Wednesday, September 9, 2009
Obama on the public option: We'll trigger it in four years unless ...
One of the little-noted details of all the health care reform bills floating out of congressional committees everywhere is they don't take full effect until 2013. The state-level insurance exchanges -- basically, a list of the private insurance products available to small businesses and individuals, plus (perhaps) a public insurance "option" something like Medicare -- aren't slated to go into effect for four years.
The insurance industry reform aspects of the bill -- no excluding folks because they have pre-existing conditions, or over-charging them, or dropping them when they sick, or all the other vile ways insurance companies make a buck by avoiding their obligation to actually insure people -- would come first. So would the money to train more front-line doctors and nurses and to figure out better "standards of care" so that wasteful fee-for-service practices (i.e., the padding of health care bills) can be reined in.
So a little light went on in my head tonight listening to President Obama talk about the public option. He's committed to it or something like it, he said. He mentioned coops. He mentioned triggers. But the point is, he said, and then repeated himself, everybody deserves a choice of good, affordable insurance products wherever they live.
Well, doesn't that mean that the insurance industry has four years to figure out how to offer good, affordable insurance products in every state? And if it doesn't -- if one overpriced United Health or Blue Cross product continues to be a monopoly in Alabama or North Carolina, for example -- reform would then "trigger" the introduction of a public option in the aggrieved state(s)?
Four years to curb their costs, insure all comers, pay out when they should and stop with the blizzard of paperwork, and turn themselves into the health-care equivalent of a public utility, doing what the public wants but in a private, for-profit or nonprofit way. Actually, make it three years, because a public option will need a year or so to get off the ground.
Here's what Obama said:
[S]ome have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.
Think lovely thoughts, Congress. But just in case the bastards can't do it, do load the public option into your legislation and attach an easy-to-pull trigger. With a three-year deadline.
Comments (5)
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Anyone experience anything about the easy google profit kit? I discovered a lot of advertisements around it. I also found a site that is supposedly a review of the program, but the whole thing seems kind of sketchy to me. However, the cost is low so I’m going to go ahead and try it out, unless any of you have experience with this system first hand? onlineuniversalwork
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Blue Cross is at it again. I think their latest radio ad is inaccurate. People with health insurance will not be driven from coverage. That's a scare tactic. Using NC Health Reform.com as their website name is misleading. AND the satisfaction rate on the insured is only somewhat accurate: http://www.politifact.com/truth-o-meter/statements/2009/sep/01/americas-health-insurance-plans/strong-satisfaction-health-insurance-coverage/ The copy: "North Carolina employers know we need health care reform, but Senator Kay Hagen and our leaders in Washington shouldn't create government-run health insurance that will drive people from coverage they already have. Four out of five people with health insurance say what they have works for them, and building on what works is the best path to reform. Learn more at nchealthreform.com." Of course the ad is running on WPTF, so what do you expect?
A trigger on a public option that isn't tripped for 4 years or even three is a bad idea. With 14,000 Americans losing their health insurance every day, and 2880 going bankrupt daily due to medical costs they can't afford to pay for, that will mean 20.44 million more Americans lose their insurance and 4.2 million will go bankrupt during those 4 years. And that is at the rates we have today - and those are accelerating. I heard an OFA rep claim that Single Payer was off the table - but I wasn't aware that Obama had ever put it on the table! Mandated health insurance and a 4 year wait for a Public Option is going to cause the insurance companies to rape and pillage for those 4 years. This will mean an enormous amount of pain and suffering for the people effected. Single Payer is the only way to get EVERYONE covered and save money. Yes it will render many of the for-profit health insurance companies obsolete except for selling optional coverage over and above what's covered under the Single Payer plan. But the Public Option plans on the table now won't cover everyone, won't lower costs, and won't spare people the misery they are going through right now.
ct -- Actually, didn't we decide with rural electrification that electricity was, if not a human right, at least a vital public commodity? If electricity were priced according to the cost of supplying it, center-city customers would pay far less for it (because they are so many more of them per mile of transmission line) and rural customers so much more that they probably couldn't afford it at all. If I recall correctly, that's why we treat electricity (and heat) as public utility, albeit in most cases the utilities are investor-owned, not government-owned. In health care, we've evolved a system -- it seems to me -- that is akin to a public utility but without any of the regulation that allows everyone to pay roughly the same rates for the same services AND that limits investors' returns on the "sale" of a vital public commodity. Instead, we have a utility that offers sub-par services (via emergency rooms and under-funded clinics) to low-income customers who pay very little or nothing for them; paying customers, meanwhile, get much better services. At the risk of running the electricity analogy into the ground, it's as if electricity were free to rural customers, but they only got it an hour or two a day; whereas those with money could buy all the electricity they wanted. On the subject of price, I can only observe that health care spending in the U.S. is roughly twice per capita what it is in other industrialized countries from Europe to Australia. Why don't our insurance companies bargain on behalf of their customers to bring hospital rates, doctors bill and pharmaceutical bills down? Clearly they don't -- or not very effectively, anyway. The only logical explanation is that they see no need to compete for customers and are aligned instead with the providers. Imho, of course. Thanks for writing.
Overpriced from whose perspective? It's expensive, alright, but so is every private plan I've seen. Is there hard evidence that NCBCBS is accumulating financial "reserves" (i.e. operating profits) in excess of what they need? Then go after them on that point. Seems to me the fundamental issue is that people don't want insurance -- they want coverage. There is a tremendous distinction between those "wants". Next we'll hear that electricity is a baseline human right, so the government should be paying our monthly electricity bills. Where does it stop?
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