fight for New Initiatives

Speak your mind and help set the policies that will guide this campaign and change the country.

· Present your ideas

· Discuss with others

The Problem

Millions of Americans are uninsured or underinsured because of rising medical costs: 47 million Americans — including nearly 9 million children — lack health insurance with no signs of this trend slowing down.

Health care costs are skyrocketing: : Health insurance premiums have risen 4 times faster than wages over the past 6 years.

Too little is spent on prevention and public health: The nation faces epidemics of obesity and chronic diseases as well as new threats of pandemic flu and bioterrorism. Yet despite all of this less than 4 cents of every health care dollar is spent on prevention and public health.

Barack Obama's Plan

QUALITY, AFFORDABLE AND PORTABLE COVERAGE FOR ALL

A. 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:

A-1. Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.

A-2. 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.


A-3. Affordable premiums, co-pays and deductibles.

A-4. 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.


A-5. Simplified paperwork and reined in health costs.

A-6. Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.


A-7. 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.

A-8. 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.

B. 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.

C. 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.

D. 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.

E. 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.

F. 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
A. 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.

B. Helping Patients:

B-1 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.

B-2. 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.

B-3. 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.

C. Ensuring Providers Deliver Quality Care:

C-1. Promote patient safety. Obama will require providers to report preventable medical errors and support hospital and physician practice improvement to prevent future occurrences.

C-2. 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.

C-3. 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.

C-4. 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.

C-5. Reform medical malpractice. 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.

D. 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.

E. 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.

E-1. 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.

E-2. 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

A. 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.

B. 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.

C-1. 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.

C-2. 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.

D. 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.

E. 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.

F. 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.

G-1. 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.

G-2. 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.

Barack Obama's Record

A. Health Insurance: In 2003, Barack Obama sponsored and passed legislation that expanded health care coverage to 70,000 kids and 84,000 adults. In the U.S. Senate, Obama cosponsored the Healthy Kids Act of 2007 and the State Children's Health Insurance Program (SCHIP) Reauthorization Act of 2007 to ensure that more American children have affordable health care coverage.

B. Women's Health: Obama worked to pass a number of laws in Illinois and Washington to improve the health of women. His accomplishments include creating a task force on cervical cancer, providing greater access to breast and cervical cancer screenings, and helping improve prenatal and premature birth services.

FOR MORE INFORMATION ABOUT BARACK'S PLAN

Read the Plan (pdf link)
Read the Frequently-Asked Q and A (pdf link)
Read the Speech (pdf link)