Tag Archives: Public Option

Dems praise new health compromise

“An unvarnished, complete victory for people like me who have been arguing for a single-payer system.” Rep. Anthony Weiner, D-N.Y.

WASHINGTON (AP) — President Barack Obama as well as Democratic liberals and moderates all found something to like Wednesday in an emerging compromise to expand the role of government in the nation’s health care system, raising hopes inside the party that passage of overhaul legislation might be within reach after a struggle lasting decades.

The same plan drew critics, though – and the threat of more opponents once closely held details become widely known.

Obama hailed “a creative new framework that I believe will help pave the way for final passage of legislation and a historic achievement for the American people.” He said, “I support this effort, especially since it’s aimed at increasing choice and competition and lowering cost.”

A provision opening Medicare to uninsured Americans between the ages of 55 and 64 drew praise from some liberals.

Rep. Anthony Weiner, D-N.Y., called it “an unvarnished, complete victory for people like me who have been arguing for a single-payer system.”

Howard Dean, the former party chairman and an advocate of a government-run insurance option, told CBS, “Using Medicare makes more sense than reinventing more bureaucracy.”

Sen. Mary Landrieu, D-La., said the Medicare expansion could help small business “There are a lot of small business people who are between the ages of 55 and 64,” she said. “If that were done (it) would provide some real relief to them.”

Sen. Blanche Lincoln, D-Ark., said she approved of the suggested national plans to be administered by the Office of Personnel Management. “OPM being the negotiator will help, I think, be able to bring the best product forward,” she said.

source:

related: Outline Of Senate Health Bill Agreement Emerging
read more here:

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The Public Option Shibboleth, or Act 2 of: HealthCare: A Diatribe

blogpost by Ogenec

Dear Readers, between DJ Hero and other pursuits, I have been delinquent in writing this piece. My bad.  And I’m kinda cheating. I’d promised that Part 2 of my diatribe would address the Baucus bill, while Part 3 would address the public option. However, in light of the passage of time and developments under way in Congress, it makes sense to flip that around. Accordingly, I’ll talk about the public option now, and in Part III whatever bill emerges from conference.
So, here we go:

“The Defining Moment”, today’s OpEd by Paul Krugman is a good place to start. GeoT sent it to me today, with the comment that Krugman was talking to me and the rest of the public option holdouts: time to be reasonable, in otherwords. GeoT was just kidding; he knows I’m the epitome of reasonableness 🙂 But his point is well-taken; in many ways, it’s time to put up or shut up. Instead of being negative about the public option, perhaps we should be more constructive and say what we affirmatively are for, rather than against.

I will do that in a bit, but let me clear up a misconception. I rail against a public option not because I’m opposed to the concept, but because I think proponents both overstate and understate its impact. The real issue is health care reform, which the public option in and of itself does not address.

Let me demonstrate what I mean.  Most proponents claim that the public option will (a) provide competition to insurers, which will in turn (b) help to hold health care costs down, all without (c) morphing into a single-payer plan.  I think that’s pure bunk.  As presently envisaged, the public option will not do (a) or (b); it’s not sufficiently robust.  If, however, you do make it sufficiently robust to fix (a) or (b), the public option will lead, ineluctably, to a single-payer system.

Let’s take these one at a time.  First, the notion that the public option will provide competition.   Not under the current plan, it won’t:  The scale of the program is too small.  As presently constituted, the CBO projects that only 6 million people would enroll in the public plan.  How does such a limited plan introduce competition?  How does it break away from the employer-based model?  Answer: it doesn’t.

Well, then, what about holding health care costs down?  That part is a double-fail.  No real competition means no downward pressure on health care costs.  But it’s even worse than that — CBO projects that premiums for the public plan will exceed what folks in private plans are paying:

[A] public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges. The rates the public plan pays to providers would, on average, probably be comparable to the rates paid by private insurers participating in the exchanges. The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees.

So let’s recap.  The public option now under consideration would not provide sufficient competition to insurers; health care costs would not go down; and premiums for those in the public plan would go up.  What’s not to like?  This kind of a public option would not present the threat identified in (c) above.  It’s so neutered as to foreclose any risk that it is a stalking horse for a single-payer system.

Most progressives agree with this assessment.  And, say they, that’s precisely the problem: we need the “robust” option.  One that is open to everyone ab initio (or shortly after inception), and that pegs reimbursement to Medicare, or Medicare plus 5%.   Here’s the problem with that approach.  It busts the budget, imposes negative externalities on insureds in private plans and the uninsured, all of which ensure a slow death for private insurance.  It busts the budget because as the number of people covered under the public option increases, so does the cost.  A greater expansion takes the bill well over the $900 billion threshold Obama has set.  And even that threshold is suspect, as both the House and Senate versions of the plan rely on Medicare-related savings that are unlikely to be realized.   As proof, just recall the recent debates over the COLA adjustment and staving off the long-planned cuts in Medicare reimbursement rates for doctors.  The likelihood that Congress will display fortitude it heretofore has never possessed to reduce Medicare reimbursements when push comes to shove is virtually nil.

Meanwhile, much has been made of the savings that will accrue to the government (and, hence, the taxpayers) if reimbursement rates are tied to Medicare.  But very few have asked the question, from whom do those savings come?  And the answer is clear: from the same people who unwittingly subsidize Medicare — those in private insurance and the uninsured. That then leads to the next problem — single-payer through the backdoor.   Fred Hiatt explains these inter-related problems quite cogently:

[I]f, as seems likeliest — and as House legislation mandates — the plan uses government power to demand lower prices from hospitals and drug companies, those providers may lower quality or seek to make up the difference from private payers. Private companies would have to raise their rates, so more people would choose the public plan, so private rates would rise further — and we could end up with only the public option and no competition at all. Single-payer national health insurance may be the best outcome, but we should get there after an honest debate, not through the back door.

Robert Samuelson also makes the same point: 

[A] favored public plan would probably doom today’s private insurance. Although some congressional proposals limit enrollment eligibility in the public plan, pressures to liberalize would be overwhelming. Why should only some under-65 Americans enjoy lower premiums? … Private insurance might become a specialty product. …Many would say: Whoopee! Get rid of the sinister insurers. Bring on a single-payer system. But if that’s the agenda, why not debate it directly?

So there’s the nub of the matter.  Either the public option will be so limited as to be neutered and of no significance in providing competition to health insurers.  Or it will be so robust as to kill off private insurance.  The economic equivalent of the Northern snakehead fish, and we get single-payer by default.  But if the latter outcome is what we prefer, let’s have the guts to say so openly and directly.  Let’s not do by indirection what we suspect we can’t accomplish with an honest and frank debate.

Click for details

This is why I’ve been cool to the idea of a public option.   The public option, in and of itself, does not address the real problem – the escalation in the cost of healthcare delivery.  Even if you stripped out the administrative inefficiency of the balkanized health insurance system, you are still left with unsustainable increases in healthcare costs.  And the public option does nothing to address that.  Which is the reason Medicare – touted as the model for the public option – is itself going bankrupt.  To my mind, the underlying issue of increasing costs is far more important.  So the focus on public option rather misses the point: it is the equivalent of addressing the symptom and not the disease.  I want a system that addresses the underlying issues of escalating health-care costs.  I think Wyden-Bennett does; I think the Baucus bill did; and I think Dole-Daschle does as well.  In Part 3, I will expound more fulsomely on this, and analyze the merged bill from this perspective.  I know you can’t wait 🙂

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The Two Faces of Joe Lieberman: Then and Now

posted by GeoT

That Was Then:

National health insurance pool-free for poor and children

Q: How would your health plan improve insurance coverage for the new generation?

LIEBERMAN: There is a morally scandalous fact-that that 43 million Americans don’t have health insurance, 2 million more than when George Bush became president. I’m proposing to create a national health insurance pool like the one that members of Congress get our insurance from. If you don’t have insurance now, you’ll be able to get it, probably free, if you’re among the low-income working poor. If you’re a child, you will be covered by insurance at birth. If you are fired from your work or lose your job, you will not lose your health insurance. MediKids is part of my program. Every child born in America will become a member of MediKids, and it will cover them from birth through 25. Why 25? Because young adults have a hard time affording health insurance, and a lot of them think they’re not going to get sick, but they do, and we need to cover them.

Source: Democratic 2004 Primary Debate at St. Anselm College Jan 22, 2004


This Is Now:

On Tuesday, Sen. Joseph Lieberman (I-Conn.) announced that he would withhold his vote for the Senate’s final health care reform bill if it included a government-run public health insurance plan, the Wall Street Journal reports. Lieberman, who usually caucuses with the Democrats, said that the bill in its current state would have to be changed significantly to secure his support. Lieberman said, “To put this government-created insurance company on top of everything else is just asking for trouble for the taxpayers, for the premium payers and for the national debt. I don’t think we need it now,” adding, “We’re trying to do too much at once.”

Lieberman said that Reid’s plan for a public option with a state opt-out clause also would not garner his support because “it still creates a whole new government entitlement program for which taxpayers will be on the line”
Source: politicologosmall

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PETITION TO SENATE DEMOCRATS:

“Any Democratic senators — including Joe Lieberman — who support a Republican attempt to block a vote on health care reform should be stripped of their leadership titles. Americans deserve a clean up-or-down vote on health care reform that includes a public option.”

Over 90,000 signatures and growing…

CLICK HERE TO SIGN THE PETITION

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Krugman: After Reform Passes

posted by GeoT

“The teabaggers have come and gone, as have the cries of “death panels” and the demonstrations by Medicare recipients demanding that the government stay out of health care. And reform is still on track.

By PAUL KRUGMAN NY Times Op-Ed

Krugman, Ph.D.

So, how well will health reform work after it passes?

There’s a part of me that can’t believe I’m asking that question. After all, serious health reform has long seemed like an impossible dream. And it could yet go all wrong.
Right now it looks highly likely that Congress will, indeed, send a health care bill to the president’s desk. Then what?

Conservatives insist (and hope) that reform will fail, and that there will be a huge popular backlash. Some progressives worry that they might be right, that the imperfections of reform — what we’re about to get will be far from ideal — will be so severe as to undermine public support. And many critics complain, with some justice, that the planned reform won’t do much to contain rising costs.

But the experience in Massachusetts, which passed major health reform back in 2006, should dampen conservative hopes and soothe progressive fears.

<snip-

The new health care system will be criticized; people will demand changes and improvements; but only a small minority will want reform reversed.

This thing is going to work.

Read the full story here:

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Senator Reid: Health Care Bill Goes Forward

Wooo Hooooo

PUBLIC OPTION WITH OPT OUT— “Crush the Filibuster”

MSNBC

44-D seal of Approval …okay GeoT seal of approval 😉

Let’s see what states dare to “OPT OUT” and what the consequences will be for the Republican leaders in those states…

Reid: Health care bill to include public option

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CBO Report green lights Health Care Reform

posted by Geo T

**44-Update**
CBO says health care bill costs $829B over decade

Health care legislation drafted by a key Senate committee would expand coverage to 94 percent of all eligible Americans at a 10-year cost of $829 billion, congressional budget experts said Wednesday, a preliminary estimate likely to power the measure past a major hurdle within days.

Full story: Here

AP Poll: Health care overhaul has a pulse

The fever has broken. The patient is out of intensive care. But if you’re President Barack Obama, you can’t stop pacing the waiting room.
The latest Associated Press-GfK poll (click here for full poll results) has found that opposition to Obama’s health care remake dropped dramatically in just a matter of weeks. Still, Americans remain divided over complex legislation that Democrats are advancing in Congress.

The public is split 40-40 on supporting or opposing the health care legislation, the poll found. An even split is welcome news for Democrats, a sharp improvement from September, when 49 percent of Americans said they opposed the congressional proposals and just 34 percent supported them.

Full story from:

The same poll also shows: Obama’s Job Approval Jumps 6%
For Details Click: Here


**Update**
Former Kansas Sen. Bob Dole says “there will be a signing ceremony” for a health care reform bill either late this year or early next.

read more:

Related Item: Senators Ask Reid and Baucus for More Time to Weigh Health Care Bills

full story here:

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**Update** “Stayin’ Alive”: the Public Option

Mike Lux
Author, The Progressive Revolution: How the Best in America Came to Be

Senate Finance Committee

Senate Finance Committee

I have said before (most recently here) that the Senate Finance Committee was conservative, in fact the most conservative committee makeup in the Senate, and that we would be likely to lose these votes:
With numbers like this, and with the entire Democratic base mobilized intensely around the issue, you would have to be politically tone deaf as a Democrat to oppose this, but this is the Senate Finance Committee, so public option advocates are likely to lose these votes. The question, though, will be the margin. On a committee this conservative, far more conservative than the Senate as a whole, if we only get seven votes for the public option amendments, that would have to be considered a major political victory, and a sign that the public option can definitely get a majority vote on the floor.

con’t @ Huffpost

The Senate Finance Committee voted down a government-run “public option” as part an overhaul of the nation’s health-care system Tuesday, rejecting the first of two amendments offered by Democrats.

The panel’s chairman, Sen. Max Baucus (D-Mont.), and four other Democrats sided with Republicans in opposing a public-option amendment offered by Sen. John D. Rockefeller IV (D-W.Va.). Baucus said he voted against the politically volatile provision because he feared that a bill including it would not get the 60 votes it would need to pass on the Senate floor. The committee voted 15 to 8 to reject the amendment.

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