The Senate Finance Committee rejected an amendment Tuesday that would have created a government-run health insurance plan, but debate over a proposed public plan is not expected to end at the committee.While I'm decidedly pro-reform and pretty neutral on the public option as a whole (just do something, anything, please!) I find it quite amuzing that lobbyists for companies like Cigna, United Health, and Humana wield so much influence in this process, with lawmakers on both sides of the aisle in their back pockets. Then again, I can understand such dogged opposition to such reform, given the fact that each of those companies continues to gross staggering profits, and can afford to pay their CEOs a pot of gold coins in bonuses each year. On an unrelated note: 2,000 folks stood in line all day to get some free medical attention at a healthcare fair in Houston over the weekend.
By a 15-8 vote, the Finance panel rejected an amendment sponsored by Sen. Jay Rockefeller, D-W.Va., that would create a public health insurance option. Under Rockefeller's amendment, a government-run plan would inherit Medicare's network of doctors and hospitals and pay them based on Medicare payment rates for its first two years.
All Republicans on the panel voted against Rockefeller's amendment, in addition to Senate Finance Chairman Max Baucus, D-Mont., and Sens. Bill Nelson, D-Fla., Kent Conrad, D-N.D., Blanche Lincoln, D-Ark., and Thomas Carper, D-Del.
Democrats supporting the Rockefeller amendment pointed to several states in which only a handful of insurers - sometimes as few as two - provide insurance coverage for the majority of those covered. The public option, they said, would guarantee a low-priced plan for consumers.
Republicans lambasted the amendment as an attempt to expand the federal government's reach and eliminate private insurers. A public plan would "crowd out" private insurers with artificially low prices, eventually forcing private insurers to absorb unpaid costs within the U.S. health system and charge their policyholders higher premiums.
Insurers are strongly opposed to a public health insurance plan in any form. Robert Zirkelbach, a spokesman for the America's Health Insurance Plans trade group, said in a statement that a public health insurance option "would dismantle employer coverage, bankrupt hospitals, and add to the federal deficit."
Members of AHIP include leading insurers such as Aetna Inc., Humana Inc., Cigna Corp. and UnitedHealth Group Inc.
Just throwing that one out there, is all I'm sayin'.
Either way, I just hope this doesn't signal the beginning of the end for healthcare reform. I know the protagonists (you know who) would much rather do nothing and "wait until the economy improves", which essentially means never.
We'll see.
Question: Do you think the prospect of the public option is officially dead? Do you think it's essential to any substantive HC reform, or merely another piece of the puzzle?
US Senate Panel Rejects Adding Public Plan To Health Bill [WSJ]
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It's not the case that they'd rather do nothing. the GOP has offered over 60 amendments to the Finance committee bill, and all but four were rejected.
Ideas like opening competition across state lines and reforming malpractice law only scratch the surface of the options Republicans have put forward to try and fix a problematic system.
Public option is not a solution to anything except the question "how do we get more control over this system?"
Those people waiting in line all day in Houston? With universal care, you'll see the same thing, every day, all over the nation... except it won't be all day - it'll be 2.5 years.
The public option as it was being presented would have been so stingy and difficult to qualify for that I don't think it would have made a difference. As it stands now the bill is just a massive giveaway to the insurance industry.
What's really needed is single payer. Open up medicare plus costs to all.
It's amazing that so many line up supporting their right to be gouged by their insurance company but that's America.
Why is this such an emergency that we need to act immediately? Just let those who cannot afford helathcare onto Medicaid or CHIP. If you can afford and plan and don't have one, then that's on you for now. If we rush, then we'll likely get another mess like Bush's Medicare Perscription Plan.
Why is everyone so worried about how much of the GDP goes to the medical industry? Those jobs cannot be exported and actually pay living wages. To me it seems like a good way to keep an economy humming.
Healthcare is obviously going to be reformed in steps. The public option is just dormant.
I don't get the argument that with a public option you have to wait "2.5" years to get health care? So tens of millions of people in Europe and Canada all have to wait years to get care when they get in a car accident and are rushed to the hospital? They leave the hospital with no medical bills, spool.
If you're British and you break your arm while visiting the U.S. your bills are covered. It's pretty simple. If you lose your job and then break your arm your bills are covered.
@spool: Do you have any statistical evidence to back up the inefficiency of Europe's or Canada's system? Who are these masses waiting in line? Maybe the 1% of people who need a liver transplant have to wait longer to get it. But average families- they have no bills and they know they're covered if they have a medical problem.
Why doesn't the GOP want that for people. It's like their consciousness hasn't caught up to a civilized society that believes health care isn't about money but rather about health.
@ Spool
Besides tax credits and malpractice reform (both endorsed by the president), what exactly has the GOP presented as a solution? Depending on whom you ask, you can already purchase insurance over state lines in some cases. Again, what is the GOP presenting, other than outright politically (and lobbyist) driven opposition?
{crickets}
I agree with Ezra, if the public option is sooooo awful, how come folks in these other countries are outliving us by as many as 5 more years, and how come our infant mortality rates in some cities are like 3rd world countries?
I've yet to understand how a tax credit is going to help someone who is momentarily without a job get health insurance.
Seriously, the hyperbole and fear mongering of those in the GOP on this issue is sickening. Just sickening.
@ Paul
Given how out of whack Medicare costs are, how does dumping another 30M people in that bucket help anything?
Nobody is arguing about the number of gigs in the HC industry. People are arguing about the cost.
Unpaid medical bills being one of the primary causes of bankruptcy in America doesn't "keep the economy humming along" I don't think.
Paying massive profits to HMOs and Pharma who make more money when people are sick also doesn't keep the economy humming along. It keeps rich people rich and average people unhealthy.
40+ Million people don't have insurance- if they did there would be more HC jobs in order to serve them.
Plus there are millions of people who have really weak insurance. A $5000 deductible is a laughable excuse for health insurance.
@ AB:
"I find it quite amuzing that lobbyists for companies like Cigna, United Health, and Humana wield so much influence in this process, with lawmakers on both sides of the aisle in their back pockets."
By "amuzing," of course, you mean "batshit insane."
I'm sure it was just an typo.
XP
I'm not explicitly against a public option; I'm against rushing into anything. The Ds are trying to ram this reform through without proper analysis or even looking at unintended consequences. Again, no one's ever explained why we can't wait a few months and really look at the proposals. Wherever the governement says something must be done now, I get scared (see Iraq Invasion, Vietnam, Medicare Perscription Plan, etc.)
One aspect of controlling costs in healthcare (w/c the US is absolutely horrid at) is to mandate that everyone must have health insurance. I'd provide links and the whys if I had time and didn't have to get back to work. You don't have to trust me on this, the info is easily found out on the 'intertubes'.
However, if you are to mandate health insurance, there needs to be a public insurance option! Without one, all we would have is a massive give away to health insurance companies. The public option will serve as a check on insurance companies and provide people an option if they become unemployed or work where no insurance is offered (like the entire restaurant industry).
The Senate Finance Committee rejection is not necessarily the end of the public option. Lest we forget, the House bills do include some provision for the public option. So there is going to be some horse trading to go around. It's just beginning, not ending.
Let's not forget that the Dems on the Finance Committee are some of the more conservative, and some are really in bed with the insurance companies - like Max Baucus.
It's time to put pressure on these so-called Blue Dogs and threaten them with primary challenges. A lot of their constituents are in favor of public option.
One other word - opening up state lines to insurance companies as a means to increase competition is, I'm afraid, a rather hollow option when in many states, one to two major insurance companies have 80-90% of the market for health insurance. In the same way, forming co-ops would be ineffective in reigning in the big boys like Aetna and UHC - they don't have the horses and muscle to really seriously play.
My concern with this health care reform, as an Independent, is that it’s all over the place, there are not enough specifics and it must be put into writing and as if “written in stone” so that not every illegal that comes to the US will get free healthcare and those that work hard all their citizen life in US pay for every “Tom, Dick and Harry”
deep breath
@silverkris:
You have the economics backwards. Competition across state lines would mean that consumers get more choice... in other words, they would no longer be stuck with the one or two options available in their states. The problem with the market is twofold:
1) Insurance companies are paid by individuals but their customers are healthcare providers. GOP reforms of this system include ideas for how to shift the relationship as between doctor and patient, and between insurance company and patient. This puts patients in more control of the situation, breeding competition and driving down costs.
2) State monopolies or duopolies are terrible for cost reduction, compensation, and competition. Turning it into a national market is better for consumers, not worse.
@ezparz:
40 million people don't have insurance, mostly because they don't want to buy it for one reason or another. People who are sick and uninsured? Closer to 13 million. There are 240 million people in the USA.
I challenge you to back up that bankruptcy statistic. I've heard it before but never actually seen the numbers.
One of the primary causes? Prove it.
@AB:
Here's a Republican idea you might like... the GOP has offered plans that are deficit neutral, all rejected to date.
Why are people in the USA dying as much as five years earlier? Because we're fatasses that eat Big Macs 5 time s a week, don't exercise, binge on sugar and high fructose corn syrup, and die of heart disease and diabetes before our time. When European countries import the American diet, their live expectancy goes down and their diabetes and heart disease goes up.
If you want to increase the lifespan of Americans, the solution isn't universal healthcare - it's universal gym memberships.
@ezra:
The GOP wants reform... just not this reform. No serious person is arguing that the healthcare status quo is fine. It's just that the options on the table are all worse!
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Universal healthcare isn't. Or, as the Irish say... "Free healthcare... you're free to wait." I've posted link after link, along with my own personal experiences with single payer and national 'healthcare' in a population much smaller than Houston's.
It's not a car accident you have to worry about... in every civilized nation you will get immediate emergency care if you need it. It's the hip replacement, the pacemaker, the physical therapy, the MRI, the PET scan that you have to wait for.
And wait.
And wait.
Sometimes for years. I'll say it again: universal healthcare isn't. What the Whitehouse wants to do is a fantasy... they might as well propose unicorn rides to the hospital.
@ Spool
We already have universal gym memberships.
It's called jogging.
Spool,
Allowing insurance companies to sell across state lines sounds good but there are problems with it. First, hospitals and doctors’ offices are already swamped trying to figure out which insurance companies cover what and filling out all the different forms each insurance company requires to ensure compensation. It is not uncommon for a small practice to hire 5-6 employees solely for the purpose of managing insurance company calls and paperwork, and that’s when they’re only dealing with 3 or 4 companies. Imagine if there were hundreds. It would instantly bankrupt most private practitioners and many hospitals.
The second reason doctors and hospitals are opposed to this idea is because right now the only way doctors have a say in the insurance industry (since there are little to no functioning market forces) is through lobbying their state governments to regulate insurance companies. If insurance companies could sell across state lines then they’d all congregate in the state with the least number of regulations and physicians in all other states would have zero say in how the insurance companies in their area opperated.
So if we’re not going to deregulate the insurance industry the only other good idea for putting downward pressure on premium prices that anyone has come up with is what Obama is proposing, a nationwide public plan that anyone could buy into. It would give the insurance companies competition, even in rural areas, effectively forcing them to lower their prices to compete. Despite the public perception this plan has as some kind of anti-capitalistic bastion of inefficiency, the public plan is designed to fix malfunctioning market forces, increase competition, and increase patient choice. And analysis by the CBO, Kaiser Family Foundation, Lewin Group, and ITEP all say it will do just that.
The invisible hand can’t move us towards efficiency in the absence of choice and competition. Healthcare reform opponents often talk about market-based reforms but reforms based on preserving current markets support a system that inhibits market competition. We need to break the monopolies and the public plan is one of the only feasible ways of doing that. In that sense it is one of the strongest “pro-market” idea out there.
Spool,
Your comment to Ezra expressing disbelief about the % of personal bankruptcies, coming from you, is pretty equivalent to a child who sticks his fingers into his ears and doesn't want to hear information that divulges his beliefs.
But here's something you can look at, and it's not some left-leaning article. Do a search and there's a lot of info to corrobrate that.
http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html
Point is, there IS a real problem for Americans being able to afford their medical bills. However, you don't seem to want to acknowledge it or appear to be in denial about the issue.
"Why is this such an emergency that we need to act immediately? Just let those who cannot afford healthcare onto Medicaid or CHIP."
Actually, the simplest way to have universal health care (and the plans being discussed now are nowhere near that at all) is to actually extend Medicare or Medicaid to a larger segment of the population. The problem though is that it makes too much sense, and threatens the health insurance industry that it is wouldn't survive here given the political dynamics in this country.
"Why is everyone so worried about how much of the GDP goes to the medical industry? Those jobs cannot be exported and actually pay living wages. To me it seems like a good way to keep an economy humming."
Well, the problem is that the for-profit medical insurance industry is more of a middleman sector - their profits are made off the backs of ordinary people and industries, yet they do not produce any sort of tangible benefit for society as a whole. Think about it - a big problem why GM and other auto companies had to file bankruptcy was because of their medical costs. Their costs in Canada are actually lower because of universal health care system provided there.
Good replies, silverkris. Let me take them in turn:
I think you partly miss the point of the GOP insurance reform. You're right that dealing with hundreds of insurers instead of a dozen or even three would be a massive expense for doctors. The solution isn't to have them also deal with the government! It'd be like giving my daughter an unabridged copy of the OED for school vocabulary, because one dictionary with everything is better than three smaller ones.
The suggested reform puts consumers at the nexus, just like with homeowner's insurance. It removes the doctor from billing eight hundred insurance companies, replacing it with a consumer-centered system.
To your point about deregulation, I don't think anyone is proposing actual deregulation - just different regulation. In the end, nationwide competition gives the federal government MORE ability to regulate the industry, as it becomes a legitimate action under the commerce clause (as opposed to the questionable Constitutionality of the public option).
Regarding what the public plan is designed to fix... the public plan is not actually designed at all. The CBO has no cost estimate that shows savings without tax increases across most of the nation, and Kaiser's study assumes all the uninsured people a) can pay, b) will buy the public option, and c) won't get sick very much. The idea of a public option saving money or encouraging competition is just that - an idea. The number of assumptions made about this concept is staggering... almost comical. Simply determining a cost for different regions of the country is going to be a Herculean undertaking, and the concept that government price-fixing can drive cost down by creating competition is pretty broken. Let's be honest, we are talking about price-fixing here... government setting the maximum price low enough that they shave away insurance profits but not so low that they run insurance companies out of business.
I could write ten pages on the ripple effect of that sentence, just on its own.
Re: Canada.. costs are lower because they perform fewer procedures, work fewer hours, and make their patients wait for non-emergency care. Whether that's good or bad depends on whether you're an economist, or a 55yr old woman who needs a hip replacement.
Finally - I would support a bill that simply said "if we can make SCHIP and medicare cost effective without compromising care, we will expand it to everyone". Medicare is the dirty little secret of the public option supporters.. because it IS a public option, and it's going to destroy the budget in the next 30 years. The only way we could extend it nationwide without ruining the country is if we impose a series of large tax increases on everyone over the age of 18... or start finding ways not to spend so much on caring for patients. Ways like long waiting lists and 'de-emphasizing' expensive end-of-life treatments.
Harvard Study: 60% of Bankruptcies Caused by Health Problems
http://www.consumeraffairs.com/news04/2009/06/bankruptcy_medical_costs.html
In my option the Dem’s Government public option system will either bankrupt the nation or more likely cause taxes for the middle class to skyrocket.
The GOP’s meddling plans will most likely cause health care prices to rise do to inflationary side-effects of adding more people into the pool. What will happen most likely with the GOP plan is to keep an everything the way it is where millions are still without health coverage.
Here’s a question I would like to ask especially those how attend religious service. How is that we have so many in this country without health coverage when so much revenue is given in charity to churches. Wouldn’t it be possible for churches to pool their members together to buy bulk health care coverage?
I wish articles would link to the source material... hate that about some content providers! I'm pretty sure that one was lifted without attribution from the AP.
After some more digging, here's the actual study.
Now: given that 75% of this sample had health insurance, and given that Obama has promised he's going to let us keep our plans and has offered no suggestions on how to cover expenses not met by current Health Insurance, my question about these bankruptcy numbers is...
... so what? No proposal on the table solves this problem. Why even bring it up?
Please explain how medical bankruptcies fit into the context of the discussion. Bonus if you can also explain why we should place the burden of paying for universal care on 100% of the population so that we can help out 25% of the 60% of bankrupt households.
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