The “Public Option” is NOT Revolutionary… Actually, It’s Been Working Great For Years
Nov 6th, 2009 | by Bobby Jones
Category : POV on Health Care Reform
You’ve probably noticed that the health care reform debate has shifted from health care reform to health “insurance” reform. Despite its efforts to work collaboratively, the insurance industry is the simple target to blame for the health care mess we so urgently need to fix. (There is no single villain, of course. It’s the entire system that’s broken.)
However, that may explain the “co-op” approach passed as part of the Senate Finance Committee bill. But, as 30 Senators pointed out in a letter to Senate President Harry Reid, co-ops (as currently written in America’s Healthy Future Act) are pretty much a non-solution:
The Senate Finance Committee included a cooperative approach to insurance market competition. While promoting more co-ops may be a worthy goal, it is not realistic to expect local co-ops to spring up in every corner of this country. There are many areas of the country where the population is simply too small to sustain a local co-op plan. We are also concerned that the administrative costs associated with financing the start-up of multiple co-op plans would far outstrip the seed money required to establish a public health insurance program.
There’s another point made further down in that letter that really is something to think about:
The major differences between the public option and for-profit plans are that the public plan would report to taxpayers, not to shareholders, and the public plan would be available continuously in all parts of the country.
Guess what? We’re already here. Established and ready to serve. A health plan that is accountable to taxpayers. CareSource, the nation’s second largest, not-for-profit Medicaid health plan and a number of other organizations like us around the country have been helping Americans get the care they need at the right place, at the right time and at a lower cost.
My point here is that even though the health care system is broken, there are still a lot of working parts, including a number of proven, experienced and effective non-profit insurance companies in place that can help get a “public option” off the ground. The best part – we can do it fast and transparently.
And while 47 million Americans now have no health care at all, speed and honesty is a big part of what we all need.
13 Responses to “The “Public Option” is NOT Revolutionary… Actually, It’s Been Working Great For Years”
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ACAP • American's Healthy Future Act • America’s Healthy Future Act • Co-op health plan • health care reform • health insurance • health insurance reform • Medicaid • non-profit • Public Option • public plan • Senate Finance Committee • Senator Harry Reid • taxpayers • uninsuredArticle References
Author : Bobby Jones
Wow! Sooo, good to read this. With all the debate swirling around this cuts through the politics and makes it clear that this can work!
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This post was mentioned on Twitter by stephhunter4: @hopkinsju not just a stupid fantasy. the public option is an existing reality. http://cli.gs/23yYaM/...
Adults couldn’t get congress to protect their health. The health care bill passed just last night has a joke of a procedure to close the Medicare Part D prescription drug benefit coverage gap in 10 years. Do you suppose Big Pharma had anything to do with the extremely slow pace of closing that gap? Did congress make available funeral funds for those elderly and retired people who cannot afford medications, even with this slow pace of closing the coverage gap, for those elderly and disabled people who die waiting 10 years for the coverage gap to close?
I suggest people tell congress to close the coverage gap now and to move the prescription drug benefit to the outpatient Medicare Part B where it should have gone in the first place so retired and disabled people don’t have to pay 2 sets of expensive monthly premiums and 2 sets of expensive yearly deductibles.
You can tell congress this by signing a petition here at http://bit.ly/drug_benefit
I would like you to tell 2 people to sign this petition and get those 2 people to tell 2 people to sign this petition.
Also the conservative Democrats joined with the klanservative members of the Republiklan party to ban abortions in this health care bill. Will these klanservatives make money available for poor women to obtain free coathangers?
Unfortunately the congress capitulated to the pharmaceutical industry, the insurance industry and religious authoritarian nuts in th Democratic and Republiklan party.
This has got to stop. The solution involves people joining to gether and boycotting the consumer products of those companies that give money to conservatives. You can look at http://www.democratz.org and find out how you can destroy the ruling klanservative coalition in congress that watered down the public option and foisted their religious fanaticism on regular citizens.
Good day. Start making phone calls and signing boycott petitions.
Interesting comment, but very very idealistic. Good luck with that!
If the Gov’t could not even administer the small “Cash 4 Clunkers” program as they promised and could not deliver the H1N1 vaccines as promised (they promised 120M by the beginning of Oct, only 13M were actually ready) I certainly do not want them administering my Health Plan or overseeing my Health Care.
Like it or hate, and even with its flaws, it this is the best HEALTH CARE SYSTEM IN THE WORLD.
shawn m, I don’t know what you’re trying to say, but the article isn’t about changing care, its about making sure everybody has access to it. watch something other then glenn beck and you might actually learn something.
I’d like to know how all this will be paid for. I’d also like to know why people have such confidence in government when it has such a long track record of fouling things up?
Don’t get me wrong, I am all in favor of universal health care and anything that challenges the Insurance Monopoly in this country, but it has to be done in a fiscally responsible manner with with significant overisght.
I do understand the concerns about abortion. While I believe it is a woman’s choice whether to abort a fetus or not, those who find the act morally offensive have every right to object to tax dollars going to fund such a thing.
Name calling by both sides acconplishes nothing and only drives this country further apart. Somehow, someway, we have to find a way to disagree with each other in a civil fashion.
Having worked for both public and private sector health plans for the past 20 years, it is my expectation that a public option will manifest as government contracts to health insurance companies/managed care companies since they have the infrastructure in place for implementation. This is how much of Medicare and Medicaid already works in many states. For example, states currently determine eligibility for their Medicaid recipients and then give eligible persons a choice as to which Medicaid health plan, which is typically operated by a private for-profit or nonprofut company, they want to enroll in. The task of providing health insurance to an additional 47 million Americans who are currently uninsured will be a massive undertaking which would benefit from the full participation of the health insurance industry. The economy of scale should allow the costs of insuring each individual or family to significantly reduce as the additional volume of 47 million people who are not now insured are enrolled into the various health plans around the country. This, along with other important changes such as tort reform and a greater focus on operational efficiencies, could make health care affordable. There should be plenty of business for everyone. This contracting approach can also reduce costs through competitive bidding. Therefore, the contracting approach, as opposed to a single payor approach, can be a win-win for everyone and should be something that can be supported by both Republicans as well as Democrats.
One of the big problems with healthcare is the cost of meds and how much of the med costs the insurance companies cover, so in my opinion the insurance companies and healthcare companies need to get together and agree on something that works for both of them, like discounted meds(from big pharma) and better copays (from the insurance companies). Don’t tell me they can’t work something out between them; thus far it is to stick the insured as much as possible, and this needs to be addressed seperately. There should be part of the healthcare bill which addresses this, and at least puts the insurance and pharmacutical companies on the spot, if not legislating this very needed change.
The one thing that “healthcare reform” certainly does NOT do is offer “choice”! Quite the contrary. This was made abundantly clear in an Op-Ed that appeared Friday, December 13, 2009 in The Wall Street Journal by Andrew Heinze, a registered Democrat from New York. Following are a few words from that article:
http://online.wsj.com/article/SB10001424052748704402404574527493169603118.html
“I’m a registered Democrat living in New York City, and I buy my own health insurance. But now, having seen the health-care reform bill that passed the House, I’m preparing for life without health insurance. And unless I’m the only person covered under the Empire Blue Cross/Blue Shield “Tradition Plus” plan, a lot of other people will end up just like me, uninsured.
I will gain one thing, though—an annual fine for losing my insurance. The exact amount of that fine isn’t clear yet, but so far it looks like I’ll be paying about the same amount—$2,000 a year—for having no insurance as I do now for having it.”
Mr. Heinze goes on to describe the fact that, today, his minimum cost for a comprehensive major medical plan is $13,000 per year. His cost on a plan that just covers hospital stays is $2,000 per year. Therefore, he chose the less expensive option. He correctly points out that the $11,000 difference would pay for A LOT of doctor visits should that become necessary. Today Mr. Heinze has a CHOICE between these two alternatives. Under the provisions of the healthcare bill passed in The House of Representatives on Saturday, November 7, that CHOICE will NO LONGER EXIST!!!
The irony here is ultra liberal Democrats want to ensure “choice” for abortion in a bill that, in every other respect, takes away freedom of choice from individuals and transfers that choice to the federal government.
Healthcare reform is something that needs to be done correctly. Another irony is the fact that President Obama wants us to rush into this very important decision while, at the same time, the General that The President personally chose to run the war in Afganistan asked for more troops MONTHS AGO, but when it comes to that decision it’s quite a different story. No rush there according to Obama! The White House says they need to take the time to get it RIGHT! Go figure!!!
Given the fact that a recent poll indicates the vast majority of Americans believe that JOBS should be the number 1 priorty for the administration in Washington while only 17% believe that to be the case on the subject of healthcare reform, it appears to me that President Obama has his priorities, shall we say, BASS ACKWARDS!!!
For the record, I am also a REGISTERED DEMOCRAT!
How much longer are we going to settle for being the only country in the industrialized world NOT to have universal health care? The current “system”, under which tens of millions are completely excluded and tens of millions more have coverage in name only, all so that profiteers and their pet politicians can live like kings, is a scandal and a disgrace. Other countries do better, and we can do better. The time has come.
Bobby Jones is not quite fair to the truth about the nature and supposed scalability of CareSource. CareSource deserves praise for meeting an unmet public need we have been derelict in meeting in this country. But how it does that in the maternalistic/paternalistic managed care/HMO model it is a glaring example of the pathological distortions in our system. In fact it is the very nature of it’s business model compared to a genuine public option like Medicare Part A and Part B for all that distinguishes it and Medicaid companies like it around the country as the signal indicators of the moral failure of our system.
The managed care/HMO model (and even PPO model for that matter) is a top down corporate control model in which the company’s decisionmakers and contracted providers are the gatekeepers to care. They are the people actually ultimately in charge of a patients health care decision-making, not the patient as he or she should be. (And it would be shameful and arrogant for anyone at CareSource to claim they as gatekeepers would or even humanly could put each individual patient’s interests and wishes first as that patient would.) In addition, patients are as a practical matter limited to seeking care from regional in-system providers.
Both of these features distinguish CareSource and managed care plans/HMOs like it from a true national public option like Medicare Part A and Part B. And even with that maternalistic/paternalistic control of patient health care decision-making, CareSouth still reports it’s overheads to be about 7%, more than twice the widely quoted CMS reported (and verified) rate for Medicare of about 3% for Medicare.
CareSource deserves the strongest praise for what it has accomplished in providing care for those most forgotten in a broken system. But it is unbecoming hubris for CareSource’s representatives to assert it could or should be the national model because it is in itself a distorted response to a broken system. We do not need to expand the dysfunctional, quasi-privatized and fragmented Medicaid system model. We need to start with the best of the traditional Medicare Part A and Part B system (NOT Part C and Part D which are efforts to destroy Medicare by Democrats and Republicans alike) and the VA system, and at most offer a managed care/HMO choice as an option for each individual. With everybody in, focusing public pressure and interest, the debate will turn to fixing and improving that system as it should be now.
As described, CareSource is doing better than many Medicaid plans. To the extent that they can replicate their success elsewhere, they should attempt to do so. However, the issues which need to be addressed in the healthcare reform discussion are much broader. http://www.yubasutterhealthcarecouncil.org/HealthReformBlueprint2009.pdf