I think the main thing is that if the Congress is going to pass something other than the public option then they’re going to have create something just as good under a different name. If the compromise is a trigger, the trigger needs to be a hair-trigger. Obama has already agreed to move off the public option as it was envisioned in the 4 bills that have passed through committee. But, whatever he comes with instead has to be acceptable to the progressive caucus. If this bill tanks, it’s going to be because centrists wouldn’t compromise and progressives wouldn’t capitulate.
About The Author
BooMan
Martin Longman a contributing editor at the Washington Monthly. He is also the founder of Booman Tribune and Progress Pond. He has a degree in philosophy from Western Michigan University.
which is why my suggested plan is to trade public option for a bunch of tough regulation and then implement public option via AIG anyways.
Somebody better do somethin’!
A brief musical interlude-
http://www.dailykos.com/story/2009/9/12/781083/-Number-two-for-brains
41,000+ views so far.
Now that I’ve read, and mostly understood, what is in H.R.3200, I just don’t care what Congress does with it. This is the bill being referenced when bloggers talk about the “public option,” right?
H.R.3200 does nothing good for me personally and generally I think it’s a Trojan Horse with insurance executives hiding inside. First, it takes four years to duplicate a system — Medicare — that is already functioning. In four years, my friends, I will be bankrupt, dead or eligible for Medicare.
Second, it’s fucking mandatory and makes no guarantees whatsoever that it will be affordable just because that’s in it’s name. I’ve seen the figure of 30% attributed to the administration and profits inherent in private insurance coverage. 30% off of the outrageously inflated rates of private insurers is still an obscene amount of money. For example, $1800 per month becomes a much more “affordable” $1260. Do I see a promise of 50% off? Or how about promising to let citizens pay only the $490 per month enjoyed by our Congresscritters?
Third, I hear someone protesting there will be subsidies and I point out A) the cut-off point is somewhere around 300-400% of the “poverty level.” So if your household makes more than say, $45K, you will get no subsidy. And B) These subsidies are a rob Peter to pay Paul scam. Look, I’m a liberal. I’m all about giving up part of what’s mine to help others. But, I think the definition of who needs help should be raised up to $60K-$75K to reflect the fact that Mom and Dad are both out there working without benefits and still don’t have any disposable income. Oh yeah, and these definitions will be regionally-adjusted so someone in, say, North Carolina doesn’t get any help if they earn more than $25K. (My first year in NC I earned less than $5000 and STILL HAD TO PAY STATE INCOME TAXES. That’s how poor people in NC are!)
Fourth, it calls for the creation of a network of “co-operatives.” Blue Cross/Blue Shield is already a “co-operative”! All they have to do is qualify to join the “new” network! Who’s going to EX-clude them? They exchange maybe 30% off of their current rates and get customers who are forced by law to do business with them! What a great deal… for them!
Those here at the Pond who know me may have noticed that I’ve been a bit surly and cranky lately — this is why. I’ve crossed over into Gilroy Territory — it’s all just Kabuki theater, folks. The US Congress is a wholly-owned subsidiary of Global Corporations, Inc. The “public option” is a fraud!
HR3200 calls for coops? I didn’t think that it did.
You are quite correct. They do not use the word, “cooperatives.” Instead they describe a network of non-profit, member-owned, government-regulated, privately-held — you know, the definitions a lot of existing insurance companies already use.
Our non-health insurance is with one of these type groups. Once a year we get invited to come to the Annual Member Meeting which is almost always on a Wednesday morning at the other end of the state. Included are proxie votes we can assign to someone we don’t know so s/he can vote for us. We never get the minutes of this meeting and have no idea what really happens there. One of these years, when I feel well enough to make the drive, I intend to go…
From what you say, I see that you’ve not actually read the bill itself. That exercise takes about a day and is well worth it because there is a lot in the bill that insurance companies don’t want you to know about.
It most emphatically in it’s current form does not create co-ops.
It creates a TRICARE-like exchange, one option of which is a publicly funded plan. An exchange is not a co-op, it’s more like a website of sales pitches for plans, which are audited for accuracy. So that you can compare private plans on an apples-to-apples basis and you can compare private plans to the public plan on an apples-to-apples basis. The federal government will establish and operate the exchange.
The provisions on subsidies are one of the things that is still in play as is the tying of the public plan to Medicare rates of payment to providers. Subsidies will apply to both private plans and the public plan in the exchange. The current bill creates a single exchange with a single subsidy level based on the federal poverty level defined for the US. The exact percentage of the federal poverty level is also still in play.
The public plan in the exchange acts as a benchmark to put downward pressure on the premiums of the private plans in the exchange. If insurers refuse to compete on a level playing field, over time the public plan has more and more policy-holders becoming more and more like a single-payer plan.
For insurance companies, the opposition to the public plan is a red herring. What they really want to kill is the entire bill, and especially those provisions that prevent them cherry-picking policyholders, denying coverage to people with pre-existing conditions, capping coverage, and canceling policies or denying payment after an claim is filed. And they are opposed to having their plans have to compete on an apples-to-apples basis with other private plans. What they don’t oppose are subsidies.
If the public option was stripped out of the bill, insurance companies would find another reason to oppose the bill.
It is mandatory so that the 25-year-olds who think they will live forever will become a part of the pool. The fact that they will pay in and except for something catastrophic will not be major costs means that premiums for everyone can be lower. But the fact remains in spite of what they might think, they could develop cancer. And if they don’t, at some later point in their life they will become higher cost policyholders. That’s the whole idea of a risk pool, an idea that insurance companies no longer grasp.
Having everybody in the risk pool is what makes annual premiums cheaper for everyone. Also with mandates, there is no cost shifting for the uninsured.
And you are correct, you representative must hear that it really must be affordable.
The thing about kabuki, and I’ve tangled with AG on this one, is that you really can’t tell it’s kabuki until the votes are counted. There are enough eagle-eyes on healthcare reform that have experienced kabuki (cough, cough FISA reform) who are pushing hard on this. So far it is still in play.
And Congressional Democrats need to know that kabuki on this issue is political seppuku. Failure to pass real reform will cause a snapback like 1994.
Thanks for an excellent explanation, Tarheel. One of the most useful I’ve seen. Maybe you could make it into a diary to give it some more shelf life?
More questions: So the plans on the exchange would be standardized like Medicare supplements are? I can’t think how else they would be comparable.
Would the subsidy for the uninsured relate to the subsidy for employers in terms of amounts?
If this bill remains mostly unchanged, it sounds like the public option really would be key to making it work. Is that how you see it, or is there any other idea out there (within the parameters of this bill) that could accomplish the same thing?
I absolutely agree with your prognostication: anything less than real reform will put the Dems into minority status for at least another generation. They’ve now oversold it, in a way, as a major change. No way they’re going to deliver windowdressing and escape with their hides intact. I wish I felt more confident that they get that.
See my reply to BooMan above re: my use of the word “co-operative.”
I confess I only spent four hours reading it and when it referred to other paragraphs in other bills I didn’t go chasing after those. I’m not claiming to be an expert at deciphering legislative language. But, I didn’t start reading it expecting to be disappointed either…
I got the whole exchange/comparison shopping part of it but didn’t see that as necessarily driving prices downward. And I don’t think it’s going to be as easy as apples-to-apples. Like shopping for anything, there will always be variations that account for price differences. Where I got the impression of so-called cooperatives from was the process of qualifying to be listed on the exchange.
The figures of 46 to 48 million uninsured are cited everywhere. Will adding these young/healthy, old/sick and/or poor people really spread the risk so significantly? It’s not like we’re talking about an infusion of half the population into the system.
Yes, there are magic phrases like “public plan” and “publically funded.” I’m just not sure what those phrases really mean. For example, the Farm Bureau Federation could certainly say they offer public plans and are definitely publically funded, i.e., their customers are “members.” If those phrases mean “Federal plan” or “government funded,” why don’t they say that?
You say the exchange will be like TRICARE and other people say parts of it will be like Medicare and the provider rates may — or may not — be based on Medicare. As I read thru it my aggravation grew from thinking, why aren’t they simply expanding TRICARE to cover non-military families? Or expanding Medicare to people under the age of 65? Why are they taking FOUR YEARS to re-invent the wheel with flashy hubcaps?!
That’s what aroused my suspicion that this legislation hides a poison pill that will, conveniently, not be tasted until after the next election. If it’s all going to be so great, why wouldn’t the Democrats want to reap the immediate benefits of a grateful public?
If you can re-assure me, I would greatly appreciate it.
I can’t reassure you because the final form of the bill isn’t there. It’s still being negotiated.
But the original form of HR 3200 before markup did not have cooperatives.
We’re definitely at the don’t screw us too badly point because so much is potentially being given away. How much? The public will know before the 2010 elections, and if it turns out to be a sham, they will punish the Democrats, starting with the Blue Dogs.
I want a Medicare Option.
Why would it not trigger for 5 years? That’s an eternity.
I want to go up to one of Obama’s town halls and shout “give me my government health insurance NOW! I WANT IT!!!”
i hope it goes down. a bad bil is worse than no bill at all: I’m not paying 31% of my income or whatever it is for junk insurance. fuck that action.
and if it DOES go down the dems deserve the egg on their face and the electoral consequences that go with it for trying to weasel out of a key plank in the party’s platform.
it’s like the globe said yesterday: we have a prty that’s severely compromised by ties to big money, and we have a party that’s gone nuts.