Why Medicare+5 matters so much...

[Kurt_and_Hunter]

In my opinion, which may be utterly wrong...

The term of art "robust public option" has come to be associated, in the House, with Medicare + 5%. (reimbursements from the PO at medicare rates plus five percent.)

The alternative is for a new PO to negotiate rates and fees from scratch.

Since the Medicare rates were negotiated by the government, why can't we do it again?

First, a hell of a lot of work and delay for nothing.

Second, the public option starts off covering very few folks.

If the PO was 40 million people from day one we would have big bargaining power, but that's not on the table. If we start with a smallish population of insured--a few million--then the private health system can afford to play hardball to wreck the nascent PO.

And they probably would, too. If they gave the government good rates then the PO is more attractive and more folks clamor to get on-board. It may well be in providers' long term interest to be uncooperative, making the PO less attractive.

So price negotiations would be a nightmare.

(Lots of individual doctors would take medicare+5 patients... why not? 5% is better than 0%. But the bigger the entity the greater the ability to game the system to keep a PO inefficient. So I am thinking about corporate hospital chains, big pharma and medical equipment makers, etc.)

[Oregone]

1. This is a good point

Ive been somewhat perturbed this has become central to the term of "robust", hiding important debates about who is actually eligible (everyone should be) and subsidization levels to make it affordable. Though, you do bring up a valid point that shows this aspect is pinnacle for its success from day 1 (and it also keeps premiums low, thereby spreading subsidy money further). But its but a piece of a multi-faceted puzzle

[tavalon]

4. This is an aside, but I'm pleased that you are staying so interested

in how America goes on this topic and many others. I suspect that if I end up moving to Vancouver, I will dump this country like the piece of crap it seems to be. My loyalty is getting strained to the breaking point.

[Oregone]

5. Its tough to just shut it out completely

I have family and friends there. My children are American citizens. And I care in general about the welfare of people. While there is some level of seperation at this point, it brings me a lot less stress, angst, and anxiety to see the course of events when seeing them from afar.

I thought when I moved Id never pick up the paper again. But I still do now, just in a very different manner.

[tavalon]

7. Yeah, now that I think about it, our friends in Vancouver are all quite

conversant in American politics. And, yeah, now that I think about it, I think I would still be interested in looking under the cover or to use another metaphor, to watch the crashing train.

[eridani]

2. What matters even more is just letting people in to Medicare voluntarily

Dems need to point to real benefits before 20013.

OK--2013

[tavalon]

3. I know it's a typo, but

it seems that you may have gotten the year the Democrats get their shit together better than if you had typed the right year.

I see some occasional glimmers but otherwise, those morons are morons.

[Overseas]

6. PO should be open to all. Medicare plus 5 gets it going faster.

Negotiating takes more time.

That's why I favor opening up Medicare as the PO. We won't have to negotiate and legislate for 5 more years to clarify the terms.

[jomma]

8. Why Medicare+5 matters so much...

I think Medicare +5% would be a great public option. The premiums would be very affordable at $6500 per year compared to regular insurance.

[bertman]

9. Good point, Kurt and Hunter, but you're assuming they DON'T WANT it to be a nightmare.

Remember who's writing this legislation for our Congresscritters.

[TheWebHead]

10. for 18 months my doctor wouldn't see a for profit insurer's patients

without paying an additional fee because their repayment rate was too low... And it was at better than Medicare +5. I'm doubting those proposing this option are making a lot of effort to talk with doctors or hospitals about the impact this idea would have.

[MarjorieG]

11. Easier to fix underfunded Medicare than set up new Public Option, but I think we're up against such

corporate bullying, that we can't even address the rural inequities that are real with Medicare. Can't even mention Medicare to the Congress, but as a selling point to the people, with real policy to match, a winner.

[andym]

12. That's why it saves more $$$ according to the CBO! nt.