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Do Not Resuscitate the ‘Public Option’
Like initiating CPR on a patient who was dead in the field and remained dead on arrival, the effort to resuscitate the “public option” is mistaken and futile.
Once upon a time, proponents of the “public plan option” sought a “Medicare-like” program that might enroll every other person in the nation and thus run private insurers out of business.
“A roadblock to reform” cried the insurance companies. In turn, nothing in the bills passed by the House and the Senate would erect a public insurer that could possibly influence the insurance market.
The House bill included a feeble government plan, to start in 2013, that would enroll perhaps 2 percent of the nation by 2019. The Senate bill simply nixed the idea altogether. Now the President, in his latest proposal, has also abandoned the "public option."
In reality the “public option” was never much more than a K-street phrase, a shadow-puppet, a political posture. All along proponents of adding a new government-sponsored insurer boasted “talking points” but never offered workable health reform.
But the insurance companies oppose the “public option” and that proves its virtue, its supporters exclaim.
Hello? Of course the insurers oppose it.
Why would the insurers want to yield even 2 percent of the market to a public plan (House bill) when they’ve been given the “option” (Senate bill) of keeping 100 percent of the market? Why would the insurance companies not fight for the whole pie when the White House let slip that it saw the “public option” as simply a bargaining chip in private dealmaking?
But there is something else here.
With its reliance on the magic of the marketplace, the “public option” is simply not a proposal for reform. In fact, it has already been tried, and failed: in Maine, a “public option” insurer known as DirigoChoice, was established in 2003. It has failed to enroll but a tiny percent of the uninsured, did nothing to reduce the costs of insurance or health care, nor did it reduced overall health spending, nor did disparities in care improve – and in the last year DirigoChoice has fatally tanked.
In the United States a corporate oligopoly of huge insurers, with near-monopoly control in most locales, dominate the market. A government insurer of any size would simply add yet another bureaucracy to the present byzantine insurance mess.
Does it really make any sense to think that a government plan could give the private insurance companies a run for their money – within the contemporary corporate marketplace – without draconian regulation upon the industry? Even with regulation, as former Cigna executive Wendell Potter explained at the PNHP annual meeting this year, insurance companies simply “flaunt regulations.”
The insurance market cannot be tricked into reforming itself. The health insurance company that wins at the marketplace avoids and jettisons sick and poor patients and enrolls the healthy and the wealthy – and a “public option” will not change this fact. The market that serves the private interests – profiteering at the expense of the sick – would continue to do so.
The proper name for this kind of “market magic” is the race to the bottom. Adding a public plan into the private mix can not and will not change the character of this cruel game.
Any successful “public option” insurance plan would wind up covering the sick and the poor. It would be designed to lose, not win, the market competition. It would not prove affordable or comprehensive. Worst of all, a highly successful “public plan option” could put our nation on a fast-track to permanent two-tiered health services, exacerbating deplorable disparities that plague us.
Regrettably, that the “public option” has been given attention at all is but a measure of how deeply our culture has surrendered to neoliberal ideology, the ideas popularized by Ronald Reagan. It is a lie that the market will always provide, most especially when it comes to health care. So why would some of our friends still seek to revive the false promise of the “public option”?
Marie Gottschalk, University of Pennsylvania Professor of Political Science, identified the psychology at work. In a remarkably prescient essay written in late 2009, she compared health reformers in the United States to victims of the Stockholm Syndrome, in which hostages identify with – and even defend – the hostage-takers.
We ought to reach out with sympathy to our friends who have fallen captive to Ronald Reagan ideology and say: Do not resuscitate the “public option.” It is time to let it go.
All along, adding a feeble public insurance plan to the insurance market has been but a very poor excuse to support “insurance reform” that will criminalize the uninsured, divert billions of tax dollars to subsidize unaffordable private insurance premiums and protect pharmaceutical industry super-profits.
Another world is still possible. It is called Medicare-for-all, expanded and improved.
61 Comments so far
Show All-"The House bill included a feeble government plan, to start in 2013, that would enroll perhaps 2 percent of the nation by 2019. The Senate bill simply nixed the idea altogether"
...Or as Democrats describe it, this is their idea of "universal coverage".
Even now, the Democratic pundits are claiming that their plan, extends healthcare to every American, when of course, even what they described as a "robust" public option, never did any such thing.
Democracies all over the world have various ways of accomplishing healthcare for all. None of them resemble the joke of a plan Obama is pushing.
The politicians and media keep repeating that Obamacare "extends" insurance coverage, as though medical insurance is really being "extended" to more Americans when in reality Americans will be fined by the IRS if they fail to buy private insurance that in most cases will be inadequate and unaffordable.
The insurance industry played the "please don't throw me in the briar patch" game in 1965 when they pretended to fight the advent of Medicare, and then they gladly "compromised" by agreeing to have Medicare cover the over 65 crowd that no insurance compnay ever wanted to insure from the start of debate.
The insurance industry will now gladly compromise on a "public option" that will, as the author points out, cover less than 2% of the uninsured, people that insurance companies never wanted to insure.
The good doctor makes good points.
AD
>>Another world is still possible. It is called Medicare-for-all, expanded and improved.<<
But we'd need to find the funding for that new and improved Medicare -- and that's possible ONLY by cutting deeply the sacred military budget. So don't hold your breaths. That is as likely as a REAL public option passing. (I'm not as despairing of a public option as the author.)
Gary
“Medicine sometimes snatches away health, sometimes gives it.”
-- Ovid
The subsidies that Obamacare earmarks for private insurers would pay for half of medicare for all. The additional tax revenue from US businesses, that would become more globally competitive as a result of medicare for all,would pay for the rest.
Politicians have never told us medicare for all costs too much...their concern is that there will no longer be boatloads of campaign contributions from insurance companies.
The $300 billion that goes annually to the profit line of insurance companies would be enough to cover those currently uninsured. The U.S. spends at a rate of nearly $8,000 per capita annually; nearly double of any other western industrialized nation. It is a process of reallocating those dollars so that 95 cents out of every health care dollar spent goes directly to patient care (expanded, improved Medicare For All) rather than the current 75 cents in the for profit health insurance system.
"(I'm not as despairing of a public option as the author.)"
That can only be because you've been nursing illusions about it. As this doctor shows, and it's been well-known for over a year, a public option was never more than a distraction, something to confuse the public with while assuring the insurance companies that nothing would come between them and their sacred profits. So, whether you despair of it or not, it despaired of you from the start.
The "Public," the hell with the public. Who do they think they are any way? Nothing but a bunch of rabble rousers thinking that the representatives they send to Washington are actually going to do something good for them instead of the special interests like insurance companies and the like.
Neoliberal Philosophy 101:
The public with government help = "discontented, lazy rabble"
The public under total corporate oligarch control = "a thrifty working class"
Quotes from Mr. Potter, one of the early great neoliberal thinkers
Any country that stands idly by while 45,000 of its citizens die every year from lack of health care is the very definition of a failed state.
Such a government deserves no respect, no allegiance and no support.
U.S.A. - pull the plug NOW.
Actually, it's the definition of a criminal state of affairs.
The sooner we recognize that the better --
And, the sooner we change our system from corrupt capitalism to
a more compassionate and humane economic system, the sooner we will
change that criminal state of affairs.
.
"According to all myth, the female - not the male -- gives life"
We have a two-headed one party system. Both parties agree that health care should be run by insurance monopolies and they are only disagreeing about minimal type controls. The most cost effective humane system was not even up for discussion.
S.I.N.G.L.E. - P.A.Y.E.R.
Like the one that is used by our military...
By now, hopefully, the only people who still buy the phony "public option" proposal are the same obamacare idiots who will kiss any pig with lipstick.
There is a simple global explaination for why every civilized country in the world has a Medicare-for-all plan. It is because they KNOW the Privateers are cutthroats and thieves and they've DECIDED to run them out of town. But America is too stupid and corrupt to do this.
It cannot be said enough. ASAP take some time to read the new book by T.R. Reid: "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care." There is no "single payer" system in the world. That is merely the U.S. semantic redefinition of universal healthcare schemes elsewhere, in order to sound less "socialistic". T.R. Reid does an excellent job of sorting out the world's health care systems into four general categories, and then sorting nations into those four columns. Each pays for their health care by different means and methods. Reid makes reasonable, but not perfect, assessments of their strong and weak points, having lived in other countries.
Having lived in Canada half my life (33 years) and having rendered clinical services in Canadian hospitals, I know that control of the source of HC money is only one of three aspects that make the ethical medicine work. Canada places income caps upon the earnings of medical professionals and prevents them from investing in the medical marketplace, e.g. MRI machines. It also caps court-won awards for medical malpractice lawsuits. These are the minimal legs of a 3-legged healthcare stool. 5-legged stools are safer.
Good point, Trylon. It should also be noted (in case Canadian health is over-glorified) that one of the downsides - and there ARE many - here in Canada is that, especially in the rural areas - it can be hard to get extensive services (without very long waits anyway) and rural Canada has a hell of a time retaining doctors. GPs (family doctors) in the rural areas are overworked (not that this isn't true in the US). The difference is they don't make the really big bucks they can in the states. As you probably know, the Primier of Newfoundland is getting a lot of flak for going to the US for heart surgery. Of course, without insurance in the US you would have to be delivered half dead in the ER, but, hey. Least you wouldn't have to wait that way.
I don't mean to over-glamorize Health Canada. I too work in the services (social work), and I'm from the US so I see the differences. But at least health care in Canada - unlike the US - IS equitable, humane, and just. THAT alone is enough to make it better, IMO.
Something I find interesting is that Canucks are flown down from the Arctic Circle to the hospital at Moose Factory, at the mouth of the James Bay. The hospital there is supported by medical faculty and other staff from Queens University in Kingston, Ontario. Provincial governments have long made efforts to require new MD graduates to spend a period up to two years working in under-serviced parts of the country. One of my friends went up to Yellowknife for a couple years.
One upside to having too much geography per Canuck is the ability to enjoy wilderness. I've canoed the Boundary Waters between Minnesota and northern Ontario, motorcycle-camped northwestern Newfoundland.
T.R. Reid has done a decent job of evaluating Canadian HC =waiting periods= but fails to notice that waiting periods for specific procedures BY HOSPITAL are posted daily on the Internet. If you are in Ottawa (awful service) but willing to travel to London Ontario, you can get your doc to set you up for the operation there. Heck, if you can schedule your own Flight, you can do the same with surgery. Americans are free to log onto the Internet website and actually SEE the vaunted waiting times, and compare them to their own: but who does?
If we can't even get a watered down National Health passed, how do you figure to proceed? From where we are right now, with the President and the Congress that are in place, with the laws and rules for making legislation as they are, what's the plan for getting a better deal?
Is there some secret cabal within Congress that will rise up and vote overwhelmingly for Single Payer? Do we have a spare couple Million$ to buy our CongressCritters back? Can they even get it out of committee?
In this Congress, Public Option is the best we can get.
And what makes anyone think that starting over will end up with a better result? Unless you change out a large number of Senators to ensure a solid bloc that can overcome filibusters and is committed to National Health, the result of starting over will be worse, not better. And driving the Democrats out of office will only exacerbate the problem, since the Rs march lock-step against even the most modest reforms.
If you are talking about political issues, it's usually a good idea to have at least some understanding of how Government and Polititcs work. Wishful thinking, magic, threats and pouting don't seem to be working.
As Coates shows very conclusively, a big part of "wishful thinking" is believing the public option has any significance whatsoever. It doesn't have anything to do with health care reform, it's only another way to delay its ever happening. If you want it merely because it sounds like it's "better than nothing," then you're supporting an illusion. Pointing this out isn't "pouting," it's facing reality. But if you insist that government and politics only can work in an illusory world, then I guess the public option works for you.
Within the confines of the current political and economic system, there is no way to proceed. The USA is a failed state.
Maybe there is a way to change the system, but I sure don't see one. Time to think outside the box, so to speak.
Ever spend too much money fixing up a crappy old car, only to give up and junk it later? That's what the USA has become, that crappy old car. Time to stop throwing good work, good money and good lives into a bad system.
-"a watered down National Health "
There is nothing watered down about the Democratic bills, they pour a torrent of money into Obama's major insurance/pharma campaign contributors.
"Watered down" implys that there is something valuable in the bills that remains after all the water is poured in. I think a more accurate phrase would be "poisoned down". Because what you are getting mostly is the forced enrollment of Americans into what are known as "junk policies", policies that, because of their high co-pays and deductables, are only as good as your health.
-"Unless you change out a large number of Senators to ensure a solid bloc that can overcome filibusters and is committed to National Health, the result of starting over will be worse, not better."
Now there you go, dismissing the idea of changing out a large number of senators. That is your mistake right there. I understand that you want to stay with the Republicans and Democrats, accept the crumbs that they toss Americans, for fear that they will hit people even harder if they resist. As a citizen of a democracy, I say, shame on you.
Where do you live?
Can't be the States, and the UK is right out--
Sioux Rose
JLOCKE: Note the parallel between the junk (forced to purchase!) insurance policies and the junk derivatives so many banks have invested in with OUR money. Ponzi scheme atop ponzi scheme, the love of money has become such a deeply-rooted mental illness in our society that those who covet it most have risen to positions where having purchased the loyalty of lawmakers, they now have engineered policies that are mostly about false instruments devised to gain greater sums of others' assets (some of it in the form of real wealth, or what's left of it). Does anyone know what anything is worth any more? If our dollars will hold value? If our home prices will go down further? If those of us who can still maintain our costs of living will be footing the bill for state services that those that went under are no longer positioned to help support? The paradigms are imploding because corruption is everywhere. The body of the nation has become ill with so many false instruments of currency passing through it.
They should kill that lousy healthcare bill that they DO have and go back to the drawing board at ONCE, to get a better bill, with single-payer going. The Public Option, no matter what people may say or think, is a slippery slope.
Just let the free markets decide if government or private companies should do the insurance covering.
Progressive Democrats for America have been sending out emails urging the populace to contact their Representatives to keep the 'public option' alive.
After reading the benefits of the public option if blended into the current Senate bill, the composite bill would be better that the current system, but the real issue here is if any bill passes Congress, and is signed by the President, then the Democrats will have something to sell the people come election time.
Personally, I don't want any Democrat or Republican in the Legislative Branch. The way the Democrats purposely eliminated any 'single payer' advocates from the healthcare 'hearings' last summer and the way the Democrats and Republicans threw out the Medicare for all for folks over 55 reminds me of the Democrats filing law suit after law suit denying Ralph Nader a place on State tickets.
Neither Democrats or Republicans want what's best for the American people. Vote them all out.
By denying anything by Medicare for all whatever plan is finally decided upon will by hypocritical as each and every one of those voters on the issue all are covered by a taxpayer supported healthcare plan.
"Marie Gottschalk, University of Pennsylvania Professor of Political Science, identified the psychology at work. In a remarkably prescient essay written in late 2009, she compared health reformers in the United States to victims of the Stockholm Syndrome, in which hostages identify with – and even defend – the hostage-takers."
Stockholm Syndrome can be used to partially explain how so many US voters vote against their interests and vote for the ineterests of their oppressors. Couple this with the blitz of media propaganda and it explains alot.
After 4 decades of ignoring public opinion and ignoring public opinion with impunity, the oligarchy is presenting a phony package of "reforms" that are simply more public give-aways and subsidies for the already bloated profits of the Death and Illness Extortion Industry. The policy is another form of kleptocracy.
This ought to clearly demonstrate that there is no democratic process. However those that are stricken with Stockholm Syndrome cannot see this.
Sioux Rose
SOCIALIST: Remember how words were divested of their true meaning under the Bush Junta. Thus the "Prescription Drug BENEFIT Program" also gave the idea there was a benefit involved; but to whom? It meant there was no collective bargaining power used to lower prices. So the benefit was to big pharma. In my mind, the nonsense passing for Health CARE Reform as currently volleyed around is phase II of that give-away.
"Healthy Forest Initiative" was to kill lots of trees.
"Leave No Child Behind" was to implement a ferocious program of standardized testing, etc.
Those in power use PR; and the PR people have studied the buzz words. Lakoff gets stuck in his own dual frames so that while he sometimes lends light to issues, he doesn't go far enough in his analysis of the ways language is used (by the MSM today) to create the expectation of largely the OPPOSITE of what is about to come down the official pike. These people are scary!
VISITING PROF: Excellent post.
Once again, the private sector has failed the citizenry.
Bill Press, Ed Schultz and Norm Goldman, the bulk of the "progressive" talk network all line up with "public Option. Each of them quoted the Bold Progressive poll showing wide support for the "public option" But look closely at the way the "public option" is phrased,
"If Congress proposed passing a strong public health insurance option PLUS allowing people age 55 to 64 to buy into Medicare, would you favor or oppose this idea?"
The implication of "strong" is that everyone would be allowed to buy in to the goernment plan as expanded and improved Medicare. There is strong support for that but that is not what the House would give us. By trickery they have used "Strong" or "robust" to mean that the coverage of the public option should be comparable. No real accounting of costs, coverage or availability for the "public option is given. As Coates points out very few will actually be eligible, they will be put in a separate risk pool and will not likely get better or cheaper coverage with it even if they opt in. It's just another lie, another sleight of hand in a Congress that can't seem to do anything but lie.
Question? Why are we willing to accept anything but the best for ourselves? Why are we always talking about the 2nd, 3rd, 4th and 5th plans, instead of the #1 plan? Who in the hell decided that the corporate Republicans and the corporate Democrats should decide that we shouldn't have comprehensive single payer healthcare. These idiots are suppose to be working for us! It costs less, it covers everyone, the method for everyone to buy into it is already in place i.e. the medicare tax. On top of that we make sure that our elected officials are required to drop their current healthcare and buy into the national single payer system. With our elected officials required to be part of the national system that will prevent them from in the future punching holes in the system. Because what ever they do to us, they will be doing to themselves and their families.
Health-care, like police, firefighters, armies, libraries, education and other necessities should not be privatized.
Privatize luxuries, socialize necessities.
I've mentioned this before, but given the opposition to single-payer, or Medicare-for-all, from the right, why don't we only offer it to those on the left? What I mean is, why don't we give everyone a one-time-only choice at, say 25yrs of age, to go 'public or private' in insurance. You choose one or the other and you can never go back, until Medicare kicks in. People that choose public get all the benefits of public: lower premiums, expanded, though generic, coverage, no chance of being turned out by your provider if you get sick, etc. People that choose private get to keep their 'options', and pay for the priviledge.
Ask all Americans, even those who can't afford it, which system they want, and then buy it for them if they can't buy it for themselves. THAT's universal healthcare.
But single payer healthcare is something else entirely. Its simply a method for lowering insurer risk, and hence premiums, by making insurance a lifetime obligation for both parties, about a topic, healthcare, that was never really a 'choice' in the first place.
Rightwingers are too dumb to get this. For them, the 'free market' mantra is now too deeply imbedded in their systems to ever recover from. But, regarding health insurance, so what? What we want on the left is simply the opportunity to buy Canada's insurance system (for example). We don't want to impact the rightwingers, or their 'free market'. And there is no reason we have to mandate a lack of choice on them, or they have to mandate such a lack on us.
Your idea might be a good one if we lived in a country where the people's will (democracy) actually had relevance.
The "will of the people", instead of being the main pillar of our society, has become a platitude (a phrase presented as if it had significance). The will of the people has been replaced by the will of the fascists (the word fascist no longer being a platitude).
"For the general welfare" has been replaced with the "free market mantra" by the fascists. And the fascists say if we let the Left choose what type of insurance they will have then that will mean less money for us fascists. Fascist ideas are so bad, they must be forced on us. We must be forced to pay for insurance or the IRS will punish us. This is being promoted by a liberal(?) who was to be a transformational President but has turned out to be nothing more than a scummy little fascist.
That is why your good idea will not even be considered.
In the future we should continue to vote but not once should we vote for a D or an R. Leave the selection blank if you have to but let them know we're here and do not accept them.
Why not Medicare-For-All with a Private Option?
Because conservatives don't want that.
Yeah, last I checked the Conservative Party had supermajorities in both Houses and Presidency.
What super-majority can't conservatives buy?
I am a progressive who wants Single Payer, but I still accept the idea that 'Politics is the art of compromise.'
That means I was willing to accept a health care reform plan that included a robust public option. That didn't mean I pinned my hopes on it. It only meant that was as far as I was willing to go in the art of compromise. For me a robust public option was the line in the sand. Beyond that it was no longer compromise, it was out and out capitulation.
In this entire debate I haven't yet seen a robust public option offered. The House bill did not have it, and so like Dennis Kucinich, I opposed it. Even the Dodd-Kennedy proposal was not robust enough for me to support it.
If the Senate comes up with a robust public option through reconciliation and repeals the tax on workers' health care plans, then I would support that. Anything less than that, like the bills already passed and the President's plan, will make things worse in my opinion and will get nothing from me but opposition.
Hmm.
Certainly some folks will be caught in the "not poor enough" category and be forced to pay premiums that they can't--
So when the IRS starts repossessing homes and jailing folks for being too poor to buy health insurance and too poor to pay the fine--or refusal on principle to pay the fine--
What then?
Will the IRS have the balls to imprison folks for being too poor?
Is this another end-run around the so-called ban on debtor's prison?
Yep. And yep again.
This is just another turning of the screw, IMHO, to force violent actions (ie Mr. Stack) to justify clamping down on this increasingly desperate populace, that is, the non-rich.
Of course, I could be wrong, but who could've predicted Otoma (or Obomba, I can never decide which captures it better) would claim he can order the killing of any American abroad who is suspected of helping meanies when he was giving us the ol' hope and change steaming crock?
Yeah, bloody hell. These people will do everything they can to turn us on one another, and making the few who have jobs and insurance fear the scrabbling masses instead of the GMMFCSSOBs who are actually screwing them, is, well if not genius, then at least taught at the University if Chicago, and other neolib/neocon elite institutions.
There are no politics. There are only the oppressed, and their oppressors.
Cheers.
Now this is a true doctor! Go Andy coats!
Another supurb analysis of what should be health care reform that sadly will do nothing more than ihform health care for profit's lobbying efforts.
Poet
Unfortunately in a dictatorship by corporatocracy, nothing will change until corporate personhood, corporate campaign financing, and corporate media conglomeration are regulated and restricted, if not eliminated.
Every other progressive goal is ultimately futile with these pillars of corporatism in place.
Corporatocracy is empowered by its dominance of media and its indoctrination of the public through a very real Cult of Conservatism. The Cult of Conservatism is nothing like traditional conservatism. It is the essence of Neocon/corporatist fascism. Amish are conservative. The Cult is radical right wing extremism.
This network is what must be exposed, identified and attacked as the totalitarian enemies of freedom and democracy. There can be no significant progress with those pillars of corporatism standing.
The Cult of Conservatism is challenged at davedubya.com
After careful study this is what I concluded about the public option many months ago:
Top Ten Reasons the Public Plan is a Bait and Switch
1. It leaves in place the deficient employer based model. As the National Organization for Women noted in their single payer endorsement (July 7, 2009) of the only viable reform model, single payer, many Americans are tied to jobs they don’t like because of the antiquated employer based insurance model. For those switching from one job to another, those wanting to go on strike, those wanting to quit a job, etc. it prevents the ability to move freely as a laborer.
2. It leaves private insurance, a major contributor to administrative inefficiency and bloated bureaucracy, in charge of health care decisions.
3. It only results in about 10% of the savings that would accrue were single payer to be enacted. That’s assuming 50% of Americans can enroll---an optimistic figure (Jacob Hacker’s assumption that Congress has drastically scaled back to a tiny plan). Since hospitals and doctors will still have to deal with 1300 insurance companies little savings will result by adding a public option, reports Dr. Don McCanne of the Physicians for a National Health Plan, March 26, 2009, www.pnhp.org. 24% of hospital budgets go to billings (only 12% in Canada) and this wouldn’t change under any version of the public option. As Drs. Steffie Woolhander and David Himmelstein note, the bureaucratic savings of the public plan option “would be miniscule”. (The New York Times, Room For Debate, June 18, 2009).,,
4. It does not pay for itself, unlike single payer, requiring a huge tax increase. As the State Legislators for Single Payer Healthcare (including initiating sponsor WI State Sen. Mark Miller) note there is “no increase in total health care spending” with single payer. Instead of everybody in, nobody out, an inclusive approach based on solidarity, public option pits the wealthy against poor, taxing the rich to provide subsidies to help poor people buy overpriced, insufficient private health insurance. In the mainstream media this is being framed as the liberals taxing the rich for their liberal plan to force everyone into big government care, when In reality, the tax proposal would be used to shore up the private insurance system, giving them more customers and higher profits. In her June 24 Congressional testimony, Dr. Woolhander estimated that it will cost 200 billion annually to pay for health insurance costs for those who cannot afford it. That’s a much larger tax increase on the wealthy.
5. It becomes part of the same failed private model: co pays, deductibles, denials of some necessary procedures, services and medications. Coverage and benefits will be similar to the private plans due to inability to control costs. (see no. 3) “The ‘Public Plan Option’: Myths and Facts available at www.pnhp.org and see the excellent analysis, “Health Care Reform 2009: A Train Wreck in Slow Motion by Dr. John Geyman, July 21, 2009 available at www.pnhp.org/blog.
6. It leaves millions uninsured. Mandates have already failed in states where it has been tried, mostly recently in Massachusetts. And, the model for a health insurance exchange, the Federal Employee Health Benefit Program leaves hundreds of thousands of federal workers uninsured, and does not control costs (Nicholas Skala, Congressional Progressive Caucus testimony, June 4, 2009).
7. It Segregates patients into two groups: healthy patients who will be aggressively pursued by insurance companies and sicker/older patients who will end up in the public plan. The public plan will not make private insurers honest. Private insurers compete by denying (necessary coverage). The public plan will either emulate this model, or quickly go under as it becomes overburdened by the sicker, older patients, reports Dr. Woolhander (June 24 House Subcommittee on House Energy and Commerce).
8. Projected savings claimed by Wisconsin Citizen Action (based on a Lewin group study of Hacker’s original PO proposal) are not based on historical trends with public option plans that have already failed in every state where they have been tried. (see Wisconsin Cost Savings under National Health Care Reform by Dr. Robert Kraig available at citizenactionwi.org) The HMO-Medicare history shows that public plans do not keep private insurers “honest”. “A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field.” The Public Option Con, www.pnhp.org
9. Private insurers will still continue to deny claims and as a result, a major issue, bankruptcy due to health costs will remain unaddressed. In their June 2008 endorsement of single payer, the U.S. Conference of Mayors noted that “millions with insurance have coverage so inadequate that a major illness would lead to financial ruin.” www.usmayors.org/resolutions/76th_conference/chhs_03.asp
10. The public option will not provide choice of provider unlike single payer since the public option will need to appeal to providers to obtain services. “Patients will still have a limited choice of provider restricted by networks” as a Physicians for a National Health Program fact sheet states.
“The ‘Public Plan Option’: Myths and Facts available at www.pnhp.org
Mitt Romney in 2012!
Rah. Rah.
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I do support single payer, and i have always thought that was best, however public option was an attempt at least to get some kind of non profit option avialable in the current bill. I think the idea of the public option was that we wanted a public option that would sell to the same groups that qualify for private insurance, it was not going to be for the poor and , therefore, it would not be at a disadvantage compared to private insurance, companies as it would be insuring the same kinds of people as private insurance. This is becuase the poor people would be on medicare, thats what expanding medicare and medicaid to extend good care to them should be all about. Indeed if public option were required to take on more poor than private insurance it would not be able to compete with private insurance.
The public option should compete directly with private insurers, should sell the the same kinds of income level people and should have similar target market and so on to private insurance. The public option should not take on people who the private insurers do not cover so it will not have more low income people than the private insurers, that was not the point of the public option, it would make it so the public option cannot put pressure on the private companies. Medicare should provide quality coverage to all of the poor who cannot afford private/public option insurance. Public option should be something that would offer product to the same demographic as private insurance except non profit and democratic, and the strong public option would be available to anyone who could afford private insurance, and the same subsidy for private insurance could be put to the public option by choice of the consumer. The purpose of this was not to put insurance companies out of business, but to drive down cost by making them compete with a non profit, which they could have done, and they would have become closer to being non profits themselves.
The public option was later so watered down that only a small fraction of those who could buy private insurance could buy into the public option and in that case it really cannot function to complete with private insurance and really start to control the cost of private insurance and their profit margins. So it was made ineffective a long while ago and many proposals would not have made a substaintial difference.
The strong public option targeted at the same group that would buy private insurance and could sell to them would have.
In the process with a healthy public option the insurance premiums would be driven down. Of course we should have a commitment to put everyone who cannot afford private insurance on medicare/medicate/schip, so that we have 100% coverage, which is, or should have been, the whole point of this thing.
I am a supporter of single payer, that would be best, no doubt, but as long as we have a multipayer bill we need national non profit alternatives, and to cover everyone who cannot afford regular insurance with quality medicare/medicaid/schip that meets all of the requirements of essential care. The current bills fall shourt of that, which is deplorable, lack the strong public option, so that i fear that if this bill as is passes with the mandatory buy in there might be a backlash with private insurers being able to drastically push up premiums further. Public option would have at least help provide some sort of non profit alternative that people could turn to.
The healthcare debate has showcased the great superiority of single payer healthcare over profit-racket healthcare. This is a good thing. Now that the monkeys in neckties and pearls completely rejected single payer healthcare, they're setting the country up for an inevitable showdown, some five to ten years down the road, when USans will face three, four, and ten five times the healthcare cost in other countries. We're fortunate actually that The Saint made his blunder.
If he had thrown the people a snack, he could have put off the showdown for another two decades or more, while slowly turning up the heat in the meantime. But he very abruptly turned up the heat this time, so the frogs will soon be bouncing around in a rolling boil. The rapid heat escalation will startle them, and encourage them to face their demons, jump out of the pot, and finally start tending to their own better interests.
They don't have "5 or 10 years". Ask Joe Stack, Oh I forgot, you can't