Progressive Caucus Lays Out Principles for Public Health Plan

[babylonsister]

http://oxdown.firedoglake.com/diary/5631

Progressive Caucus Lays Out Principles for Public Health Plan
By: Scarecrow Friday June 5, 2009 3:49 pm


The Congressional Progressive Caucus today released a statement describing principles and conditions that any public health insurance plan must meet. (h/t mcjoan)

Principles for a Public Option -

The Congressional Progressive Caucus stands united behind President Obama’s call to provide high quality, affordability, and accessibility in healthcare choices for all Americans. The overwhelming majority of Congressional Progressive Caucus members prefer a single-payer approach. If a single-payer plan is not enacted, we agree with President Obama that there must be a robust public health insurance option like Medicare offered alongside the private plans. This public plan would provide a guarantee of coverage, affordable, high-quality and accessible healthcare, and lower costs – regardless of income, health status, race, employment, or gender. We oppose any conditions or triggers undermining and limiting the availability of the public option.

The Congressional Progressive Caucus calls for a robust public option that must:

· Enact concurrently with other significant expansions of coverage and must not be conditioned on private industry actions.

· Consist of one entity, operated by the federal government, which sets policies and bears the risk for paying medical claims to keep administrative costs low and provide a higher standard of care.

· Be available to all individuals and employers across the nation without limitation

· Allow patients to have access to their choice of doctors and other providers that meet defined participation standards, similar to the traditional Medicare model, promote the medical home model, and eliminate lifetime caps on benefits.

· Have the ability to structure the provider rates to promote quality care, primary care, prevention, chronic care management, and good public health.

· Utilize the existing infrastructure of successful public programs like Medicare in order to maintain transparency and consumer protections for administering processes including payment systems, claims and appeals.

· Establish or negotiate rates with pharmaceutical companies, durable medical equipment providers, and other providers to achieve the lowest prices for consumers.

· Receive a level of subsidy and support that is no less than that received by private plans.

· Ensure premiums must be priced at the lowest levels possible, not tied to the rates of private insurance plans.

In conclusion, the public plan, like all other qualified plans, must redress historical disparities in underrepresented communities. It must provide a standard package of comprehensive benefits including dental, vision, mental health and prescription drug coverage with no pre-existing condition exclusions. It must limit cost-sharing so that there are no barriers to care, and incorporate up-to-date best practice models to improve quality and lower costs. All plans, including the public plan, must include coverage for evidence-based preventive health services at minimal or no co-pay. All plans, including the public plan, should be at least as transparent as traditional Medicare.

DK's mcjoan also links to the Blue Dog non-starter proposals for quick comparison.

Again, it's my view that a carefully structured public plan option would lay the groundwork for single-payer in the future. I don't see anything in the CPC's principles that would be inconsistent with that view.

Note that the first of the CPC principles rules out the "trigger" mechanism concept floated by Sens. Baucus, Grassley and Snowe. Other principles establish that the public option is open to everyone, without pre-conditions.

This also seems to rule out Sen. Schumer's proposal that the plan rely exclusvely on premiums or be limited by financing available to private plans. What the CPC is saying, I think, is that we should design the best public option we can to meet consumers' needs for affordable, quality health care open to all, without regard to the private insurance industry structure or concerns. That puts the consumers' needs over the private insurer's desires. From the CPC press release:

“Americans deserve health care that favors patients over the health insurance companies,” said CPC Co-Chair, Raúl M. Grijalva (D-AZ). “They were given decades to control costs, improve quality and increase access but they have failed. At a minimum, we need to give them real competition in the form of a robust public plan that puts patients first.”

It's a strong statement to have out there.

[Vidar]

1. Sounds good. Thanks for posting it.

[bvar22]

2. This is the absolute minimum.....

...we should accept from our Democratic "representatives".

ANYTHING less will be a sell out to the BIG Health Insurance Industry.

"There are forces within the Democratic Party who want us to sound like kinder, gentler Republicans. I want us to compete for that great mass of voters that want a party that will stand up for working Americans, family farmers, and people who haven't felt the benefits of the economic upturn."---Paul Wellstone

[FLAprogressive]

3. Here's what the CPC needs to do. Vote against any insurance backed plan.

It'll force the party's hands.....

[Greyhound]

4. K&R, what's so damn hard about selling this?

As GrASSley (unintentionally) pointed out, given the opportunity, almost everybody would dump their private insurance in a heartbeat (and they'd get many more of them, too).
:kick: & R

[roody]

5. knr

[kath]

6. Three cheers for the Progressive Caucus!

Too bad we don't have more REAL Democrats representing us...

[BlooInBloo]

7. I know it's a lie, because DUers say it's impossible for a non-single payer system to be any good.