How about a public option system that would be regional in nature.

[Tony_FLADEM]

We could have a public option that would be run regionally. Each health care region would consist of 5 states. For example, I live in Florida. My region would consist of Florida, Georgia, Tennessee Mississippi and Alabama. I would be able to go to any of these states and participate in my public option. This would be funded by those who participate and a tax that would be levied at the federal level.

The states would like this because it would give them more freedom to spend federal dollars and it would be more politically viable because they couldn't say the Federal Government is taking over health care.

[Bill McBlueState]

1. I don't like this

Americans' standard of living shouldn't suffer if they happen to live in a region with a poor track record of meeting citizens' basic needs.

[Lorax7844]

9. unrec cause this is a bad idea

Medicare is powerful because it represents millions and millions of people. If you break up the public option into regions it weakens the overall negotiating power when dealing with drug companies, etc. In fact his is one of Chuck Schumer's proposals to make the public option less of a threat to private insurance.

Bad idea.

[SharonAnn]

10. Regionals would be too small to negotiate the best prices. They'd fail, which is what

which is what the insurance industry wants.

[Tony_FLADEM]

18. You have 30 million people in the Canadian system.

These 30 million are able to bring down prices. My point is that a system that includes 300 million people into one system in not politically viable. Notice they are not even considering a single payer system. Breaking it down into regions at the local level is the most viable way politically to have a system that covers everyone.

[zipplewrath]

2. 10 federal districts

What you're describing is still a "federal" program. It is federal in the sense of being a cooperation of several states, just not necessarily all of them. But it would be done under the auspicies of the national government. These regions you describe could be the 10 federal districts for example. That'd still be a federal program. You'd have some federal committee or chairman or something and they would derive their authority from the federal government. Oh, and you really start to gut the barganing power by dividing up the economies of scale that way.

[Tony_FLADEM]

12. What I am describing is similiar to what they have in Canada.

the health care system in Canada in run on a regional basis. It's easier to run a system with 30 million people than 300 million people.

[Gormy Cuss]

3. That would produce wildly disparate levels of coverage based on geography

if the history of state-level administration of other social safety net programs is an indication.

[Tony_FLADEM]

14. You would have standards that would apply to all within the region

You could take the benefits of being in a rich state (Florida) and combine it with the benefits of being in a small state (Alabama and Mississippi).

[LiberalFighter]

4. Please read HR 676 first

HR 676

There are two parts of this website that should be reviewed. The FAQ's and the bill itself.


Below are two points.

Do we really want our health care system to be controlled by government bureaucrats?

Of all the straw man arguments that you hear from the opposition, and of course you will hear this one more and more as the election season heats up, this is the one that has has to take first prize. To begin with, government bureaucrats no not "run" the current Medicare system and they will not "run" the New Medicare either, at least not in the sense that they will intervene between doctor and patient where critical health care decisions are concerned as the current system presently allows. But the overwhelming irony comes from the fact that under the current system CORPORATE bureaucrats run the system with an iron fist denying needed health care to thousands for the sake of higher profits, patients who are paying huge premiums to get it. So the question becomes - why is it better for the system to be run by corporate bureaucrats than government ones? I guess you have to be the one to decide that issue but to a lot of Americans, given the track record of the corporate bureaucrats over the last half century, the issue is really a no brainer.

Isn’t this really just socialized medicine like your critics say it is?

No, it really isn’t, not even close. Socialized medicine is where the state owns and controls all of the assets of the system and employs all of the medical personnel involved as well. With the New Medicare, the state owns nothing and only exercises minimum control over the process such as establishing much needed cost controls and some helpful operating guidelines and mechanisms. Real examples of “socialized” services include those necessary public services such as police and fire which everyone agrees needs to be provided as government services for the benefit of society. How would you like it if all of the police and fire departments across the country were set up like our current medical system is today and their services were only available on a pay-per-use basis where only the well to do and privileged could actually afford to have access to them? That doesn’t make any more sense than having our medical services limited as they are now in that very same way either… does it!

Would you really want states to control how the money is spent at the whim of whoever is the Governor and in the legislative body each year? Or even the state courts to decide the issue? Or at least try to?

And if you pay into the system do you want to be limited to the region you are assigned?
What happens if you move to another region either because of your job or retirement before age 65?

[mike_c]

5. how about simple, straightforward, one-size-fits-EVERYONE...

...single payer universal health care? Why not the real deal? HR 676, not HR 3200!

[annabanana]

6. My guess is that YOUR options (from so many "less rich"states)

would be worse that MY options (NY,NJ,CT)

This is unacceptable.

[Tony_FLADEM]

16. You could combine poorer state along with rich ones.

[Uben]

7. A better idea.........

......how about our congress critters establishing regulation that prevents insurance companies from exploiting Americans! Why can't they just do their fucking job? WHy can't they reasonably regulate banks to eliminate these fucking bubbles? Why can't they regulate the fucking outrageous interest rates the credit card companies charge? Why the fuck do we bother to elect people who do nothing? We pay their salary and provide for their healthcare, why can't WE be their main concern instaed of the fucking special interests? Why do we allow them to put special interests above the interests of the American citizens?

We need to have a law where members of congress can be hanged if they are caught with their hand in the cookie jar.

[WyLoochka]

8. Nope

Would not support this. The most effective cost cutting can be achieved by having one huge risk pool wherein - at any given time - 80%-85% of the insureds are healthy and thus, infrequently accessing the system and wherein one set of codes is used for procedures thus cutting admin costs.

Splitting the risk pool into regional pools adds entirely unnecessary costs and inefficiencies.

If we are going to fix insurance - let's do it right. One and only risk pool for the public option.

[Tony_FLADEM]

15. It's more efficient to deal with 30 million people as opposed to 300.

You get the benefits of increased bargaining power with the efficiency of it being run more locally.

[backscatter712]

11. Unacceptable. It breaks up the bargaining power.

The reason it needs to be national is so the public option is large enough and has enough clout that it can negotiate down prices.

But I'm sure the private insurers like the idea of breaking the public option into useless little bitty pieces.

[Tony_FLADEM]

13. One could argue it's better to negotiate with 10 entities as opposed

to 1 (the federal government) because of the role politics plays at the federal level.

[backscatter712]

23. But each of the 10 small entities would be outgunned by the private insurers.

They wouldn't have the clout to do anything useful to insurance prices, and the insurers would have enough power to game the system and crush them. And because they're broken up by region, you end up with each piece isolated in the market and not really able to collaborate well or bargain collectively well (and you know the insurers will put legislation in that keeps them from bargaining together) so their bargaining power is vastly diminished.

That's the evil genius of Kent's co-ops - he proposes this non-profit system, then by breaking it into a bunch of small pieces and hamstringing them, he ensures that they would not be serious contenders in the insurance industry. It's classic pretend-reform.

[lumberjack_jeff]

17. Why?

Your post suggests that there is something about the public option currently proposed by HR3200 which precludes care in another state, and/or that there is some ambiguity about how the coverage is funded.

The health insurance exchanges must be administered on a state-by-state basis because each state has an insurance commissioner, and set of laws governing insurers conduct, but the broad framework of the public option (which competes with the private insurance also offered by the exchange) is established by the feds.

[Tony_FLADEM]

19. The health insurance exchange is a great idea!

Unfortunately, the public option idea being administered at the federal level is not realistic politically. If the country was not running trillion dollar deficits and Medicare and Medicaid were better off financially, then a public option at the federal level would be accepted by most people.

A public system run more locally is a compromise.

[lumberjack_jeff]

20. A federal public option is supported by the public, the house, the president and the senate

The only catch is that the majority in the senate is not filibuster-proof.

http://energycommerce.house.gov/Press_111/20090714/hr3200_summary.pdf

[alfredo]

21. Let states opt out. If Texas or Alabama wants out, let em.

They'll come crawling back after they vote out their governor.

[TreasonousBastard]

22. It might be run with regions like Medicare is...

Medicare contracts out its administration by region to various companies, often as not health insurers, and while I don't know how much leeway each region has to set prices and policies, it does make it easier to manage than if a DC bureaucracy tried to take on the whole country. That would be closer to what Canada has.

If you mean several completely independant regions, with each making all its own rate and coverage decisions, that could end up as chaos. And there is no way anyone would allow a situation where a resident of Pennsylvania couldn't go to a hospital in Ohio or New Jersey, even if it was closer and offered better care for the particular problem.