The Senate HELP Committee “public option” will be multiple “options,”

[ipaint]

and these will be run by insurance companies

By Kip Sullivan, JD

When the Senate Health, Education, Labor and Pensions (HELP) Committee passed a bill on July 15 creating an anemic “public option” program, Health Care for America Now (HCAN) and other “public option” proponents were ecstatic. They welcomed the “public option” in the HELP committee bill, proclaiming it “strong” or “robust.” But the actual provisions in the HELP Committee bill call for numerous “community health insurance options,” not the single “Medicare-like” plan promised by “public option” advocates. That means the individual “options” will probably be as small and weak as the co-ops now under discussion in the Senate Finance Committee. More importantly, these “community options” will almost certainly be run by insurance companies.

snip


...If my interpretation of Section 3106 is correct – if the Senate HELP Committee’s “option” program is going to be balkanized and run by the nonprofit wing of the insurance industry – then reasonable people have to conclude that the deck is really stacked against the Committee’s “option” program. Even if Section 3106 authorized public employees, not Blue Cross Blue Shield employees, to create the dozens or hundreds of “community health insurance options” called for by Section 3106, the program would fail to pose any challenge to the insurance industry and might even die in the cradle. The health insurance industry has been very difficult to break into since at least the 1980s, and has become more so in the wake of the merger madness that swept through the industry in the early 1990s. But if public employees are not going to be directly responsible for creating the “community options” – if the nonprofit wing of the insurance industry is going to be doing that – then the entire “community option” project of the Senate HELP Committee amounts to a cruel joke on the public. Should the public trust corporations like Blue Cross and Kaiser Permanente to make a good faith effort to build competing insurance companies?

Section 3106 is a mess, but its meaning becomes clear after several readings. Section 3106 does not create the “Medicare-like” program promised by Jacob Hacker, HCAN, Howard Dean, and other “option” advocates. Instead it proposes a program that authorizes DHHS to create numerous health insurance companies tied to geographic areas, and to contract with members of the existing insurance industry to create and possibly run those companies.

Leaders of the “public option” movement have an obligation to advertise the HELP Committee bill truthfully. It is not accurate to say the HELP Committee bill creates a “robust” or “strong” public option. It is not even accurate to say the HELP Committee bill creates one “option.” The truth is the “option” is balkanized and very weak. In fact, HCAN, Andy Stern, Howard Dean and other “option” advocates who have praised the HELP Committee bill should do more than cease to praise it. They should tell the Senate HELP Committee they oppose it.


http://pnhp.org/blog/2009/08/14/the-senate-help-committee-“public-option”-will-be-multiple-“options”-and-these-will-be-run-by-insurance-companies/

[snot]

1. NOOOOOOOOOOOOOOOO!

P.S.: K&R'd.

[Teaser]

2. impossible to say.

It reads such a mess it could be either really good or just meh.

Frankly, I can live with meh, but I'll be disappointed.

[Cass]

3. Pres Obama talked about this at his town hall the other day.

I hope I am understanding his explanation of the public option proposal correctly. My understanding is that it would be the same system and menu of plans available to federal employees but that coverage would not be subsidized with taxpayer funds for the public in the way it is for federal employees, except for low income individuals who would not otherwise be able to afford coverage.

My question is what is the $600 billion cost for? Is it for the subsidies to be provided to low income individuals or does it include other costs to administer the plan? I wonder about this because if the "public option" winds up to be a menu of choices that is run by private insurance companies, then government costs to administer it should not be significant I wouldn't think.

This is confusing. I thought the public option would be similar to Medicare but that's evidently not the case. I wish the town hall meetings would have been held when there was an actual plan that could be discussed instead of broad generalities.

[backscatter712]

8. The way I understand it works...

If your income is less than 150% FPL (my number may be somewhat off on this,) you're eligible for Medicaid and get your health care on the house.

If your income is between 150% and 400% FPL, you get a subsidy, on a sliding scale based on your income, which caps your premiums and all out-of-pocket expenses, and those subsidies go to the private or public insurance plan of your choice.

You get one of three or four public plans as part of the public option program - one's a basic plan, which gets you basic necessities, pays for 85% up to a maximum out-of-pocket cap, the next one, which costs a little more gives you 90%, the next one gives you 95% and perks like access to a gym.

I'd say this arrangement isn't too bad. It's not that the public plan is broken up - you pay for different service levels, but all three service levels are combined together clout-wise when the .gov negotiates with providers for benefits.

[ipaint]

9. The public plan will be contracted out to

private insurance companies which would be privatizing the "medicare for all" public option.

Doesn't that defeat the purpose of a gov. run insurance choice. Isn't that similar to what they did when Billy Tauzin rammed through medicare part D during the bush administration?

I don't think the for profit insurance companies are interested in running a public option that will directly compete with their own for profit plans and lower prices across the board. Their shareholders would demand they do just the opposite.

It's a bit insane to farm out the public option to private for profit companies.

[Cass]

11. Thanks for your explanation, Backscatter712. I did misunderstand what Obama said at the town hall.

So, the plan they are proposing - the exchange- is modeled on the menu of plans currently offered to federal employees but is not the same thing. It would receive no taxpayer subsidies other than subsidies for those who need help affording it and will be self-sustaining.

Like many of us here, I prefer a single payer plan but this might be an ok compromise if it gets people access to quality healthcare that they can afford that is real coverage and not the scam plans that are out there now. I also hope there are no triggers in it, either. People need coverage now not in 10 years. The thing that I don't like is letting the insurance companies run the show because the profit motive is still attached. They have proven to be underhanded slimeballs in their dealings with consumers so they need to be heavily regulated big time, and not just the wink and a nod oversight given to the financial industry.


Btw, here's a link to the transcript of Pres Obama's town hall meeting the other day for anyone interested. http://www.nytimes.com/2009/08/12/us/politics/12obama.text.html?pagewanted=1&_r=1&adxnnlx=1250266083-aPeyw7DXYN3abxnvfb0TRg

[madfloridian]

12. The PNHP opposes strongly anything but single payer.

I have followed this health care discussion closely, and I have been concerned that they have been so vocal against a public option.

You are right, what I have heard and read about the various plans (leaving out the Senate Finance committee one)....is not bad.

Thanks for your summary.

[ipaint]

4. So goes the insurance for everyone goal.

I guess as long as your not the one left without anything is tolerable.

Non-profit HMO's owned and run by private for profit insurance corporations with the goal of competing against those same corporation's for profit plans to bring down costs. That's a public option? One that will lead to medicare for all?
:crazy:

[cdsilv]

5. I'm betting that the 'fine' will be cheaper than any 'insurance'...if I pay the fine....

do I get some sort of 'default' coverage?

[ipaint]

13. If you keep your income under $14,000 a year you get inferior universal coverage

and no fine like all the other under class wage slaves- medicaid.

[ipaint]

6. k n/t

[ipaint]

7. Dean said HELP bill was a "great bill".

BROWN: Well, we have a good bill that came out of the Health, Education, Labor and Pension Committee—you know, strong public option, employer mandate, everybody needs to be in the plan, very strong consumer protections for all people who have insurance and for those newcomers that are just getting insurance. The Senate Finance Committee is not coming up as good of a plan, as Senator Rockefeller said.

But we‘re not—we‘re not going to do things like exclude the 11 million children who are now in SCHIP. We‘re not going to accept a weak public option or a non-existing public—existing public option. Those are the president‘s priorities. That‘s what every Democrat on the Health, Education, Labor and Pension Committee voted for.

We‘re not going to lay down and come up with some sort of phony co-op that some few number of number of Democrats seem to want.

DEAN: And in fairness to your committee‘s bill, it is a great bill.

http://www.msnbc.msn.com/id/32218739


What is the official definition of a strong public option?

Private HMO's? Medicare for all?

[slipslidingaway]

10. knr - missed this thread earlier so I posted it again...

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6303554&mesg_id=6303554

but think I'll leave it so the topic might get some attention

:)