Reaction to the deal:
* Sen. Joe Lieberman (I-CT) weighed in by saying he still opposes a triggered public plan--one of the elements of the compromise.
* Sen. Kent Conrad (D-ND) isn't a fan of the idea of letting certain people under the age of 65 buy insurance through Medicare, but he says it's not a deal breaker.
* Sen. Russ Feingold (D-WI), who burst into the heart of health care negotiations without warning, was a holdout in negotiations between liberal and conservative Democrats, and seems on the fence about the agreement.
* By contrast, Sen. Bernie Sanders (I-VT) says he thinks the Medicare buy-in might be better than a weak public option.
linkby Gov Howard Dean MD
I have long supported the expansion of Medicare, which is why I am supportive of a Senate proposal to expand Medicare to include Americans over the age of 55. I believe that the inclusion of a public option that gives Americans real choices about their healthcare and creates real competition is also essential.
These are two pieces of real reform that go hand in hand.Medicare is a government-run, single-payer system. What the Senate is working out could move the ball forward, if people under 65 will -- for the first time -- have the option of signing up for such a program under certain circumstances. The specifics of those circumstances matter a lot. The under-65 pool should not be limited to high-risk people only, and subsidies will ultimately be needed for those who cannot afford the premiums.
The other groundbreaking piece of the current Senate proposal is that a significant number of Americans over 55 who do not have access to health insurance today, would be able to get it within six months of the final bill being signed. Of course, more reform and access to choices are needed. However, this proposal moves us in a very good direction. The realities are Congress rarely passes reform that is not incremental and it is important that the increments they pass are headed in a direction we ultimately want to go. Expanding Medicare would do that.
The proposal to expand the Federal Employee Healthcare system could also be a step in the right direction. While I am not a fan of the private health insurance market, with the proper regulations, this could work. The OPM has done a reasonably good job of running the current plan, but Senator Rockefeller’s proposal to require insurance companies to spend 90 percent of their revenues on healthcare is absolutely essential.
We must continue to work towards a system that gives Americans real choices. The truth is America already has a socialist system (the Veterans Administration with 25 million people). We already have a single-payer system (Medicare with 50 million people). And we already have a private insurance system (with almost 50 million Americans uninsured). The American people can reform healthcare by making real choices, but Congress must let us have those choices.
Both the current Senate proposal and the House bill will give us choices that Americans did not have before. The central problem will be that not enough Americans will have those choices. So while we may be able to take big steps in the right direction – the fight for healthcare reform does not end here. We must continue to pressure Congress to pass real reform.The compromise also includes
this:
GOVERNMENT-RUN PLAN: A tentative compromise would eliminate a new federal insurance plan to compete against private carriers, something that was unpopular with moderate Democrats. Instead there would be national nonprofit health plans administered by the Office of Personnel Management, which oversees the popular Federal Employees Health Benefits Plan. If those nonprofit plans didn't provide sufficient competition, additional government involvement could be triggered. Supplementing the national plans and in a concession to liberals, Medicare would be opened to uninsured people beginning at age 55.
The
Federal Employees Health Benefits Program is really good, but needs improvement.
Some plans, particularly the one offered by some employee unions such as the National Association of Letter Carriers, and by the Blue Cross and Blue Shield Association on behalf of its member insurers, are nationwide; others are regionally-available plans such as HMOs. The FEHBP is open to members of United States Congress; in the 2004 presidential campaign, Senator John Kerry proposed opening enrollment in this plan to all Americans.
A chief criticism of this program's legislation and management is that the purchasing power of the Federal Government is not utilized to draw down premiums and expand coverage. This controversy is similar to that which surrounded legislation for the Medicare Prescription Drug Coverage passed during the George W. Bush Administration. In the FEHBP, the Federal Government sets standards that, if met by an insurance company, allows them to participate in the program. The result is numerous competing insurance plans that are available to Federal Employees, but which vary only marginally in price and coverage, and which results in choice overload. Additionally, such a situation tends to favor the larger, more well-known plans because the consumer will opt for them if unable to make an informed decision. Instead, it has been proposed that the Federal Government give notice that it is interested in only offering a few plans for Federal employees to choose from, and that it would accept bids from companies for the best proposals possible. The benefits of such a process would be lower costs to the Federal Government and employee, and greater health coverage under the plans. The insurance industry generally opposes such ideas due to the resultant loss of profit. In addition, many companies would not be able to participate in the program unless they were part of a large cooperative plan that was accepted as a winning bid by the Federal Government.
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