Klein: "a pretty good deal. Better by far than what Democrats looked likely to get a week ago. "

[Clio the Leo]

(Note: Ezra has NOT been pleased with the progress of the Senate's negotiations lately....)

The team of 10 reaches a deal on the public option

<snip>

The details will be important here. What are the conditions for the non-profit plans? How many of them do there need to be? What's the regulation look like? When does the Medicare buy-in start? But assuming those pieces don't come in much worse than expected, the combination of national non-profits and a Medicare buy-in seems like a pretty good deal. Better by far than what Democrats looked likely to get a week ago. And more likely, by far, to seed health-care reform with scalable experiments.

A public option partnered with Medicare might have been better than these policies, but national non-profits and direct competition between Medicare and insurers is more promising than the compromised public plans that succeeded the initial policy idea. In fact, it's like we split the idea into two parts.

The national non-profits are not exactly like, but not that far from, the compromised public plan in the House version of the bill. They won't be publicly run, but with the OPM regulating them tightly and carefully choosing which offerings are accepted into the market, the impact might not be that different in practice. They're like publicly-regulated utilities more than private plans, and they have the advantages of offering a single product nationally and being freed from the profit motive, both of which were key to the theory of the public option. Indeed, these look a lot like the semi-private insurers that function well in Germany, Sweden, and the Netherlands, among others.

Meanwhile, the Medicare buy-in lets people in the broader insurance market see what national bargaining power can do for individual premiums. Right now, Medicare's rates are largely hidden, as no one pays premiums, and so no one can really compare it to private offerings. But if the premiums become visible, and Medicare's superior bargaining power is capable of offering rates 20 to 30 percent lower than its private competitors can muster, we'll see how long it is before representatives begin getting calls from 50-year-olds who'd like the opportunity to exchange money in return for insurance as good as what 55-year-olds can get.

http://voices.washingtonpost.com/ezra-klein/2009/12/the_team_of_10_reaches_a_deal.html

Is anyone else starting to wonder.... what took them so long to get something that was apparently BETTER than what they had before?

[LynnTheDem]

1. Hey, maybe a few more decades and Americans will get a system as good as

much of the rest of the world already has!

Ya never know.

[andym]

2. The key is really how tightly they will regulate the non-profits

Capping premiums, demanding a reasonable set of guaranteed services etc is key. What they really need to do is to make sure that the non-profits don't find hidden "profits" to keep for themselves.

[Thickasabrick]

3. I read the comment sections in this article and someone brought

up a great point....why did Obama unleash the FDA to try and kill the re-import drug part? I'm wondering what exactly did he promise them? (Big Pharma).

[Hissyspit]

4. The Soft Bigotry of Lowered Expectations.

[neshanic still]

8. Perfectly said.

[drm604]

5. "national non-profits"

That sounds interesting. We'll have to see. I'm skeptical of us getting anything that might give some real competition to the insurance companies but... we'll see.

[unc70]

16. "national" triggers "WARNING! Remember credit card reform"

Time after time in industry after industry the claims for "more competition", "more options for consumers", "less redtape", "or other BS TP, are really cover for attempts to remove or preempt state laws that limit abuses, protect consumers, mandate performance (medical coverage, fuel efficiency, interest rates).

Credit card reform should make each of us wary.

With the health care legislation, there have been multiple attempts to sneak something in preempts or somehow nullifies state regulations, consumer protectons, or anything else.

[mcablue]

6. In Netherlands, there is drug price regulation

There would be none of that here.

[mcablue]

7. And I ask...if the trigger is so awesome, why didn't Obama promise one during the campaign?

Just asking.

[flyarm]

9. I have a better question: where was the transparency he promised when he was holding secret meetings

with Big Pharma and the insurance boys and the mega Hospital conglomerates? What happened and what was promised??..well those of us that warned about this were basically told to STFU..now those in real need will be totally fucked and they will only have themselves and the cheerleaders to blame! And I for one will have zero sympathy! Remember many of us questioned what the hell was going on and trying to expose what was going on and it became obvious to anyone paying attention some of the cheerleaders were on some kind of payroll were telling those who dared to question to STFU!

[Phx_Dem]

15. Good for the Netherlands.

:crazy:

[democracy1st]

10. Keep Hope Alive

[eridani]

11. Bullshit on "looking like the Netherlands"

If that were the case, there would be one uniform premium of $150 or so per month per adult, with NO copays and NO deductibles at all. And NO age rating either.

In countries with regulated private insurance, the government directly controls the prices and the contents of the basic comprehensive package.

[andym]

12. But it's not BS on Germany

Things are different in Germany:

http://www.civitas.org.uk/pubs/bb3Germany.php

"German sickness funds are required to be financially self-sufficient and premiums are set as a percentage of income. This percentage varies from fund to fund, with an average of 14 per cent, to fall to 13 per cent under Schroeder reforms. The premiums are deducted from pay packets with employer and employee paying half each."

If we could even get something like Germany here, many people would be pleased. However, it would require tight regulation of the new non-profits being proposed. We'll see how close they come when the details are available.

[eridani]

13. They could cut that if they had a payroll tax

The Netherlands taxes businesses, and removes the 5% chronically ill population to be taken care of by the government.

You'll notice that proposed insurance in the "reform" plans is pretty shitty, with 30% copay and $5000 deductible. The German system is tolerable only because there are no deductibles or copays--their tax takes care of everything. If what we are going to be forced to pay would take care of everything, I could live with the excessively high prices.

NONE OF THESE COUNTRIES ALLOW AGE RATING!!!

[andym]

14. I think the points you make are correct

Especially if one were paying 13-14% of one's income, no copay and no deductibles are more than reasonable.

In America at least, right now, it is easy to pay the same percentage and still have at least copays. (My insurance is about the German level in percentage and includes copays, but no deductibles in the HMO).

I'm not sure where the US bills currently stand relative to percent income calculations.

[sandnsea]

17. This is not better

I am so appalled I can barely speak. We had non-profit insurance years ago and "reform" was undoing that and going to for profit. Now "reform" is going back to what we used to have? What bullshit. And the people who can't afford insurance premiums now, aren't going to be able to afford unsubsidized Medicare premiums. They need to remove the mandate if this is the basis of their plan.