must if we expect this health reform to take root. The public plan needs to have the power to control costs and real regulatory power over the for profit insurance companies.
Excellent analysis of the pluses and pitfalls.
Health Reform: The Fateful Moment
By Theodore R. Marmor, Jonathan Oberlander
"
...A second rationale for establishing a public plan is that it could effectively control its health spending. Like Medicare, a new federal health insurance program for Americans under sixty-five has the capacity—with its purchasing power—to restrain the prices it pays to hospitals, doctors, and other medical providers. Such a public plan, which would not need to make profits, almost surely would have lower administrative costs than private plans—for example, the traditional Medicare program devotes only 2 percent of its expenditures to administration, as compared to 11 percent for private Medicare Advantage plans. The potential for savings is significant. The United States has the most expensive health care in the world largely because we pay higher medical prices and incur higher administrative costs than other nations. (Greater use of some expensive medical technologies is another source of higher spending.)<6> Offering lower premiums than private insurers, according to its backers, is a central advantage of a Medicare-like public plan.
...If both houses of Congress pass health reform legislation, a conference committee will struggle with reconciling divergent bills and conflicting political coalitions. The political dilemma is that abandoning a strong public plan—in order to win votes from centrist Democrats and moderate Republicans in the Senate—will alienate liberal Democrats in the House, who threaten to withhold support if such a plan is not included.
President Obama's involvement in this political endgame will be crucial. The most important unanswered question in health reform is how much influence the President will exert on the conference committee. Will Obama successfully pressure Senate conferees to accept a more liberal reform—including a robust public plan—than they prefer? Or will he accept a more conservative bill in order to take credit for a political victory?<17>
Whatever health reform legislation emerges this fall (if any), we can plausibly predict that it will substantially reduce the number of uninsured Americans. That in itself would be a major achievement, though it will surely fall short of universal coverage. Moreover, unless it provides system-wide limits on health care spending, any legislation that emerges from Congress will not reliably control the costs of medical care. These two issues are closely linked. Failure to control costs would jeopardize the very gains in health insurance coverage that reform promises."
http://www.nybooks.com/articles/22931 also talk about heath care reform starts about 21 minutes in by the same author as the article above. If we get a weak public option with limited power over cost controls including over for profit insurance corp. profits this reform won't work.
Speakers: Jeffrey D. Straussman, Dean of Rockefeller College of Public Affairs & Policy, University at Albany;
Theodore R. Marmor, Adjunct Professor of Public Policy, Harvard Kennedy School;
Alan Altshuler, Ruth and Frank Stanton Professor of Urban Policy and Planning, Harvard Kennedy School
http://www.youtube.com/watch?v=IC5-Sae_aKs
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