I am coming to the realization that the Public Option will not Significantly drive down costs.

[Perky]

The financial realities are daunting:

Despite insurers profits and practices, the major problem is the 40% more that we bear for health care when compared to the rest of the industrialized world. Insurance reform that properly regulates the insurers so that they can not force people out of coverage, essentially requires them to take on more risk. While the Public Option squeezes them on pricing, its effect will be to slow down the cost curve rather than bend it downwards.

As much as as their may be populist and progressive sentiment wanting to drive private insurers into the sea with pitchforks, the reality is that they are here to stay. Taking away their profits might feel great... but it in not going to reduce their cost and is likely to increase insurance rates. Unless you dramatically increase the pool of the insured to offset that increased cost, premiums will continue to rise. A mandate is essential, but at best it is going to retard the growth in premiums not reverse it. Because, again, the cost of care is out of line with the rest of the industrialized world.


That is the rock and a hard place. How do you require people to have coverage they cannot afford because the underlying cost of healthcare is 40% too high.

You can put the burden on business to carry employees, you can put the burden on insurers to cover those they would prefer to drop; you can have a Public Option that attempts to drive down private insurance premiums but unless you reduce the cost of what Doctors and hospitals charge, nothing changes.

I want everyone covered, I support a strong public option, I am just not convinced anymore it is going to do what we think it is going to do which is reduce the cost of coverage or improve access.

[RDANGELO]

1. I think that this will continue to evolve.

Once we start moving toward european type reforms, it will take on a momentum of it's own. The people understand that we have to get the costs under control, and they will see that the only way to get there is with more government involvement. This time they are taking on the insurance companies. Maybe in Obama's second term, they will take on the doctors and the Pharmaceuticals.

[Taxitall]

19. doctors and pharmaceuticals?

how about the LAWYERS?! and frivolous lawsuits that are costing doc's (and therefore patients) billions every year?

[depakid]

20. If that were true, then healthcare would be WAY less expensive in Texas

But of course- it's not.

So that argument = FAIL.

[John Q. Citizen]

2. That's why thinking people have advocated for a single payer plan. Why mess around when we already

know what works?

Why pretend there is some fantasy way to do things, when the way it has worked time and time again is through a single payer system.

Are we so stupid we can't see the writing on the wall?

[Perky]

5. Yes... We are that stupid,

but that is the political reality

[John Q. Citizen]

7. Only among th eleadership, not among the population. The people are so much further ahead of the

idiot leaders on this.

This is how morally and intellectually bankrupt the leadership is: They claim that there has to be the "choice" for people to keep their private insurance, while at the same time ignoring the fact that many people make the "choice " to not buy insurance at all.

So apparently one "choice" is sacred, and another "choice" is stream rolled right over.


It's so self serving and hypocritical it would be laughable if the the criminal private health insurance companies weren't killing 18000 Americans a year through greed.

Instead of implementing good policy for everyone, our leaders are instead doing contortions to try to figure out how to implement bad policy to protect the criminal health insurance racket.

Enough!

We need to tell them the truth instead of participating in the lie.

[Perky]

8. I thinkk you give the electorate too much credit

They are easily swayed and easily scared. They are fearful of anything they do not easily understand. Harry and Louise are not going to convince the 80% who have coverage that they are better off with scrapping all they have known for something unproven. Cost reduction is a great motivator but it has to be so substantial that it trumps other considerations in this selfish society.

[John Q. Citizen]

9. I disagree with you. I also know that if a Public Option is your starting point, it certainly won't

be where you end up. i think thats pretty obvious to most by this time, even if it isn't to some.

Expanding Medicare is incremental. It's American and it's proven
Creating a brand new untried government program is radical to some people's way of thinking.


People elected Obama because they wanted a liberal solution. Heck, Harry and Louise said he was a socialist and people didn't bat an eye.

If people had wanted Romney Care (Mandates to buy private insurance with subsidies for low income) they would have elected Romney.

But they didn't.

Cost reduction is only a fraction of the benefit of a single payer solution. One of the biggest benefits is no worries, no paper work, no choosing a new plan when you change jobs, no reporting your income when it changes so your subsidy changes, and no more hassles with private insurers whose fiduciary responsibility is to attempt to not pay.

[Perky]

10. Ok but how doyou get rid of the Private insurers?

Politically speaking? You have to ethier demonize them or drive them out of business,,,,,

[John Q. Citizen]

13. How many congress people still take money from Tobacco companies?

Not many. But a few years back, most did.

So yes, you have to demonize them (like was done to big tobacco) but it should be even easier than big tobacco since nobody is addicted to their insurance company. Anyone who tries to be is canceled by the company, after all.

Everybody already hates insurance companies. More than anybody used to hate tobacco companies.

The first thing would be to pass guaranteed issue, pure community rating, and outlaw annual and lifetime caps. Don't trade, just pass it.

Then expand Medicare for all and eliminate the gaps in coverage and fund it through FDIC and a tax on stock transaction and a small capital gains over a certain amount.

This whole current idea put forward by Obama that we owe the criminal insurance industry anything is dangerous and stupid. It's our health care, not theirs. They have no right to our money, our tax dollars, or to anything.

[Perky]

18. ...

[MarjorieG]

3. If we allow anyone in to exhange pool, non-proit option, we'd get enough people, eventually.

How can we ever regulate privates, have them self-regulate due to competition, enough? Public option could begin to set up county hospitals, not fee for service, all of which need to be started after we fight off private insurers for basic structure. Heard that on Countdown with Dean, interviewing VA author.

[thunder rising]

4. There is soooo much wrong with that statement.

I'm 53 and cannot get health insurance hence availability is a BIG deal at any cost.

Single moms either cannot get coverage or cannot leave a shitty job over health insurance concerns.

Due to my age, even though I am an extremely healthy individual, I am denied direct employment since I would cost any company that hires me a great deal of money.

[mbee]

6. In my view the first thing that needs to happen is that

healthcare coverage be removed from our employment. This will force the insurance companies to become competitive just like homeowners and car insurance. The second thing that needs to happen is we need to establish health centers where the total person is treated. The healthcare that exists today is just pretty much you meet with your doctor and he diagnoses the problem and then puts you on drugs for the remainder of your life. In a lot of cases the medicine just masks symptoms rather than improving your health. There are many medicines that are needed, but in a lot cases lifestyle changes can be of bigger benefit. If we had health centers where you could see a nutritionist, a physical education person, psychologist or whatever we need. Drugs can be the answer in some cases, but they are not the only answer. All these ads on TV are absurd and should be stopped. I think the representatives in Washington are blackmailed by the drug companies and that's why everything is stalled.

[grantcart]

11. It is an evolutionary step.

Like social security or medicare you have to establish the right in people's minds first.


The public option will become the driving force and it will eventually change from fee for service. Ultimately we will become a singple payer system, but it will happen in stages.

[John Q. Citizen]

15. Yes, that's what they said about Medicare, alright. How did that work out?

[uponit7771]

12. It wont in the first decade after that we're in da clear

[TheKentuckian]

14. Nope, but that 20-30 years is better invested in going in the right direction

than running backwards for another generation.

[leftofthedial]

16. Any chance for real health care reform died when single payer

was taken off the table.

We'll get the minimum possible tweak to health care in the form of an insurance reform bill. It will accomplish four things:

1. It will ensure that the health care insurance industry maintains its profits.

2. It will change nothing of substance, except that it might require all of us to give money to said insurance companies.

3. Politicians will pretend they accomplished something and will brag about having passed "reform."

4. It will be at least another generation before the issue comes up again.

[debbierlus]

17. The Waxman deal as currently stands does not produce a strong public option

And, they did not fix it in committee. They won't allow the public option to be tied to Medicare rates.

The health insurance companies have dictated the debate and written the legislation.

If the reform was truly about improving access and affordability to the American citizens, single payer would never have been taken off the table.

The dems are making a huge political mistake. Forcing people into mandated purchase of private insurance without a strong public option will gurantee that many Americans won't be able to afford good coverage for the exact reasons you stated in your post. Everyone is eligible to be covered does not translate to full coverage for all Americans. Many will only be able to afford catastrophic coverage. Many won't purchase it at all, if they simply can't afford the price. (We already have it here in MA, and a family of three making over 65,000 dollars a year, the price tag in 1,200 dollars a month). The cost realities are going to be cold water in the face of many people who believe this will create affordable care.

The democrats should be insisting on a VERY strong public option, if only for their own political future. Bad legislation will be worse then no legislation, if people come to view THEIR reform as terrible and the Republicans will point and say 'we told you that government run insurance doesn't work'.

This corporate fascist system of private insurance for profit is immoral, & financially insolvent.

[PassingFair]

34. Tied to 5% above Medicare rates....not so bad.

http://www.charlierose.com/view/interview/10524

It will get BEEFED UP in reconciliation.

[Aramchek]

21. might as well just give up, huh?

[Perky]

22. Oh Hell no.

I want everyonee coverd NOW. I am just saying that they real issue is not soved by giving everyone insurance,

[Amos Moses]

27. Might as well quit pretending

that an insurance mandate is the same thing as affordable health care. :think:

[Aramchek]

28. an insurance mandate isn't the goal, a public option is

and it will be in the bill Obama signs

[Amos Moses]

29. How is it an option if only a small portion of uninsured can opt

into it? All indications are that it will be years before it even takes effect. Is this really the goal we want to set? It sounds more like a forfeit than a win to me.

[Aramchek]

30. I don't agree with your 'facts', but would you prefer to go for single payer and get nothing at all?

that would be a true forfeiture.

[Amos Moses]

31. Since you asked,

I would prefer single payer. That way, we would get health care instead of a government enforced insurance scam.

[Aramchek]

32. we all would prefer single payer. that doesn't mean it is going to happen.

at least not now.

why don't we get our foot in the door first, and eventually a public option can be expanded into single payer.

something is better than nothing.

[Amos Moses]

35. Set the bar low every time

so you'll never be disappointed. We voted for "change", not "something".

[Aramchek]

37. do you really think your definition of change is the truest?

[Honeycombe8]

23. The premiums are subsidized, so everyone theoretically would be able to "afford" it.

That's my understanding.

Getting a public option is the first step. Then it can be tweaked in the years (decades?) ahead. IF the Dems stay in power.

[Honeycombe8]

24. The bill (I think) will also be adding more regulation of the ins. cos.

That, plus a public option, should help fairly soon. Premiums will be subsidized for those with an income below a certain level.

Nothing is perfect. One step at a time.

Personally, I think a public option WILL have a downward effect on health care costs fairly quickly.

[annabanana]

25. I don't think you ever thought it would.

You have floated thread after thread of "alternatives" to a public option. I have never seen you show any interest at all in a public option.

[Perky]

26. I actually would prefer a Sngle Payer

But that is not in the cards. I am not opposed to a Public Option either. But I also understant the political realities in the Democratic caucus and and learning more about the economics the more I read.

What I oppose is any solution that produces a scenario where there is no cost savings but their is a perception that prices are going to come down, I think that would really hurt us in the long run,

[PassingFair]

33. You make the government plan effective, and you TAX the employer paid portion of business plans.

The vast NUMBER of people moving onto the government
plan will force hospitals, pharmaceutical companies
and doctors to negotiate lower rates if they want
the business (and they DO).

Simple.

[quakerboy]

36. Depends

If it was all handled fairly, then it really would drive down costs. Between the negotiation potential of a big public plan and the fact we wouldn't have to pay 30+% off the top to CEO's/profit, we could see a big savings. That is not factoring in the benefits of preemptive care. You can have 100 $100 primary care visits for the same cost as 1 $10,000 hospital visit.

On the other hand, I think it is reasonable and realistic to assume that if/when a public option comes into being, even if we outlaw consideration of pre-existing condition, we can safely assume that the private insurers will move heaven and earth to find ways to make sure anyone who is likely to need actual care will be on the public plan, making sure that they themselves only have to insure the healthy. In this way, they can hope to offer "competitive" pricing, and stay massively profitable for the CEO's

[jeanpalmer]

38. It's hard to take any of these solutions seriously.

Both single payer and public option leave the for-profit health care provider system intact.

Why not wipe out the profit motive completely by establishing a government-run health care system. Like the UK and other countries have done. This is an obvious option. And yet there's no consideration or discussion of it. Just like there's no consideration of single payer by this Congress or President. So the current discussion is really skewed toward one result -- an insurance scheme with a small public option. That's not taking an honest look at what kind of system would be best for the country.

A government-run system gets rid of insurance, the billing system, and providers running up the bill. That seems like a lot of saving to me. Seems like a system that can do that ought to be given consideration. But it's not.