So much has been said and so little done over the last ten or more years about healthcare reform that many of us have stopped listening.  However, with the heavy emphasis placed by President-elect Obama on the issue of healthcare reform, and the astronomical rate at which health care costs are rising, it would seem that the chances of sweeping reform are greater now than ever before. 

Over the last few weeks, many of my physician clients have asked what reform under Mr. Obama will mean for them.  Frankly, it is too early to tell how the proposed Obama plan will impact physicians and other providers.  The weak economy can be expected to occupy much of the Obama administration’s time in the coming months, but many anticipate that Mr. Obama will move fairly quickly on his healthcare plan.  Accordingly, physicians should keep a close eye on the plan as it develops.

Here are some of the more substantive reforms promised by Mr. Obama in his initial plan:

  • Guarantee affordable, accessible health care coverage for all Americans through new affordable health insurance options by:
  1. guaranteeing eligibility for all health insurance plans;
  2. creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance;
  3. providing new tax credits to families who can’t afford health insurance and to small businesses with a new Small Business Health Tax Credit;
  4. requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan;
  5. requiring all children have health care coverage;
  6. expanding eligibility for the Medicaid and SCHIP programs; and
  7. allowing flexibility for state health reform plans.
  • 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;
  • Require that health plans that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs;


  • 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 and costs. Health plans will be required to disclose the percentage of premiums that actually goes to paying for patient care as opposed to administrative costs.
  • Require providers to report preventable medical errors, and support hospital and physician practice improvement to prevent future errors.
  • Establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have accurate and objective information to make the best decisions for their health and well-being.
  • Strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance.
  • Eliminate the excessive subsidies to Medicare Advantage plans and pay them the same amount it would cost to treat the same patients under regular Medicare.
  • Allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S.
  • Repeal the ban on direct negotiation with drug companies and use the resulting savings, which could be as high as $30 billion,33 to further invest in improving health care coverage and quality.

The Obama plan can be viewed in its entirety here