Public Option Versus Single Payer

[DemocratSinceBirth]

If we go with the former we avoid having to deal with the whole "if you like your doctor you can keep him" controversy. A public option based on ability to pay, the more you make the more you pay, in which everybody can purchase as well as employers maintains choice while providing universal access. From a political marketing perspective it would be much more difficult to oppose. If you like your private insurance you can keep it. If you don't you can buy a government sponsored plan.

I suspect large employers like Wal-Mart would be the first to buy into the government plan.

[LonePirate]

1. I'm perfectly fine with this approach. I recall Pelosi passing a public option back in 2010.

There's nothing that leads me to believe she couldn't do it again.

[DemocratSinceBirth]

3. 155 million Americans get employer based health plans.

I suspect a lot of them like it. We just invite grief by taking it away.

[Adrahil]

2. I prefer a public option, but....

... I think we need to move away from employer-provided health insurance. It doesn't make any sense, and with people changing jobs fairly frequently in this economy, it's messy. FEHB is a decent model.... a national pool of available plans with some differing options depending on where you live. But a Government sponsored option is available anywhere, at any time, to anyone. if it is superior to the private plans, good. People will start using it.

[DemocratSinceBirth]

4. Insurance companies aren't stupid. They killed the public option in 010....

They killed the public option in 010 because they know they can't compete with a government based plan. That's also why Big Pharma opposes the government buying pharmaceuticals.

[Adrahil]

8. I don't disagree.

But whatever approach that actually IMPROVES the delivery of healthcare is likely to be opposed by the folks in the middles skimming money out of the process.

It is also possible that a private insurance company (or even more than one) could be contracted to administer the public option.

[DemocratSinceBirth]

10. Blue Cross administers Medicare in some states.

[MiddleClass]

16. Keyword being administers, not provide

They're just administering the Medicaid insurance in certain areas, in New York. I think it's called CMS, who administers Medicare.

I don't know exactly how many there are, they are more of the local business administrating 5 or 6 states Medicare program.

I think we're getting on track here, focus our desire and nail it home. If we take over government after the midterms.

Divide and conquer, public option eliminates opposition from public providers, doctors, nurses, imaging centers, hospitals, nursing homes, people with private insurance provided by their employer, in other words, the majority of the club that is called the United States.

Let's not make the perfect the enemy of the good.

Let's invoke the achievable rather than lose the dream

[Demsrule86]

7. Easier said than done. This is not going to happen anytime soon.

And if you could use the ACA with cost controls or a public option, it would be helpful.

[Adrahil]

9. I think the path of advancement lies through the ACA. NT

[Demsrule86]

13. It is the only path in my opinion. I do think as time goes on more and more employers will

let people have insurance through the ACA which will bring down costs as enrollment increases. It was never a good idea to tie insurance to jobs.

[La Lioness Priyanka]

5. Public option is far less likely to cause a revolt among democrats from purple states and cities

and even some solid blue states have had issues with single payer (check with VT for details)

also, i support a public option more than single payer. we are always pointing to europe but a large number of those countries have multiple systems and not single payer

https://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/#link3

[Demsrule86]

6. This is true. I do not believe single payer will ever come to this country...now the ACA with

cost controls and a public option would be workable.

[Grins]

11. I don't understand why ANY company would want to provide employee health care.

Universal, single-payer, whatever - would free them from staffing huge HR departments, negotiating with insurance companies, training programs for employees, and making health care contributions, all of which would go to the bottom line.

A couple years ago it was reported that the costs of health care -on a per-car basis - exceeded the cost of the steel to make the car! That is a cost that German, British, Japanese, Korean car manufacturers DO NOT HAVE making their cars that much more profitable. And that would be reflected in their quarterly/annual earnings, something Wall Street 'should' love. Why do we insist on hampering American corporations with this?

[YCHDT]

12. K&R

[genxlib]

14. Absolutely true

Single Payer would be the single biggest boon to our economy that we could enact.

Part of it is what you point out.

The other part is that it would unlock entrepreneurship in a way that nothing else can. So many people work for companies because of the stability of health care. Having your health care needs taken care of would free people to pursue their dreams.

[MiddleClass]

18. That steel argument was brought up by GM

Trying to screw retirees out of their promised benefits,

so exactly as you say, why do we insist on hampering American corporations with this.

They have to keep paying years later, when robots are building cars and humans are long retired.


It makes no sense for anybody, handing over a competitive advantage to imports.

[genxlib]

15. Public Option is the next generation of improvement.

I am not sure this country will ever go to full Single payer but a solid public option would move certainly help.

I think the main benefit that people tout is the price competition that a non-profit motive will have.

I think there is a bigger picture to it.

There are several factors that define how insurable people are. These factors can be viewed across several continuum: poor-rich, young-old, healthy-sick, etc.

The fundamental problem with the system is that we allow the for-profit companies to cover the patients on the lower cost side of those scales: young, healthy, rich

All of the others are covered by the Government: old, sick, poor.

Shifting that balance of lower cost patients into the government system (with their premiums) will make it a great deal more cost effective and efficient.

[MiddleClass]

19. Spoken like a professional actuarial

This has been the secret sauce for years.


Big picture, turn excessive salaries, excessive profits, excessive stock dividends, excessive prime real estate, excessive spending in general, into affordable healthcare, massively stabilized government programs, that are now totally unsustainable. Remember United States used to have 14 workers to every retiree, were headed to one worker for 14 retirees. (A little bit of over exaggeration for effect).

Fixing 5 problems with one action, you can't get more efficient than that

[zipplewrath]

17. Mostly semantics

It would be foolish for anyone to create "single payer" in one fell swoop. There will never be anything "single" about it. Converting our current system will require multiple steps and the PO is just one of them. Truth is, we want to be careful about dismantling the employer based system, and yet allowing those employers to reap the benefits of no longer funding health care. In essence, some large portion of what they are paying now, will have to be paid as an employment tax to fund the healthcare. Quite honestly, when it is first created, the Public Option should ONLY be for those who do not have access to employer based plans. Over time, smaller employers can be allowed to convert their employees over to the public option/exchanges. It may be the case that larger employers never get access to the exchanges, but instead, a separate structure will handle their employees, with separate funding apparatus. The military will probably always have a separate structure for active duty personnel. There may always be a VA. There may always be a Medicare. The only thing truly "single" about it will be that in the end, your medical care WILL be paid for, that will never be questioned and it will be determined well before you ever seek medical care. Oh, and maybe we'll finally get control of healthCARE costs such that it actually produces better outcomes and at a lower cost.

[mvd]

20. I want to go to single payer

If the public option needs to be a step, I could support it. But I want to have a system with the profit motive out, and it took some time in Canada, so we can do it here. Coming from the states first is possible, too. A public option can be undermined if insurance companies remain so powerful. I will always want single payer.