Matthew Yglesias had an interesting exchange with Kevin Glass over whether the public option, a government-run health insurance plan, can be “financially independent.” That’s related to Chuck Schumer’s proposal that public and private plans compete on a level playing field, with no “unfair subsidies” for the public plan.
Yglesias addressed the issue here, after Senator Mary Landrieu told reporters, “I’m not for a government-run, national, taxpayer-subsidized plan, and never will be.” She’s hardly alone in that view.
After noting that Steven Benen listed several “government-run, taxpayer-subsidized” health plans — Medicare, Medicaid, SCHIP, VA, etc — that Mary Landrieu already supports, Yglesias added:
The larger issue here, I think, is that unlike these programs the “public option” wouldn’t be a taxpayer-subsidized program. It would be a government-run health insurance plan that people could buy.
. . . which promoted the exchange with Glass about other government programs that are subsidized. As Yglesias argues, we subsidize Amtrak operations because Amtrak provides a valuable public service that would not likely be provided by the private market and/or if it depended solely on passenger fares.
But there’s more to how the “unfair subsidy” argument has been misused in the current health reform debates. Somehow many in Congress have got it into their heads that the federal government should not subsidize the public option, because that would somehow be unfair to private insurers who don’t get any federal subsidies. But of course, that’s wrong.
All of the insurance plans in the exchange(s), public and private, would be heavily subsidized by the federal government. Congress is currently debating how large those subsidies should be. And they could increase those subsidies in the future if needed to keep the level of uninsured to a minimum.
The governing principle underlying the health reform bills is that the nation cannot accept leaving 47 million people uninsured, leaving most poorly treated, many to die and more to face extreme financial hardships.
But the market has not, will not and cannot solve that problem. Even if there were no public option, the private insurers in the exchange(s) would not be able to provide decent, affordable coverage to the uninsured unless the federal government forced people to purchase insurance, taxed businesses and others and used the money to subsidize the premiums.
Government subsidies are needed to make the plans affordable. So you can bet that if the number of uninsured started to rise, because people couldn’t afford the rising premiums, the private insurers would be swarming Congress explaining how important it was to increase the subsidies to meet national goals of keeping these folks covered.
A public option would share in those subsidies, though the charge is that it would be disproportionate. But the public option isn’t just another choice, like the 4th or 9th private plan. It’s a necessary safeguard against private insurer practices that, despite regulations and cost-risk-sharing rules, will have powerful incentives to push high-cost patients out of the system or into discriminatory treatment.
The public option will perform the essential public function of making sure the toughest cases aren’t pushed out or discriminated against; they’ll still get affordable health insurance. It will also provide the public function of inducing private insurers to comply with the regulatory scheme, lest they mistreat people and lose market share. It could also perform other “public” functions, such as setting the model for provider incentives to help keep those costs under control. Whatever means the government uses to control costs — as in Medicare — should be employed by the public option too. That’s why linking to “Medicare+5%” makes sense — it reduces the need for subsidies.
Once the public option is understood as providing these essential public functions, the concerns about whether we might ever “subsidize the public option” are seen as completely misplaced. If we want to ensure adequate care for the uninsured through a mandate and exchange system, the government has to provide whatever subsidies are needed to sustain affordability for that coverage.
So of course it will be subsidized, because that’s inherent in the framework for making sure people who would otherwise not receive adequate care will be covered. It’s the same principle we use to sustain Medicare, Medicaid, SCHIP and so on.
If Congress has some other principle for guaranteeing coverage — say a universal single-payer system paid with taxes — let’s hear it. But so far, no one complaining about the “subsidy” issue has proposed one.



41 Comments







Why do I think that most of the crying and wailing and gnashing of teeth on all this is of the “Why are you forcing us to actually do our jobs under a microscope?” style of whine?
I’M SICK OF HEARING OF THE PUBLIC OPTION.
THOSE IGNORANT BASTARDS IN WASHINGTON, WILL SHORTLY FUND MORE MONEY FOR AFGHANISTAN AND SEND MORE TROOPS THERE PAID FOR WITH OUR MONEY.
BUT THEY WON’T GIVE US SINGLE PAYER NOT FOR PROFIT HEALTHCARE WITH OUR MONEY.
YOU PEOPLE ARE SICK FOR SETTING BACK AND LETTING THEM DECIDE FOR YOU, SPEND YOUR MONEY FOR YOU, AND GIVING YOU EVERYTHING BUT WHAT YOU WANT AND NEED.
THEIR ARE ENOUGH LAMP POSTS IN WASINGTON TO ADORN THEM, WITH ONE OF THEM.
Whoa, Diablo!!
Don’t scream at us.
loo hoo, you were asking about hr 676 in an earlier thread and i left you a bunch of info/links in a few later comments (it’s probably way more than you wanted, but you might find a couple of the links useful).
Dang, a wealth, selise. Thanks, I’ll get to them soonly!
didn’t meant to give you homework, just some resources in case you wanted them.
Apparently, there are plans afoot to have the insurance companies run the Public Option.
There is and has been an essential contradiction in using the Public Option to control healthcare costs. If it gives insurance companies real competition, they will label it as unfair. It it is not effective, then costs will not be contained. So the problem that insurance companies have with the PO is precisely that it might work as advertised.
While this dichotomy does exist, I’d say the condition is even worse than that. The entire framing of the Public Option as introducing a “competitor” to private insurance highlights the fundamental contradiction. Namely that a competitive market will produce improvements in cost and coverage. This is false.
A competitive market is antithetical to these goals when dealing with risk-pooling. So while the Public Option presentation is contradictory within itself, it is also contradictory in its pretense.
The issue for insurance companies is the effect of any kind of competition on their profits. Quality of service does not enter in to it, which is to say I agree with your overall point that competition has no place in the actual delivery of healthcare and, in fact, would undercut its quality.
It’s amazing to me that everyone doesn’t see the perversity of “profit” from the health problems of individuals. It’s just stupifying, really.
This is tangential at best, but I wonder if Landrieux and Bayh and their ilk voted for the farm bill during its last iteration. The farm bill has been loaded with subsidies for years. The government subsidizes all sorts of things, all the time–and much of it has only a fraction (if any at all) of the public benefit this bill will hopefully have.
Hiya firepups!
Are they going to fix medicaid at all? Like make it so that more doctors accept it?
I recall earlier descriptions (House bills?) that said Medicaid payments were to be upgraded closer to Medicare — but I haven’t seen anything further.
They are expanding eligibility to Medicaid — up to 133% of Fed Poverty Level. And as Clyburn noted on Countdown last night, one of the options the House is considering is whether to increase that eligibility to 150% of FLP. There is also a provision in the Buacus bill that would allow states to carve out those between 133% and 200% of FPL and cover them separately with a “state plan” or other state-created option.
One of the issues is who pays for this. Currently split between feds and states; the bills either have the feds pay for all of this expansion or at least 90/10 split with the states, which has the states worried.
howdy! long time no see. hope you are well.
i have no idea what they are going to do, but i can tell you what the cms report that was released last week said on this topic about the tri-committee version of hr 3200. (i’m so sorry it is probably not good news, but it’s just a report about one bill that is sure to change no matter what happens):
i posted this and some more bits from the cms report yesterday in the comments
Thanks for the cite. So, rates for primary care will rise to Medicare levels, but rates for everything else don’t?
looks like it.
i wish i had more details but the length of the bill was too much for me, and i gave up before reading it all.
I doubt it.
no, the governing principle underlying the health reform bills is that the Democratic Party can reward its corporate contributors from the medical industrial/insurance industry with a massive, daring bailout/giveaway by forcing many millions of Americans to pay whatever rate for whatever rotten insurance the cartel deems will not lead to open revolt.
the uninsured and those driven to bankruptcy, they are just props. The solution to the uninsured and the vast waste and inefficiencies in the system, much of which is scraped off as profit and funneled to the richest and greediest, is well known – most civilized countries have already implemented some kind of everybody in, nobody out national health care system, and they are happy with it.
It is very revealing, the amount of deception required to advocate for the Democrats paltry bills.
thanks scarecrow. the batshit crazy corporatist critique of a neoliberal corporatist policy makes my head hurt.
Good clarification.
All plans, public and private, in an exchange will be available for subsidies if qualifying persons select them.
All plans will have to present information about the plan to permit apples-to-apples comparison in the exchange.
The public plan will have the same rules.
The difference. Private plans negotiate rates with providers. The public plan (in the House version) sets rates at Medicare rates plus 5%. That is not a subsidy. If they want to argue that mandating a rate based on Medicare rates is an unfair advantage they are wrong. If you do that, you can open the public plan to the Medicare provider network and not have to establish a provider network from scratch. Which is why negotiated rates sort of puts the public plan at a disadvantage.
The idea of capitalism as I see it is that the incentive (profit) serves as the motivator for the business to maximize its productivity and reduce its costs so that in the end the business profits and the consumer (us) gets the best value for the price. So when the market is doing its job both the business and the customer benefit. In the health insurance world, the market is working for the business but not working for the consumer. It is the nature of the product that the business’s goals are opposite of the consumer. In other words, in the world of health insurance, capitalism and the free market can’t work. Consider the parallels here:
Our income tax system is so complex an entire industry has arisen, costing billions, just so we can file our taxes at the end of the year. Now imagine if the government came up with a plan that would simplify the filing so that we didn’t need to hire all the consultants, accountants, bookkeepers, or buy all the do-it-yourself software. Would the American people really stand for it if the industry started lobbying, and spending millions, and running ads to try and stop the reform of the tax system? Would they let their Congressmen and women get away with all the crap that is going on in the health care debate, and allow the tax code to continue to be impossible for the average citizen to wade through when there is a solution. I say there would be outrage. That’s the way it should be with health care. We need to change the terms of the debate so that the voters can see the benefit to themselves, rather than just seeing the possibility of their taxes going up. The health insurance industry is nothing more than an scab on the sore that is our health care system. They can be easily replaced. Their product is nothing more than a promise on a piece of paper. Nothing they can improve or the free market can make better. It is just a cost for no reason. Let’s fix it.
AMEN!
Go Boy.
First, they came for the universal single-payer, but nobody spoke up for it, so they killed it.
Then, they came for the robust Public Option, and even though two-thirds of American citizens spoke up for it, they still killed it, watered it down, neutered it.
And then they came for the 44,000 U.S. citizens who die each year because they lack any health insurance, private or public, and killed them, 44,000 dead, each and every year.
Adn then these murderers of U.S. citizens counted their profits and headed gleefully off to their bank to deposit their blood-stained lucre, laughing alongside all the politicians, these “public servants,” and their political operatives, that they’d bought.
“Subsidies” are a stalking horse the right will use to ensure no woman obtains an abortion, or even contraception if they have their way, under Public Option. Any argument about “subsidies” must recognize that it’s about the right’s need to control women’s bodies, and sexual behavior.
Firepups: I am trying to get this analogy into the meme-stream. Help me out about how to do that. I am a doctor and a wonk and love to argue on data but to get this passed we are going to need clear and compelling narratives. Let me know what you think of this one, which I sent in today as a letter to the Boston Globe.
To the Editors:
Pear and Herszenhorn’s article on health care reform bills [p. A2, 10/24/09] does citizens a disservice by focusing on politics rather than showing why these details matter. The specifics being hammered out now in the House and Senate will determine whether we get real reform or something worse than nothing. In particular, if the final bill compels people to buy health insurance (the individual mandate) but does not create real competition for private insurers (a robust public option), it will impose a severe financial burden upon ordinary people struggling to afford health coverage. It will also be a huge windfall for the very corporations that have been a big part of the problem. It is important that we change a misleading analogy: This is not a case where we are arguing over whether to settle for half a loaf. Instead, the legislation is like a machine where if the parts do not balance, the end result will be ruinously expensive to operate, fail to do its job, and injure the very people who need to use it. The next few weeks are critical and the outcome still very uncertain. Now is the time for people to push back against the millions of dollars in lobbyist money trying desperately to stick us with a broken (but very profitable) machine. Everyone who cares about this -and that should be all of us- should contact their representatives and urge them to vote against any bill with a mandate but no effective public option.
Sincerely,
Robin Colgrove, MD
Needham, MA
************
Robert C. (robin) Colgrove, MD
~~~Personal Information EDITED OUT By Moderator~~~
Attending Physician in Infectious Diseases, Mt. Auburn Hospital, Cambridge MA
Instructor in Microbiology and Molecular Genetics, Harvard Medical School, Boston MA
Good letter. I assume this is the NYT article your letter discusses:
http://www.nytimes.com/2009/10/24/health/policy/24health.html?_r=1&hpw
And I agree the Times reporters have given insufficient attention to the merits of proposal versus the political debates. The Presriptions blog on the Times sometimes does a better job.
If you’re here at FDL, you probably know that we devote several posts a day to these issues, with a focus on the public option, as well as affordability/fairness issues, etc. We’re trying to keep up with the arguments for the variations, opt outs/in, triggers, etc. This site at FDL is devoted to political action to promote various reform proposals:
http://fdlaction.firedoglake.com/
Most of us here are single-payer advocates of varying degrees of intensity, and some have latched on to a viable public option as one of the only fallbacks left on the table. We’re forced to argue against weakening it further (access to it would be severely restricted, at least in initial years, and uncertain after that).
You are also welcome to write your own posts here — the Seminal page of Firedoglake.
hi drrobin,
my only suggestion is rather than describe the public option you want with terms like “robust” and “competition,” which have different meaning to different people, you might use more specific language to describe the feature you want it to have — for example, available to all.
OMG. Make that into a petition, please!
earlier this week digby posted some info on the “affordability” issue. here’s a bit of it: The Light Dawns
if these numbers are correct, this doesn’t sound affordable to me — not for mandated insurance. it’s a mind blowing tax hike.
Everyone into the pool, and everyone pays a fair share, and doctors take it or retire. Reimbursement from the govt. plan MUST be reasonable to time and effort that doctors make to earn their credentials. More primary care doctors, geriatricians, nurse practitioners. Reasonableness. Not-for-profit. Let the insurance executives go find some other people to steal from!
scarecrow (or anyone else who has an idea on this),
this is the biggest part of what i have trouble with in trying to evaluate this reform strategy. i don’t see how the po can induce private insurers to comply with the regulatory scheme.
the way it looks to me is that if the regulatory scheme (rules, enforcement, etc) is sufficiently strong, and the po’s costs are low enough to undercut the private insurance plans on costs to consumers, then the po may be able to make the private insurers compete on cost (for unsubsidized customers only). but that is all — not on compliance with regulations.
am i missing something?
Thanks to the people who responded. I feel bad about not fighting hard enough the last time around (I was a “fellow” at the time with small children, and foolishly thought that Clinton and the Democratic majority would of course get health care reform passed). This time I am concentrating on what can really make a difference: writing letters, signing petitions, donating money, etc. In addition, though, the “narrative” is crucial. Geek that I am, I am all about data and logic, but to get this done, we need stories and metaphors that people understand viscerally. This one was my modest contribution: that hobbled reform can be worse than nothing, jumping half-way across the chasm. Not half a loaf but a machine with an essential part removed, likely to blow up in our faces. And that if ordinary people do not use the chorus of their voices, they only hand over power to those with big checkbooks to open.
amen!
p.s. i expect you may find some geeks and wannabe geeks here to keep you company!
Let’s take Ms. Landrieu at her word. Since she is not in favor of government subsidized health care, I propose the immediate cancellation of taxpayer-funded health care for Senators and Representatives.
Dismantle the Capitol Hill basement’s, Navy-staffed 24/7 health facility. Revoke Congresscritters’ preferred access to Washington area medical facilities – a privilege paid for and possible because those hospitals know that whether they treat an ingrown toenail or replace a heart, the debt incurred is backed by the full faith and credit of the taxpayer funded United States Government and that they will be promptly paid in full.
Sen. McCain and Hatch and Grassley, for example, could still lay claim to Medicare health facilities, should their sizable and growing portfolios suddenly disappear in a whiff of Wall Street scandal.
Ms. Landrieu, on the other hand, may be too young for Medicare. She’ll enjoy the private sector’s pro-women underwriting policies. If she has a womb or breasts or has ever had a baby, she would quickly find herself unable to find medical insurance nationwide. Any dependent family members would be similarly afflicted. She might then have to dip into the savings she’s acquired via “shopping” at Wal-Mart.
Seriously, part of this campaign must now be to demand that taxpayers fund no Congresscritter health or pension plans beyond Medicare and Social Security. We can’t afford it, these millionaires don’t need it. Let’s give them something in common with their constituents beyond a putative address in the same state.
Sounds good but they make the rules not us. So we can’t take anything away from them, and they know it. It’s just like with their raises they could give a shit less if we approve of them, they just take what they want.
John Edwards, for all his faults, was serious about ending Congressional health coverage on July first if they hadn’t gotten a bill to the President’s desk. I believe he might have tried, too.
And now I’m seeing Villagers talking about Valentines Day 2010 for a health care bill! I suppose the longer they take, the sweeter the graft.
Is anyone remembering that Medicare is about to go broke by the tune of thirty eight trillion dollars.
They are telling us this might cost one trillion over ten years.
No matter what they pass, how long will it last, if they haven’t fixed the looming medicare problem.
They have two ways out tax the livin shit out of us, or try to borrow more money.
Their borrowing will come to an end sooner than later, and that means look the hell out for you wallet.
Even if they taxed us at eighty percent of our wages it would take ten to twenty years to catch up, let alone pay off the debts.
So even if they pass healthcare, don’t plan on having it help you for long.
I copied my post to my facebook page and a friend commented, reminding me that I was probably riffing off Thoreau, from Civil Disobedience :
” Friction is normal to a machine so that its mere presence cannot justify revolution. But open rebellion does become justified in two cases: first, when the friction comes to have its own machine, that is, when the injustice is no longer occasional but a major characteristic; and, second, when the machine demands that people cooperate with injustice.”
I think with health care we are at the point where the friction owns and operates the machine,
You are probably right, but will see if even that is enough.
Lemmings follow the leader over the cliff everytime, never tapping Him on the shoulder saying there’s a cliif ahead.
Shortly after healthcare, or a poor excuse for it is desided we will see whether we are a country of men or lemmings.