Altman Part 4

In this section of the book, Altman described all aspects of the Obama plan for health reform.  He summarized Obama's plan at the end of Ch. 11 as essentially a near universal system achieved through an expansion of Medicaid, insurance reform, and employer mandates.  A main issue with the Obama plan was how to control the already high costs.  Altman was apparently a big contribution to this issue in the obama plan, as he claims to have recommended the cost control measure in the Obama plan.  Altman is realistic on this topic, stating that high reductions of costs are fairly unlikely in the future.  The main thing that stuck out to me in this section was the amount of negotiating that had to be done in order for any reform to pass through our bureaucracy.  Obama's plan couldn't be as comprehensive or universal as he wanted it to be because he basically had to deradicalize his reform ideas to an addition to existing medicare and medicaid in order for it to be politically viable to pass.  What also caught my attention was the amount of social implications that come along with homogenizing a healthcare system.  Issues such as paying for contraceptives bring a whole element of morality in the issue of what the government should use its taxpayers money for.  These social issues become major problems when a reform is votedon in the house. In my opinion I contribute these problems to the lack homogenization in our country.  The different areas of our country (rural vs urban) have their own culture that affect their inhabitants opinions.  Since individual states have a more homogenized culture within them than the United states as a whole, I feel it would be best to leave more power in the states' governments on this issue.