Public Plan
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Why Do We Need a Public Option Anyway?
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Understand Healthcare Reform in 2 Easy Steps
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8 Things You Need to Know About the New House Health Reform Bill
Triggers, Politics and Party Tricks
Published October 28, 2009 @ 06:00AM PT
A public option “trigger” has received a lot of attention lately. Thankfully Harry Reid bypassed it for an opt-out solution instead, because it’s a proven Really Bad Idea. Since the Wonk Room's Igor Volsky thinks it's a fabulous idea to combine an opt-out public option with a trigger, let's put this one to bed once and for all. Following is a quick lesson in political science, so you can recognize this underhanded trick when you see it in future.
Consider: the intent of a trigger is to activate a remedy (a public option) in the event that certain conditions aren’t met by existing forces (private insurers.) Now, we wouldn’t be considering healthcare reform unless there were already significant, long-standing problems in virtually every aspect of our system-less healthcare. That includes $850 billion of waste every year, almost enough to pay for 10 years of reformed healthcare. The insurance reform gun has already fired. So why design a trigger to potentially address this urgent issue sometime in the distant future when things are even worse, perhaps catastrophically so?
The short answer is that doing nothing is the politically safe route. It’s a proven way to get re-elected by not rocking the boat. Olympia Snowe knows that, and probably hoped a trigger would allow her to claim she voted for a public option (what her constituents want) and at the same time kill it (what most Republicans want.) Under the trigger, a public plan would be created only if private insurers didn’t make “meaningful, affordable” coverage available to all Americans within “several years.” Believe it or not, none of these terms has been defined. So what would trigger a public option? You guessed it – nothing.
5 Flavors of Public Option
Published October 26, 2009 @ 06:00AM PT
This week will reveal the frustrations of a representative democracy more than any in recent history. It’s too much to expect our Congressional representatives to vote based on what a majority of their constituents want, a public option that is cost-effective and covers most of the population. Between partisan politics and the measurable effect of even small amounts of insurance lobby money, constituents seemingly can’t make their voices heard. So Congress will be presented with 5 flavors of ice cream from which to choose. Here are the public option flavors of the week, and if you need a little musical flair to get you excited about them, we’ve got that too.
First, from the Billionaires for Wealthcare, who crashed the AHIP annual meeting in Washington, D.C., last week, here is “The Public Option” sung in show tunes:
Meet Medicare Part E
Published October 23, 2009 @ 06:00AM PT
How much time-consuming bluster did it take to get to this simple and obvious option? Open up Medicare to everybody, like Ted Kennedy originally proposed in the Senate HELP bill. Part E does stand for “Everybody.” While it’s only one of the three public options being considered by the House, it’s the strongest. Keith Olbermann gives us a great introduction to the concept in the video clip above. Meet Medicare Part E.
Public Option Popularity in Limbo
Published October 22, 2009 @ 06:00AM PT
Consider this a watch list update. Things are looking rosy for a public option right now. The majority of Americans support it, up to 57% from 52% two months ago. Bipartisanship is no longer in vogue, with 51% preferring a public option to a bipartisan one. Nancy Pelosi is rumored to be inserting a strong public option in the House bill, one that may be cheaper and cover more people than the combined Senate bill. Even Harry Reid is considering including “public option lite” in the Senate bill, with a state opt-out clause. So why all the talk about the public option being in limbo, of looking for alternative ways to try and keep private insurers in check?
Health Reform Lite or Value Meal?
Published October 21, 2009 @ 06:00AM PT
For anyone fazed by healthcare reform histrionics, take heart. We’ve been here many times before. The real question is, for all the political, capitalistic, and social angst, what’s changed? According to medical economist J.D. Kleinke, who first arrived on the scene in 1989, only one big thing: now everybody gets to whine about the status quo on Facebook. He goes so far as to call the healthcare bills moving forward today “a violent endorsement of the status quo.” I can’t say I disagree with his logic, but two women just gave me hope for this go-round.
Kleinke points out that in 1989 we had a dysfunctional third-party payer insurance system based on fee-for-service. Some insurers, hospitals, doctors, drug companies, and even employers figured out how to game the system and make out like bandits. Medicare was forecasted to become insolvent, Medicaid programs were underfunded, and malpractice costs were supposedly bankrupting healthcare. Costs were skyrocketing along with the number of uninsured. Does all this sound familiar?
Yet in 20 years, he says, all we can come up with is to fit more insured patients into our current mess and make it harder for insurers to kick them out. Each time the smallest of reforms is proposed (like adding prescription benefits to Medicare) entrenched US stakeholders rally mass hysteria, and the result is government funding of more corporate services. That’s true, J.D., but times have changed; about that Facebook phenomenon …
5 Moves to Watch in Healthcare Reform
Published October 19, 2009 @ 06:00AM PT
With the frenetic activity of the last few months, you may be wondering what’s going to happen next in the healthcare reform carnival. First there was the breathless buildup to bill … after bill … after bill. Then the ensuing media circus took over. Tea partyers continue to spout hyperbolic nonsense we hope bears no resemblance to 18th century history, and many members of Congress regularly emit scaremongering tripe that has nothing to do with campaign contributions from the insurance industry. Really. Meanwhile private insurers progressively expose their ugly underbellies. What’s next?
Take a deep breath and take heart: there is an actual semi-logical legislative process. And you can follow it, in between sideshows. In fact, here is a simplified outline of the complexities, adapted from the National Health Council (you can also download the entire Health Reform Legislation: Potential Impact on Patients PDF):
Big Insurance Promotes a Public Option
Published October 13, 2009 @ 06:00AM PT
Big Insurance just made the most convincing argument yet for a public insurance option. In a memo explaining a highly questionable study that AHIP commissioned from PriceWaterhouseCoopers, Karen Ignani explicitly promised that private insurance prices would rise dramatically under proposed healthcare reforms (I didn’t think they would confirm my wallet-stealing point so quickly.) Now we have it straight from the horse’s mouth – thanks, AHIP!
Actually, private insurance prices have already risen dramatically with NO healthcare reform. We can rest assured they will continue to rise. But it’s nice to have a scapegoat, isn’t it? Obviously the point of this study is to disrupt the passage of Max Baucus’ bill. AHIP isn’t satisfied with the millions of new enrollees it will reap, or the no-strings-attached government handouts (otherwise known as subsidies) to pay for those enrollees’ inflated premiums. Nope, they want more for all their lobbying millions.
First, they want a stronger individual mandate to lock in the maximum number of captive customers. Second, they want the excise tax on high-cost plans to go away. Third, they assume reflexive higher provider private insurance reimbursement rates due to Medicare cuts (though a Milliman, Inc. study already debunked the myth of cost-shifting.) Fourth, they promise to pass any industry taxes straight on to consumers – yep, we told you that was a lame idea. Is there any better combined argument for a public option to remove the private insurance choke-hold on our outlandish healthcare costs?
