Do Not Resuscitate the ‘Public Option’ by Andrew D. Coates, MD

[Better Believe It]

Do Not Resuscitate the ‘Public Option’
by Andy Coates
Andrew D. Coates, MD is a leader of Physicians for a National Health Program and the grassroots coalition Single Payer New York.
February 23, 2010

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?

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.
Please read the full article at:

http://www.commondreams.org/view/2010/02/23-4

[Tuesday Afternoon]

1. Another world is still possible. It is called Medicare-for-all, expanded and improved.

K&R

[zipplewrath]

2. The future is not static

A public option, even for 2 percent of the population, was the "foot in the door". It almost couldn't fail in that if it ran just like a private insurance plan, it would not have to turn a profit. That'd be a cost savings right up front. Furthermore, it could become an attractive option for expansion in the future. In reality, it was probably the best way to work towards "medicare for all" by allowing the program to grow in a more managed fashion and being able to modify and improve it over time before it became burdened with the entire population. And 2 percent of 300 million folks is still a large plan. And if it is the younger people who enter into this plan (quite possible in that they would be easy to insure and are those most likely to be "forced" into purchasing insurance) it would become a "new normal" for the future.

One way or another this country is going to end up with single payer. It's just a matter of how soon, and whether it is of a GOP design, or a more progressive design. PO was seen as the last chance for it to be a progressive style plan. If we don't get it, I truly suspect the GOP will ultimately bring it to us (only Nixon could go to China) and we'll be stuck with whatever monstrosity they dream up.

[sui generis]

3. it's all smoke and mirrors.

We went down the wrong path to begin with and now we need to cross through the trees at top speed to get on the right one. Sonny Bono might have something to say about that.

It should have only ever been a public PLAN. With a private option. The government could easily have mandated coverage using a W2 election or else voluntary contribution. If you choose the private option, manage your exemptions or get a tax refund at the end of the year. It funds itself. It provides healthcare to the ininsured and uninsurable, and it insures the immortal 20 - 30 somethings who don't think they need insurance without requiring a premium in addition to a deduction. The rest comes out on scale just like any other income tax.

Why was this so difficult for our noble electorate to conceive? It's almost as IF they made the worst possible choices all along, even knowing better. Makes you wonder why, or not.

[xchrom]

4. +1

[Gormy Cuss]

5. +1

A public plan with a private option is what most Americans want -- if it's presented that way.


(and for the Sonny Bono reference: :spray: )

[Vincardog]

8. +1

[newtothegame]

6. Medicare for all is a GREAT idea if they can figure out a way to actually cover treatment costs.

For all the cry about private insurers making huge profits, the reimbursement they provide our hospital at least gets near our cost. Medicare reimbursement is around 52% of our cost, and Medicaid is even worse. Because of all this, we're way behind where we should be technologically speaking and it doesn't look to get any better. We can't even cover current operating costs, let alone keep up with medical advances. What the hell would happen if everyone went on Medicare and ALL our reimbursement was that low?

Understand, having one payment system would be a DREAM for overworked hospital billing departments. But we have to find a way to cover at least close to what we spend or the quality of our hospital will collapse.

I'm fully prepared for all the non-healthcare DU'ers to start railing me as an industry insider, overpaid executive, whatever you want to call me. But these are the FACTS at this hospital.

P.S. K&R'd

ed for sp

[Vincardog]

7. How about this? We pass Medicare part E for Everyone, then make it better?

[stray cat]

9. Would people be happy paying 10% of their income fore Medicare for all?

for those who object to mandates for health insurance would an equal mandate for Medicare be ok? It would likely make Medicare monetarily sufficient as well as lead to real amounts for reimbursement

[newtothegame]

11. I'd be thrilled to pay 10% of my income. nt

[PHIMG]

12. Where are you getting 10%

Pulling numbers out of your butt?

The vast majority of people (like 98%) would pay less under Medicare for All. It saves $400 billion a year. And you'd trade in skyrocketing premiums, and unpredictable out of pocket co-payments and deductibles for predictable and steady taxes.

This is why Medicare for All has such high support.

[PHIMG]

10. If everyone is covered then the hospitals don't need to write off NON-PAYERS

First off, if you work in a hospital you may want to do a little more research on the policy proposal you are trashing.

Under HR676, Medicare for All:

1. Rates for pay-for-service -- there is negotiation between providers and the NHS, it is not using the old model.
2. Hospitals can choose to go with the GLOBAL BUDGET and not charge on a per-service basis.
3. Under Medicare for All, hospitals will lose the problem of uncompensated care in the ER because everyone will have Cadillac healthcare insurance from the government.

PLEASE READ HR-676 ... do some research... Medicare for All is a 30 year movement with PNHP (peer-reviewed research) as the intellectual head.... the concerns you raised have been addressed in the bill.

You are repeating fear-mongering b.s. from the likes of Bill Nelson and Mary Landrieu (expanding Medicare will KILL hospitals.)

[truedelphi]

15. Thank you for your common sense arguments. n/t

[Better Believe It]

13. Self Delete

[eridani]

14. Or you could have a public option that was actually open--

--to all members of the public.