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| Web links from candidates:Anna NevenicDale Kinnear
This is from the CDC Health Care group: CDC-Healthcare
Palm Desert Greens Dems is a member of the CDC.
Miles Mogulescu(is a member of the HCA-California Business Group)
Entertainment attorney, Academy Award-nominated filmmaker, writer, activist
Posted: October 30, 2009 04:21 PM
The Public Option in Congress Is Now a Sham. Who Cares If Lieberman Kills It? The
so-called "public option" -- as it remains in the bills being proposed
in the House and Senate -- is a fraud and a sham. It bears no
resemblance to the "robust" public option originally sold by its
supporters as the most pragmatic, "uniquely American" multipayer way of
achieving affordable universal health care, instead of importing
successful single payer models from other democratic capitalist
countries which provide better health to its citizens at considerably
lower costs.
The pygmy public option now being proposed in the
House and Senate will not be a viable competitor to mandated private
insurance.
• It will not put any meaningful pressure on private insurance companies to moderate their premiums. •
It will not have the market power to pay lower fees to doctors and
hospitals than private insurance and will thus not be less expensive
than private insurance.
• It will not even be available to most Americans.
• Since it will be unable to effectively compete with private insurance, it will end up with few, if any customers.
At
this point, it really doesn't matter whether or not a final health
reform bill includes this type of public option in name only. The
public option, as it's now being proposed in the House and Senate, will
have no meaningful impact. If Joe Lieberman or other corporate
Democrats kill this meaningless public option, it will make no
difference in the lives of most Americans. With or without a fraudulent
public option, millions of Americans who will be required to buy
insurance or pay a fine will see their premiums skyrocket as there will
be no effective limits placed on how much private insurers can charge
the customers whom the federal government will make buy their product.
The final nail in the public option's coffin came when House Democrats (with no help from President Obama to twist Blue Dog arms)
fell 10 or 12 votes short of including a requirement that the public
option pay providers Medicare rates plus 5% and instead will be
required to negotiate rates with each doctor and hospital in America.
This all but guarantees that the public option will end up paying more
to doctors, hospitals and drug companies than private insurance.
It's like a brand new Mom and Pop store trying to compete with WalMart.
Here's
why, without a tie to Medicare rates, the public option will end up
paying more to providers than private insurance: The largest private
insurers in each market already have tens or hundreds of thousands of
members. When they negotiate rates with providers, they get volume
discounts of as much as 30%-40% off "retail rates," just as WalMart
gets volume discounts because of its market clout. (Because of its even
greater bargaining power, Medicare often pays providers 15%-20% less
than private insurance).
But
without the ability to tie pricing to Medicare rates, the public option
will have no ability to negotiate volume discounts. It will start out
with no subscribers. It will then have to go to each hospital, doctor
and drug company to negotiate rates. Without any subscribers at the
outset, these providers will have no incentive to give volume discounts
to the public option, which will end up paying more than large private
insurers. This in turn will make the public option more expensive than
private insurance. As a result, it will sign up few subscribers. With
few subscribers, it will be continue to be unable to negotiate volume
discounts. Even if the public option were allowed to pay Medicare plus
5% rates, unless it already had a large number of subscribers in a
particular market, providers would simply refuse to accept public
option patients at these reduced rates, prefering to treat patients
from higher-paying private insurers. So it's a chicken and egg
situation. Few subscribers will lead to higher costs. Higher costs will
lead to few subscribers. This is a public option designed to fail.
As
a result, when the Congressional Budget Office first evaluated the
Senate negotiated-rate public option plan, the CBO concluded that it
would end up with no subscribers. Perhaps with a little pressure from
Congress, the CBO is now projecting that by 2019, approximately 6
million Americans would be enrolled in the negotiated-rate House public
plan. The CBO also projects that "a public plan paying negotiated rates
would...typically have premiums that are somewhat higher than the
average premiums for private plans." The CBO notes that this public
plan would attract a "less healthy pool of enrollees" than private
plans. With a less healthy pool of enrolees who require more services
than private plans, the cost of the public plan would continue to
escalate beyond the cost of private insurance, further reducing the
number of people who sign up, and further reducing its negotiating
clout, leading to a vicious circle of increasing costs and
unaffordability that would do little or nothing to put pressure on
private insurers to lower their premiums.
As
Kip Sullivan, a long-time fighter of universal health care, has argued
articulately, the devolution of the public option from a robust
proposal projected to cover over 129 million Americans and lower
insurance costs to a sham public option that will at best cover 6
million Americans in 10 years and have no impact on lowering insurance
costs is a case of "bait and switch".
The
"public option" was initially proposed by Yale political scientist
Jacob Hacker and Campaign for America's Future leader Roger Hickey as a
more politically "pragmatic" alternative to the long-time progressive
goal of establishing universal single payer health care (as though
insurance companies and their paid-for Congressional allies wouldn't
fight against a robust public option as hard as they would fight
against Medicare for All).
Hacker and Hickey laid out 5 criteria that, they argued, were essential to the success of the public option.
1.
The PO had to be pre-populated with tens of millions of people by
shifting all or most uninsured people, as well as Medicaid and SCHIP
enrollees, into the PO, so like Medicare, it would represent a huge
pool of enrollees on day one.
2. Only enrollees in the PO, not in private insurance, would be eligible for government subsidies.
3.
The PO and its subsidies would be available to all nonelderly Americans
(not just the uninsured and employees of small businesses).
4. The PO would pay Medicare reimbursement rates.
5. The insurance industry had to offer the same minimum level of benefits that the PO offered.
If
these criteria were met, the Lewin Group (a subsidiary of health
insurance giant United Health) projected that the public option would
enroll 129 million Americans, have overhead of 3%, pay hospitals 26%
less and doctors 17% less than the private insurance industry, and have
premiums 23% below the private insurance industry average.
That
was the "bait." Now came the "switch." The puny public option proposals
that are still on the table in the House and Senate meet only the 5th
of the 5 criteria for an effective public option and eliminate the
first 4 criteria. They are not pre-populated; subsidies go to both the
public option and private insurance; large employers are barred from
buying into the public option; and the public option is not allowed to
use Medicare rates but must instead negotiate rates on a provider-by-
provider basis.
The result is that instead of enrolling 129
million Americans and decreasing insurance premiums, the sham public
option being proposed in the House and Senate will enroll between 0 and
6 million Americans and will cost more than private insurance.
It's
time that organizations which supported a "robust" public option tell
their supporters the truth: that the public option in the House and
Senate bills bears no relationship to the public option they have been
fighting for. (Instead, the Health Care for American Now blog praises
the public option in the House bill as "a strong competitor to private
insurance, keeping prices down and attracting customers.") Its time
that "progressives" in Congress like Anthony Weiner, Alan Grayson, Jan
Schakowsky, Raul Grijalva and Lynn Woolsey admit to their constituents
that, with no help from President Obama, they've lost the battle for a
"robust" public option. Media figures like Keith Obermann and Rachel
Maddow, who've been vocally talking up the public option, should be
reporting the truth about the pitiful public option that's left on the
table.
As it stands
now, the sham public option in the House and Senate bills serves only
one purpose. It gives political cover to progressives and liberals in
the House and Senate to vote for mandates that will use the power of
the federal government to force uninsured individuals to buy inferior
and over-priced private insurance or be fined by the IRS by being able
to say, "Well, at least the bill contains something called a public
option," even if it's a public option in name only. Better that Joe
Lieberman's filibuster threat forces Congress to drop this sham public
option from the bill. At least, then, progressives and liberals will
have to squarely face up to the implications of their vote and decide
if this type of "health care reform" is really in the interests of the
American people, or indeed, in the interests of the Democratic Party.
As
the final bill takes shape, it's going to be a close call whether this
type of mandated "health insurance reform" with no price controls on
premiums is better than no reform at all.
Read more at: http://www.huffingt onpost.com/ miles-mogulescu/ the-public- option-in- cong_b_340501. html
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‘No Guarantee’ — With Plan, or Without
This isn’t the first time that CPR, a group headed by former Columbia/HCA head Rick Scott, has tried to tie health care overhaul efforts to "government-run health care," we have pointed out the problems with that leap of logic. This time, CPR is saying that the federal health plan – which is presented as an option for individuals and very small businesses (at first) in the pending bills – is the route by which government is going to take over the health system, and the trigger for the clearly undesirable dangers described in the ad. The narrator is right about those hazards: There is "no guarantee" that they won’t happen. But what CPR doesn’t mention is that they could also happen – and in some cases are already occurring – under the current health care system. Lose your own doctor? Many people experience that today, if their employer changes insurance plans, if they change jobs, or if they become uninsured for any reason. Wait longer for care? Given the shortage of family doctors, which is only expected to worsen, we can expect wait times to increase even if the system remains untouched. Pending overhaul legislation aims to ease that, in fact, by increasing certain payments to physicians and making other adjustments to encourage training of primary care physicians. Rationing? That occurs on a regular basis today, whenever insurance companies or government programs like Medicare reject claims, or when the companies drop people who have become ill for not disclosing often minor and unrelated preexisting conditions. Under pending legislation, insurance companies would be unable to deny coverage to individuals because of preexisting conditions. And when it comes to losing one’s insurance, that’s another everyday occurrence under today’s system, as millions of people who have lost their jobs in the recession have found. Under the pending proposals, individuals could lose their current insurance plans, though for different reasons; small businesses might decide to buy coverage through a newly created health insurance exchange, for instance, rather than stick with their current plans. The big difference? For the vast majority, if not all, people, "losing your insurance" would simply mean switching insurance plans – not losing coverage, as many do today. As for whether "the president’s public option plan could lead to government-run health care," the operative word is "could," which makes it hard to disprove. The real question is, how likely is it? As we said before, Obama has not proposed a government-run system and, in fact, has rejected the idea. Some think it would come into being de facto, however, if vast numbers of people ditched the private system and opted for the public plan. But under the pending Senate bill and the House Energy and Commerce Committee bill, the plan’s cost structure wouldn’t be all that different from that of private insurance – so it would be unlikely to draw a huge number of takers. The original House bill had a provider payment formula that would make the plan cheaper for consumers. That type of plan could attract a lot of people – if eligibility was eventually expanded beyond individuals and employers with 20 or fewer workers, which is where the bill stops.
 PDA contribution site. Contribute to single payer healthcare effort here. http://www.takebackredcalifornia.org/index.cfm Take Back Red California sponsored the Red to Blue Dinner at the Convention. They are a grassroots coalition that connects northern California Democrats in urban counties with northern California Democratic activists working in rural counties especially on a local level.
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