How Obama can sell the discontented on his "public option"

[Oregone]

First, I think it is clear that the recent opinion polling has revealed large nationwide support for a public ran health insurance entity, which the politicians have noticed. That much has been confirmed by Obama's sharp rhetoric in favor of the "public option" today at his Presser. Perhaps it is too early to draw conclusions, but I would think that some "public option" is a done deal (though who knows what it will look like, and other provisions that will come with the "reform").

Of course, there are some (me included) who see little sense in applying band-aids to a system completely broken that results in constant bankruptcy, death, and under-treatment. We are those who are critical, calling for a single-payer system. Although this group has not even been invited yet to any debate, perhaps it is time they can start influencing it.

Well look, I will 100% support whatever "public option" that congress jacks up, as long as it also provides (as an additional measure) universal single-payer catastrophic health insurance for all citizens and legal residents.

Now, thats simple to ask, right? Just a simple default policy that ensures each person will not spend over X% of their income on health related expenses (premiums/copays/deductibles). We can all sit around and talk about "affordable" all we want, but with this measure, we can actually set a real line of what is a reasonably affordable expense for health care in a worst case scenario for an insured person. If the "public option" paired with the private market cannot meet that point, then by all means, this needs to be addressed.

If Obama's mixed market "public option" approach works, NO ONE will ever pay such an un-affordable amount that the catastrophic public policy kicks in to cover 100% of the rest of the costs. Its merely there in case Obama's plan does not work. Further, it also sets a limit, as to what the potential liability of all private insurers will be (thereby forcing them to re-access their risk models, and drastically reducing premiums instantly). If private insures with a 25% copay knew they would only pay out (3*X%*income), then they would know they need to collect far less to cover their entire pool.

Essentially, this creates a contigency plan to ensure no one dies, goes bankrupt, or remains under-treated due to 1) co-pays/deductibles that make insurance unaffordable to use 2) denial of claims which leaves them with a bill they can never pay for.

And, for people who whole-heartedly support Obama's plan as the ultimate fix, you can consider this plan as being "free", since it will never be used in the scenario that this reform actually fixes the system.

The question isn't why should the "reform" include this, but rather, why shouldn't it include this? What possible reason would there be to exclude a backup policy to address instances of when a broken system (which people refuse to drastically overhaul) continues to fail in servicing a society.

Im not talking about something here that pays for everyone's care from the get go, but something that covers over $20K (out of pocket) of someone's care who makes $100K a year, because the premise that any more is reasonably affordable in a "reformed" system with "Universal" Healthcare is absurd.

[Cleita]

1. I had catastrophic insurance before I went on Medicare. This is what the

problems are. A large deductible each year insures that you will never reach that deductible so you are still paying for your medical bills out of pocket and paying into an insurance as well. If you get an expensive chronic disease, you still have to pay off the deductible, often between $1,000 and $5,000 a year, each year. This is how families go bankrupt even when they have so-called health insurance coverage. I want a public option to be either along the lines of Medicare and Medicaid, or like the VA that covers everything. The only thing we should be paying out of pocket is the premium or extra taxes, however, it works out.

[Oregone]

4. This is quite a bit different

A single-payer free universal plan IN ADDITION to any "public option" that people can choose. So, while everyone is covered with a public/private plan, this kicks in if they fail.

So, as you said, you want a public option like Medicare. And I say, in addition to that, we need a catastrophic policy, such that if somehow the plan you chooses still fucks you, you are covered. Also, with it based on income levels, the deductible may be heavy, but not devastating.

This is actually a real path to single-payer too if anyone wanted that later (simply by lowering the deductible). This isn't the problem. If everyone had this by default on top of the shitty reforms they are doing, it could solve a lot of problems.

[drm604]

2. I do like the idea of catastrophic coverage.

I prefer single-payer, but it looks like that's simply not in the cards. A public option combined with catastrophic coverage for everyone is intriguing.

The irony of public catastrophic coverage would be that private insurers would likely embrace it wholeheartedly, giving lie to their free market rhetoric.

I think I've heard this idea discussed somewhere before. Do you know if this is being seriously discussed in Washington at the moment?

[Oregone]

5. I don't think it is being discussed anywhere.

I stole it from my BC, Canada drug plan
http://www.health.gov.bc.ca/pharmacare/plani/planiindex.html#7

Its my own stupid crusade, but I welcome anyone to join. There is very little "bad" about the idea, and maybe it just needs some steam.

It allows the private market to work their magic and only kicks in if they fail to provide affordable coverage.

Yes, the private market may like it because it doesn't threaten their existence and lowers their potential liability.

It isn't pure single-payer, but could become de facto single-payer as the premiums are lowered arbitrarily close to $0. As long as healthcare is "affordable" enough for society, there is no reason to evoke single-payer.

[MarjorieG]

3. This was a Kerry 2004 idea. I hope the public pool is big enough to work.

[drm604]

7. Yes, I knew that I heard it somewhere before.

I remember now that it was Kerry. Damned Swiftboaters. Damned Ohio. :grr:

[Oregone]

8. I admit I never made it though one of Kerry's speeches to pick it up

So, I guess he had a few good ideas after all. :)

[MarjorieG]

9. He had plenty, many of which became Obama's, even to phrases.

[Sebastian Doyle]

6. Well, for starters he could tell douchebags like Schumer, Conrad, and Baucus

to keep their filthy, corporatist hands off of it.