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So I’m on a terrific demo at the Apple Store in Pittsburgh, because when you’re at Netroots Nation, you’re expected to have a working wifi system, and mine wasn’t, and I tap into the usual suspects and discover that my young friend Jane — she who’s whip must be obeyed — has become the stuff of nightmares for even younger Matthew Yglesias.
Young and brilliant Matt is relieved to have the equally young Ezra Klein confirm that the public option now supported by Gov. Dean and that passes for the minimum insurance reform we can expect in the Age of Death Panels is more "progressive" than what Dean was advocating in 2004.
This apparently means two things in Matt’s view: we’re making progress in developing proposals we haven’t passed yet and, more important, this progress is non-radical enough to earn Ezra’s seal of approval. Young Matt describes Dean’s original plan and how it would play in Hamsherland today:
This was a pretty good health plan. But it wouldn’t achieve truly universal coverage (he bragged, “It doesn’t have to be this way in America. In Vermont, where I served as governor for the last 11 years, nearly 92% of adults now have coverage”) and it didn’t include a public plan. The up to age 25 thing is a good idea that I’d like to see incorporated into present-day discussions. But basically this plan amounted to something that today would count as a squishy moderate proposal that would get you denounced by Jane Hamsher as an insurance company sellout. And yet reading it in 2004, everyone recognized that for all its incrementalism the Dean plan was, in fact, a series of progressive measures that would constitute a huge advance over the status quo.
Gosh, what a relief! And I think it’s swell that no one is suggesting that the reason Dr. Dean’s prescription has changed to demand at least a strong public plan to force the insurers to be honest or lose market share is that he’s come to realize how sick the current insurance system is and why it’s going to need to be replaced, at whatever pace Americans feel comfortable with.
I just hope that when Jane co-hosts a health care reform event this evening with Dr. Dean, he does not feel too threatened by Ms. Hamsher.
49 Comments
Like the Rumpole reference. Good luck with the Life Panel.
It looks like we are down to even the supposed progressives trying to figure out what level of crap the rubes can be sold as reform. And let’s remember too that a lot of hamsherland is to the left of Hamsher on this.
I guess what surprises me more than anything is how many “progressives” are blowing their progressive cred by backing various of the Democratic sellout proposals.
There is that, for sure. It happens whenever you try to ingratiate yourself with power brokers and poobahs with access.
Here are the questions I have yet to hear answered by the folks attacking Jane on this:
1) If we’re having such a tough time getting a decent public option passed, why does anyone think that single-payer would have had an easier time passing?
2) If the public option is such a horrible terrible no good very bad sellout of progressive ideals, why is the health-industry lobby fighting it tooth and nail? You’d think that they’d love it to bits, from all the inflammatory language I hear SP-or-Nothing folks directing at it.
ROFL!
The prospect of Jane Hamsher attempting to ingratiate herself “with power brokers and poobahs with access” is laughable. I mean, really — I am laughing here. If you think Jane’s work is about attending better parties and scarfing better cocktail weenies, you really haven’t been paying attention.
“Medicare for All!” is not certainly a political impossibility, but it has reflexively become one.
Part of our problem is that every time there’s momentum for this issue, and there’s sort of a built-in assumption by the public that we’re talking Medicare expansion, the political establishment abandons a clear and simple goal within a known framework in favor of some needlessly complicated “market-based” solution of dubious efficacy with no real definition, no track-record, and no built in support or popularity.
That’s what I find so funny about this whole thing, conservatives didn’t kill single-payer; liberals did.
What is the calculus for determining “possible”, such that it doesn’t just become the art of maintaining the status quo?
The sentiment seems to belie two things; we already have Medicare, and it’s an exceptionally popular program.
What’s often described sounds a lot like reflexivity. Narrowing the conversation based on perceived politics, before even getting to an assessment of a solution or policy on its merits. It’s self-defeating. We’re succumbing to imaginary obstacles rather than overcoming real ones as they approach.
What we have now are two proposals that don’t accomplish much of anything, and change practically nothing about the status quo for the overwhelming number of citizens, but look at all the opposition. That opposition isn’t necessarily on a linear scale where you can say, “Man, look how much they oppose this incredibly weak reform, surely the ocean would rise up to swallow the country if we tried to go single-payer.” Some of the most vehement opposition are furious due to thinking whatever is going on now is going to affect their much beloved Medicare, not because everyone might get it too.
Some of this opposition, what of it is legitimate, is the direct result of attempting to erect something that literally nobody understands, can’t articulate, and has no experience with. When you have a policy platform constructed on those three things, it should come as no surprise that people just go batshit, and misinformation spreads like wildfire; because there’s almost no actual information to relate to. Whatever one thinks about the possibility of passing “Medicare for all,” it should be beyond obvious that something as nebulous as what underlies the current debate could conceivably have even worse odds. You literally end up throwing hundreds of health economics studies, myriad effective international case studies, and the huge popularity of our own single-payer-like systems out the window in an attempt to rally support for a complete unknown in every respect.
It doesn’t take much for all the reflex defensiveness to come out. Who is attacking Ms. Hamsher? Or is disagreement instantly taken as attack? Single payer is the one option that will actually work. We know because it has worked in most of the rest of the industrialized world and here at home in the VA and with Medicare. The same can not be said for the public option. We don’t know even if there will be a public option but what little we do know about it and what has been happening to it is that it will be at best a figleaf for a sellout to insurance companies, drug companies, and the medical industry in general. No one has said that single payer will be easy to get past these entrenched interests and their bought politicians in the White House and Congress, but doesn’t it make more sense to fight for something that we know works rather than a hollow shell? And why shouldn’t this combine of medical interests vitiate the public option? For them, it just makes their real concern, single payer, that much more unlikely. It gets us supporting crap options which they can weaken and then use against us as our failed approach. And besides shouldn’t our metric be what we believe in rather than what our opponents say about one plan over and against another?
I’m going to predict right now that if we get some kind of premium-based opt-in public option it’s eventually going to be what they use to kill Medicare, not the other way around.
I think of this as confidence we are more confident that we can pass a better plan than when Dean ran for president.
The GOP should be worried sure they defeated Dean but healthcare did not go away it became even more important.
Why because healthcare costs under their Private system have gone up but wages have not kept pace and now with the economy tanking people are even more worried.
Now then Christmas time is coming either we have a real good Christmas shopping season or several retailers will go under.
Even if we pass a healthcare bill that takes effect right now the public demand for a healthcare bill will grow as unemployment grows.
If I were the GOP I would argue for a second Stimulus Plan targeted for the poor that would take effect right now
that is much larger than the first in order to prevent further unemployment.
Swine Flu is coming don’t forget if it turns out bad this year we will get healthcare passed. The danger is that we accept the GOP’s first deal on the issue when we can get a much better plan than we are currently talking about.
I’m thinking of just stealing the French plan lock stock and barrel.
After all the Swine Flu will hit right as they are just getting the vaccine out there is no guarantee the vaccine will work for the version of the virus that hits us.
Plus between cars and airplanes America can spread a contagious disease faster than a poorer country can that and our food system food processing and restaurant workers without healthcare can spread this disease even more.
Close contact with pigs can infect humans can close contact with people infect pigs?
Heh, as YOU have pointed out often, nothing’s fully drafted much less vetted, voted and signed by Mr. Obama. *G*
But yeah, WRT Matt Y and Ezra K, when progs go bad, indeed.
Who’s side are they on, anyway? Not mine . . .
Norse would boot them outta the foxhole in a flash . . . . with VERVE! *G*
Scarecrow, thanks for posting this . . . I had to reach for some cheap Merlot to steady the blood pressure, that and a square of dark chocolate . . . WTF is WRONG with those two?
“Some of the most vehement opposition are furious due to thinking whatever is going on now is going to affect their much beloved Medicare, not because everyone might get it too.”
Really? Got evidence of that, Nate Ole Buddy? Other than ‘I talked to people at a town hall meeting’ anecdotes?
Cuz that’s a pretty ballsy and HEAVY statement to make, no matter WHAT case yer making for the topic.
Honestly, I really want to know if that’s proven fact or your conjecture?
There’s SO much I don’t think I agree with you in your #7, and then you come out with this.
Which I concur with heartily.
And this model will not only take out medicare/medicaid, it will be aimed at Social Security, after that.
Where the VA comes in, to serve our armed forces, I’m not sure, but I’ll bet they won’t screw soldiers over TOO much. More. Yet. Again. Deny services . . . that’s not just for Private Insurence, ya know.
Again, I’m with ya on if we lose this one for ANY semblance of challenging insurance/med/pharm on rates or regulations, it’s a warm up for Medicare. And WE Granny and Grandpa boomers once we hit our 70’s, will learn what Death Panels REALLY are . . . . only a decade and a half away for SO many of us. Many there, now.
Ignoring for the moment that my anecdotal experience at town halls and observing footage of others would absolutely constitute some.
So far as I know, no national poll has been conducted that has asked, “Would you support expanding Medicare to cover more people as opposed to Barack Obama’s ‘public option’?”
I’m basing that assertion, qualified as it clearly was, on my observations.
Can you state specifically what you disagree with here
and here
In making that observation, the thought of JH never entered my mind. I was speaking in general, finding it alarming that so many bigwigs and insiders are hovering about. My whiskers sense message control.
Not an implausible prediction.
I’d probably caution against the bad Merlot. This post is a bit tongue in cheek, because of the gratuitous comment about Jane. But Matt’s a smart, decent guy, and the argument that positions have evolved in recent years is, of course, valid.
I just think it was unhelpful to suggest how far we’ve come, when we don’t have a bill out of the Senate yet, and when we’re fighting hard to hold the line on further compromises, having taken so many hits already.
Or maybe I was just pissed about my computer, which now seems to be feeling better.
Re Medicare. NewsHour on 8/13 was a segment on geriatrics and Medicare with Geriatrician Wasserman – see http://www.pbs.org/newshour/in…..eriatrics. talked about some of the crises in medicare care for aging. Wasserman says that geriatrics deals with quality of life and improving function; as one who deals with chronic pain on a daily basis, these are constant concerns of mine. He says that one of the problems with Medicare is that beginning in 1992, medical specialists, who rarely see seniors and have no experience in primary care, began to determine the reimbursement costs for doctor’s services under Medicare with out regard for the special care seniors need vis a vis quality of life and improving function issues.
My favorite doctor is a neurologist who does a lot with pain management services in his practice. He is also radically committed to functional, integrated medicine that addresses the patient as a whole person, and works with other medical service providers in a shared, coordinated fashion, rather than a simple referral basis, both of which are totally unlike traditional medical practice. He struggles to maintain the kind of practice he believes in within an insurance system that makes absolutely no sense, whether in terms of absurd reimbursement codes,and payments, all of which constantly threatens his dream, no matter how highly respected the practice is by patients or other doctors. I grieve for him and others who understand the kinds of reforms that are needed to significantly improve health outcomes that goes far beyond pushing this or that pill as with traditional practice.
Anyway, the Dr. Wasserman segment was very helpful.
Also, I commend the September Atlantic article by David Goldhill, “How American Health Care Killed My Father” ( http://www.theatlantic.com/doc…..ealth-care ) which I’m just beginning to read (it’s 18 pages long!) but he begins by asking why in the heck do we tolerate the hundreds of thousands of medical error and bad practices causing so many hospital deaths that are the norm in even the best of our hospitals. Here’s a typical quote: “Accidentally, but relentless, America has built a health-care system with incentives that inexorably generate terrible and perverse results. The following are the specific topics/themes of his article:
Health care isn’t Health(or happiness)
Health insurance isn’t health care
The moral hazared economy
There’s no one else to pay the bill
Uncompetitive
Our favored hospitals
You are not the customer
The strange beast of health-car technology
The limits of “comprehensive” health-care reform
A way foward
I think that Goldhill has some great insight and analysis in this article that merits our attention for his assessments of problems and answers. I’m reasonably sure his conclusions are in no way THE final word, but worth consideration toward final words that we may or may not be seeking in the political process at hand.
Blessings,
Blessings,
Blessings
~~~ModNote: Second link repaired.~~~
Ok, I’ll try to tackle this . . . and without attacking you . . .
“Part of our problem is that every time there’s momentum for this issue, and there’s sort of a built-in assumption by the public that we’re talking Medicare expansion, . . . . .”
What built in assumption? Who are you saying HAS this assumption? I’m still trying to learn about it all. I’m not sure I’ve read much about a built in assumption that the public in general thinks it’s all about Medicare expansion.
From what I’ve read and seen the only assumption I have is that the opposition to health care reform in general is led by a loony right wing fringe being manipulated by the industry’s that have so much to lose MONEY WISE from reform, regulation and such. The 1% gaming it all, again, against their complete control of it all. Have I missed something?
“Some of this opposition, what of it is legitimate, is the direct result of attempting to erect something that literally nobody understands, can’t articulate, and has no experience with. ” . . .
What legitimate opposition do you speak of? I see none. I hear of none, that’s legitimate. I see scared, ignorant and uneducated people, all white, spooked by the vagaries of what they believe that are spoon fed by the radio and tv, and paid by for the industry’s that will suffer economic losses as healthcare reform might be actualized and implemented, all for the good of the masses for coverage, and for our economy as 30% of our present costs of GETTING care are eliminated from the profit lines and admin staffing that’s embodied in the present system to DENY care and treatment to the masses, even those WITH coverage.
“. . . .is the direct result of attempting to erect something that literally nobody understands, can’t articulate, and has no experience with.”
Ok, the issues at hand for healthcare reform are plainly ’splained in many places, and posted on the internet. Just like Obama’s Birth Certificate. And HR 676 is as simple as simple gets. But of course, the opposition to change is not interested in the details, they just are scared of losing their White And Right control over it all. Bullet points have been posted galore as to the prog goals, you’ve read them so I won’t repeat them here (I don’t have the linky’s bookmarked and I’m not about to go look for them).
So, Nate Old Buddy . . . I just can’t go on and on, it takes too much time and effort to state the obvious when you’d like to draw it out long and deep and still deny. You exhaust me, and I just won’t play that game.
But thanks for a civil if protracted denial of the reality I believe in.
May Teh Progressive Bless Ya, Hoss, if you ever need care . . . . ;-)
“I’d probably caution against the bad Merlot. This post is a bit tongue in cheek, because of the gratuitous comment about Jane. But Matt’s a smart, decent guy, and the argument that positions have evolved in recent years is, of course, valid.”
The Merlot is actually tasty, it just comes from a box, which MOST folks would automatically reject. *G* Tongue in cheek? I sure missed THAT! lol Of COURSE positions have evolved, I got the impression Matt and Ezra are dismissive of that????
“I just think it was unhelpful to suggest how far we’ve come, when we don’t have a bill out of the Senate yet, and when we’re fighting hard to hold the line on further compromises, having taken so many hits already.”
Of course!!!! Way too soon to flip out on LOSING.
We only lose when the final final is done by Prez Obama.
If it’s a good one, with competition for the HC industry, we win.
If the final final is NOT competitive, and watered down to exclude the basics of moving forward and COMPETING with the entrenched 1% money makers who profit from our illness and dying, then we lose. And all hell breaks out, likely.
“Or maybe I was just pissed about my computer, which now seems to be feeling better.”
I’m sorry to hear bout yer ‘puter . . . . perhaps it’s policy has a preexisting condition that’s not covered? /snark
*G*
Love yer stuff, thanks for the reply . . .
NIce comment, Marchan . . . that’s a full blown diary if I ever saw one . . . thanks.
seconded
HR 676 isn’t what anyone is promoting. HR 3200 is what people are promoting. You’re making my point for me. That people are scared, terrified, and confused. They don’t understand what is going on, and it should come as no surprise that they don’t. The “public option” is a new construct, an idea with no analog in American experience, and even worse; it’s a totally moving target.
Nobody can articulate the “public option” itself, and further nobody can articulate the certitude of its effectiveness as a result.
These completely incoherent people throwing fits are low-information/uneducated. Without a concrete goal and system to point to, one that they’re comfortable with, know about, and have had experience with (like Medicare, VA, TriCare, etc.), then you’re asking them to believe blindly in a complete unknown. Asking such a thing of a population that is low-information/uneducated is not an effective mode of politics.
The idea that “Medicare for all” as a political impossibility has become conventional wisdom, but that convention completely ignores the massive political positives for such a policy. Even low-information/uneducated people like Medicare, it’s a known system, that would be relatively simple to phase-in enrollment increases, etc. It’s not at all clear that the “public option” is more politically palatable. I give you the character of discourse today as a case in point.
The people who lose their minds over government take-overs of __________, because they’re shills for money are going to exist either way. You pre-negotiate functional policy away to satisfy them, and all you’ve done is trade in solutions for prima facia pacifying the guy in the room who’s getting paid to scream the loudest. That’s just crappy politics, and it’s antithetical to actually accomplishing something that will work.
In short, should it come as any surprise that it’s become a huge pain in the ass to get support behind something that literally nobody wants. The opposition is opposing just as hard as they would otherwise, but you’ve lost all the benefits of a clear policy directive in the process of placating them. Now you’re left with a big heap of BS, and wasted a bunch of political capital on something that’s almost certainly doomed to failure.
If MDs want to lower their malpractice rates, they should lower their rate of malpractice. Medical errors kill 100,000 Americans per year.
I confess to having no clue, but “public option” sounds to me like a way for corporate insurers to dump their expensive subscribers onto the public, so that they can increase their profits.
That, btw, was the point of Medicare…it was, after all, written by a Republican.
What the bills do is create an “exchange” in which different insurance plans can “compete,” in the sense that people who are eligible for the exchange can choose any of the plans offered in the exchange. The PO is one of the options people can choose, or not.
Can private insurers dump the high risk patients, who are then forced to go to the PO? There are provisions to stop/discourage that or move money if that occurs.
1. Every plan offered in the exchange must meet exchange rules, one of which is to have open access — the plan must accept everyone and no plan can exclude anyone for prior condition or unfairly rescind the policy after you get sick. The standards for price (premium) differences are the same for all plans in the exchange, including the PO. So that’s one rule to prevent this “dumping” that you fear.
2. Another provision sets up risk sharing, which means that if it turns out that Plan A has, for some reason more lower risk patients than Plan B, so that Plan B’s premiums must go up to cover higher costs, then the exchange moves money from Plan B to Plan A to equalized the financial risks and help keep Plan B’s premiums competitive. That should have the effect of discouraging Plan A from discriminating too much.
Will these measures work?
I believe the private insurers will tend to “select” lower risk folks merely by the way they market their plans, even though the rules will prohibit them from overtly refusing to accept anyone who applies. If/when this occurs, the second mechanism will kick in. So the battle will be over setting the rules for how this risk allocation mechanism functions, with the private plans who want to discriminate hoping to limit the loss of dollars to any other plans, like the PO who don’t want to discriminate and that have higher risk patients. We will have to watch this process closely, or it will systematically drive the plans with higher risk patients out of business. The details matter, and the battle has to be fought every day.
howard dean has repeatedly and massively lied about health care reform.
someone should be calling him on it.
Hi Scarecrow. Thanks for that explanation. Is there any model for such a scheme working anywhere in the world, and working well? Or are we off into uncharted territory here?
what nonsense.
stop with the triangulation.
there are no single payer or nothing folks of significance. that is just bullshit. there are however two very real issues:
1) there arepeople who don’t think the po route will actually work. it’s not single payer or nothing, it’s a demand for a viable workable policy. there are significant critiques that have been made by real experts, for example elizabeth warren’s coauthors (on the medical bankruptcy studies). ignoring them is as stupid as ignoring elizabeth warren would be. ignoring their analysis does not make it go away. and ignorant triangulation reflects badly on you, not them.
2) there are people who think it was and is stupid for us to pre-compromise the single payer solution for an unproven and questionable alternative (while understanding that there will be compromise and that effective politicians must in fact compromise). their unwillingness to go along with the pre-compromise does not make them “single payer or nothing folks”
people do actually have good reasons to disagree about these matters. name calling doesn’t change that.
I’m reading that article via HuffPo and am on page 4 of 6, and it’s pissing me off.
Goldhill starts off with good insights but quickly degenerates into the standard AEI free-market capitalism pitch. The healthcare problem is lack of competition and too much government intervention, ya da, ya da, ya da. He glibly ignores the fact that the rest of the world doesn’t have our problems and invariably has more government intervention and that competition in the healthcare industry is not competition to provide a better product:
– insurers compete at avoiding sick patients and their healthcare expenses.
– providers to compete at selling treatments, which is the only thing they are paid for, e.g., see “The Overtreated American”: http://www.theatlantic.com/iss…..ownlee.htm
i agree. absent strong regulation and enforcement (especially on risk adjustment) that does not now exist — and would have to be written and implemented over the objections and lobbying efforts of a very powerful insurance industry — that is what i think a small po would do.
the other route to a viable po, as kip sullivan has described jacob hacker’s earlier proposal, would be very large pre populated public option (that could use risk pooling to overcome adverse selection).
personally i think it would probably need both to succeed.
…. but, in the mean time, putting aside the mandate and public option issue, all the other regulation reforms are very much needed (including the issue of risk adjustment to limit the “race to the bottom” type competition — which is needed regardless of whether or not there is a po) and imo should not be delayed.
even though we disagree, i really appreciate your willingness to consider and discuss the policy issues involved.
Yes. Pigs are a mixing bowl between Humans, Pigs & Birds, so says the research.
Beware of the Smahtt kids!
Um, you assume a public option that meets the tests most progressives demand is easier to pass than Medicare for All. I contend it is not. It is no easier to pass than Medicare for All, but it is easier to chip away at and reduce to nothing because “public option” is a Rorschach that can mean anything to anyone, whereas Medicare is a known quantity.
Why are the insurance lobbyists fighting it? Why not? They have won a number of battles on that front already, including no national public option, no Medicare doctor network, no Medicare reimbursement rates, subsidies not limited to public option, no government funding for public option that doesn’t need to be paid back, no streamlining of other government financed health care programs, no pre-set customer network. They have plenty of money. Why not keep picking at it? Not to mention if they let up it may turn into something sustainable. Further, in the language of the Senate HELP bill the pub. opt. would be managed by private insurers, and offered by community, not nationally. Why wouldn’t they continue to work to shape it as it best helps them?
howard dean is now going so far as to advise bloggers to lie about the public option.
watch the youtube and read ralphbon’s comment @1:
http://seminal.firedoglake.com/diary/7224
1) If we’re having such a tough time getting a decent public option passed, why does anyone think that single-payer would have had an easier time passing?
there was no decent public option, in any of the bills, not even at the start.
all of the industries that are now profiting handsomely from the status quo all have huge sums of money to lobby with and would have fought tooth and nail against anything that even looks like it might interfere with their continued siphoning off of money into their pockets.
if you wanted public support to help counteract the fatcats, medicare for all would have rallied that support much more so than what right now looks like nothing more than the govt forcing people to buy an unaffordable and proven-defective product that will possibly kill them.
2) If the public option is such a horrible terrible no good very bad sellout of progressive ideals, why is the health-industry lobby fighting it tooth and nail? You’d think that they’d love it to bits, from all the inflammatory language I hear SP-or-Nothing folks directing at it.
count me among the sp-or-nothing folks. i’m no wendell potter, but i know enough about the insurance industry to have decided that we need to remove it entirely from the provision of necessary health care.
as for the health industry fighting, the short answer is that temper tantrums work. throw a tantrum, get a concession. throw another tantrum, get another concession. throw another tantrum, get another concession. throw another tantrum, get another concession. ad nauseum, until we end up with something resembling the status quo.
champion thread, folks!
my 2cents:
this tendency is a reflexive habit amongst folks who have deeply internalized the logic of “least worst-ism.”
All a (D) politician has to do is utter the words ‘not politically feasible at this time’ and they can continue to count on the unwavering support of most ‘progressives’ and they can just proceed to operate in transparently bad faith, as Obama & co have been doing in the course of this whole health insurance reform circus.
1) If we’re having such a tough time getting a decent public option passed, why does anyone think that single-payer would have had an easier time passing?
Because Medicare for All is easier to explain. It is just like Medicare only it will cover everyone and will be better than the present Medicare system and even include long term care. It will be more difficult to demonize because people already know that Medicare works. As Consortium News pointed out, a functional public plan will put the health insurance companies out of business as surely as an outright Medicare for All system will, so the health insurance companies are resisting the pubic plan just as fiercely as the Medicare for All proposal.
bingo! A real overhaul of the current broken system would inspire real authentic, massive grassroots support, especially if backed up by the Presidential bully pulpit – and it would assure a place in history for the leader who enacted it.
so, PW, the ‘tough time’ you and the Washington Democrats are having is because the ones who are having to defend Obamacare, whatever it is on any given day, are ‘just following orders’ from the Leadership, who keep moving the goalposts, so you can’t credibly state what is good about it, because that is just one more capitulation away from being gone anyway.
and there is lots in it that the Leadership has maybe instructed you not to discuss, like the dreaded individual mandate, that will sink your Party like a millstone if they are foolish enough to enact it.
Here’s where I am right now. It might very well be that Enhanced and Improved Medicare for All (HR 676) is easier to pass than the public option/exchange bill. Consider these selling points:
Medicare already allows you to choose your doctor, and if the reimbursement rates are not lowballed so much in order to destroy the program, most doctors will participate
You will still be able to choose plans that provide coverage beyond basic coverage.
Cost containment is agreed to be greater under a single-payer plan than under any alternatives; the experience in single-payer nations shows that the savings can be up to 50%
It builds on what we currently have, just from the public end instead of the private insurance company end
It does not put the government in control of healthcare
Therefore, it meets President Obama’s criteria.
It is 30 pages instead of 1000 pages.
People already understand Medicare and support it.
Now for the downside:
It excludes investor-owned providers from participating, but allows a transition period for them to convert to partnership or non-profit organizations; the upside of this is that only the healthcare professionals providing the services get paid, not third parties
It is funded by
a tax increase on the top 5% of incomes; the upside is that these folks are probably more likely to be paying high premiums right now, which they will save
a transaction tax on the financial industry; do I need to state the upside
That’s it.
I agree completely with TarheelDem. There seems to be a lot of disagreement amongst a bunch of people who basically all agree:
1. Single-Payer is the real objective but the current Dem. leadership is too timid to go for it despite 50 years of impasse since Truman’s failure & a clear mandate from the American people to try.
2. We’d prefer Bernie Saunders to be sitting in the Oval office providing clear & stout support for this goal.
Failing this, however, most likely agree that Medicare for All is the best alternative. This call dates back to our very own Sam Gibbons (Florida 11th district) before his retirement in 1997. Unlike “Change you can believe in”’s invisible plan, it is well understood & equally well supported, by virtually all Americans. Unfortunately it still leaves the ‘for profit’ components in the equation but puts a tight leash on them whether they be big pharma, the hospitals, specialists or other providers.
Unless the Dem. leadership grows a pair in the next 2 months, this seems to be the best we can look forward too. Me, I’d love to have the U.K.’s NHS for all its failings!
Link please if your still around what about birds and humans the Swine flu has some Avian fly mixed in.
So, my question is: can an insurer do business outside the exchange, where he could presumably offer low-cost plans to selected healthy folks, e.g., college students. If so, the exchange plans would have to charge correspondingly higher premiums, thereby becoming a less attractive option to the healthy, etc.
OTOH, if all insurance business must go through these highly regulated exchanges, there are sure to be screams of “regimentation,” “fascism,” etc. Also, I’d expect a lot of corruption involving which insurers get stuck with which sickly subscriber.