House: A public option with basic, enhanced, and premium care? Senate: only "essential" benefits?

[Karmadillo]

http://www.commondreams.org/view/2009/07/23-4

Published on Thursday, July 23, 2009 by CommonDreams.org
Spinning Healthcare: A Bad Case of Vertigo
by Norman Solomon

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A key Senate committee had just approved a bill with a public plan that would "compete with private insurers," the Times chart explained on July 18. The public plan "would provide ‘only the essential health benefits,' as defined by the bill, ‘except in states that offer additional benefits.'"

Meanwhile, the newspaper noted, "Democrats from three House committees are working on a single plan." Under that plan, "Different levels of coverage -- ‘basic, enhanced and premium' -- can be offered through the public option."

Those few grainy sentences, quickly swept beneath the waves from oceans of media, referred to a disturbing aspect of "public plan" scenarios. If the ostensible goal is healthcare for all, then -- at best -- some of the "all" would end up being much more equal than others.

The Republican Party is coming from such a right-wing place that any government action to improve healthcare access is ideologically unacceptable. In contrast, the broad outlines of a Democratic "public plan" at least embrace the precept that the not-so-tender-mercies of the market are insufficient to fully provide for the population's medical needs.

But as a practical matter, a "public plan" coexisting with the private health insurance system -- generally touted by U.S. media as the pole of real options farthest from the Republican "free market" fixation -- is inherently reconciled to major inequality in access to healthcare.

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What we're seeing now is a slightly freshened version of a timeworn tap dance that ranges across a constricted media stage. As Lieberman notes: "Absent from the debate are not only single-payer systems like the ones in England and Canada, but other systems with multiple payers, like ones in Germany and Japan -- or, for that matter, any discussion of why a system that relies on competition among private insurers in The Netherlands hasn't resulted in lower prices for consumers, as advocates claimed."

The variety of healthcare delivery systems abroad, in industrialized countries, spans a common assumption -- healthcare as a human right -- an assumption that doesn't cut the mass-media mustard in the United States. "What's common to all these systems," Lieberman points out, "is that everyone is entitled to healthcare and pays taxes to support the system, and medical costs are controlled by limits on spending. The specter of a system that takes a significant bite out of stakeholder profits in the U.S. is the real reason the debate is so restricted."

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[Cleita]

1. I mentioned this tiered benefits system with alarm when the House plan

first came out. Of course, no one listens to me. We need to demand that the public option be Medicare for all. My solution would be to pass HR 676 which is an improved and comprehensive Medicare for everyone. You know if people want to go out and waste their money buying private insurance and forego their Medicare rights, let them, just don't let them off the hook for paying into it. I believe however the government raises the money, it won't cost more than $5,000 a year per person maximum and probably could be done for a lot less. It could easily be accomplished by lifting the cap on the P/R tax.