Hi Adam:
Thanks for sending your commentary, which was very in formative. I too have written one---for JECH---and attach it for your interest.(It is a pdf of the proof so it has some editorial stuff at the beginning, which I cannot figure out how to delete--sorry) I believe that our agreement is substantial.
Your paper repeats what I recently read in a Lancet commentary on 'chronic illness'---that Obama is proposing to improve primary care, public health, and prevention. I failed to find these in anything I read about his proposals and wondered where you got it from? I'd love to see how he phrased it, as the only thing I am aware of is the focus in 'disease-management' (which is the antithesis of primary care).
Other questions, for my information.
1. I was glad to have the reference to your paper on the VA. Do you know what is the Administrative overhead for the VA?
You may be aware that there is a campaign to discredit the Woolhandler/Himmelstein figures on administrative overhead in the US health services system; everyone agrees that insurance company overhead is about 7%; to this, Steffie and David add the huge costs associated with individual billing, to come to a total of at least 20% and as much as third of total costs. What is it in the VA? Also, at the end of your second paragraph of Controlling Costs, you refer to 'elsewhere' and the reference is to your VA article. Does 'elsewhere' mean the VA?
2. In the second paragraph of Expanding Coverage, you mention two things, the second one as a "moreover'. Isn't this "moreover' part of the mechanism of the National Health Insurance Exchange idea, since how else (besides instituting a competitive government program) could one persuade insurance companies to participate in an 'exchange'?
Your thoughts would be appreciated!
Barbara
-----Original Message-----
From: Anglo-American Health Policy Network [mailto:[log in to unmask]] On Behalf Of Adam Oliver
Sent: Saturday, January 24, 2009 4:44 PM
To: [log in to unmask]
Subject: Obama's pre-election plan
Hi
As you know, I had to put a brief paper together on Obama's health care proposal for a magazine, Policy World, that goes out to the members of the UK Social Policy Association. The paper was published this week, and therefore since the proposals may soon be another part of history (or, who knows, the future), I thought that you might like to have a look at what I wrote (attached).
Thanks to all of you who have helped me try to understand a little bit the US health policy scene.
All best,
Adam
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