US Congress “Public Option” Healthcare Compromise with Insurance Companies Does not Live Up to Promises to American People

Kucinich Amendment May Save Health Reform

By Joshua Holland, AlterNet
Posted on July 17, 2009, Printed on July 17, 2009
http://www.alternet.org/bloggers/www.alternet.org/141404/ 

No time today for a lengthy analysis of the Tri-Committee health bill. My quick-and-dirty take is this.Those who think the bill is a wonderful progressive victory with a robust public option are wrong, and, on the flip side, the charge that it’s a “bailout for the insurance industry” is totally divorced from what the bill would actually do if passed. 

It is the most progressive, comprehensive and significant health care legislation to come down the pike since Medicare was passed in 1965. If it were enacted as written, it’d go a long way to solving a lot of our problems (but by no means all) and wouldn’t break the bank in the process. (I’ll have more next week on the good, the bad and the ugly in the new bill.)  

But it also fails some of the basic criteria that most progressives have long said is a red-line that can’t be crossed. First and foremost, it doesn’t have a public option that can compete with private insurers and result in significant cost savings.   

It has a public plan in which — as far as the statute goes (it can be expanded in 2015 but there’s no mandate to do so) — only 9-10 million people will be eligible to enroll by 2019. Similarly, the publicly-administered exchanges are projected to cover about 30 million by that year. (These relatively small insurance pools will be able to bargain in concert with Medicare to some degree, so their power will be magnified, but still…) 

That greatly limits the potential for cost containment. What it does is bend the curve of projected cost growth downwards, and cover about 2/3 of the uninsured. But we’ll still have 3-6 % of the population uninsured and being treated at the ER. And while bending the upward curve down a few notches is a very good thing, it doesn’t get us where we want to go — not when you consider that we pay $2000 more for every American than the OECD average each and every  year. 

But it’s more than just the costs or the people left out. Crucially important is that the public plan won’t be big or effective enough to serve as a living example of the kind of large-pool public exchange models federal employees now enjoy. And that means it won’t be a back-door to a European-style health care system. This is really key. As I wrote last week about the divide between single-payer advocates and those pushing a public insurance option: 

The divide that does exist in progressive circles is tactical, not ideological. Most of those pushing the public option would, if they had their druthers, enact a single-payer system. But they recognize that the two commercial enterprises that have spent the most on political lobbying in recent years are the “disease care” and insurance industries.  

Like single-payer advocates, they believe that a large insurance pool with extensive government regulation and some subsidies afford the greatest potential for (near) universality and cost containment. 

And they think that given the choice — given a demonstration that this approach works better than having a fragmented system of private insurers — most people will eventually opt into the public plan, and we’ll end up achieving something approaching a single-payer system — although an American-style variation — through the back door. 

Obviously, a public insurance plan for which 10 million are eligible to enroll isn’t going to serve as an example of the efficiency that comes with a single-payer type system. And the fact that they designed a pretty good public option for which most of the public will be ineligible to enroll (and that wouldn’t have as much potential for cost savings as one would hope) was enough to make me consider opposing it. Howard Dean told me recently that he thought a bill without a robust public option wasn’t worth passing, and I agree. 

And that’s where Kucinich, a supporter of single-payer, comes in. He’s trying to save the whole promise of this project. 

This morning, an amendment he authored was added to the House bill that allows states to create their own single-payer systems instead of adopting the federally-run exchange system. The original bill allowed states only to enact their own exchange system — it was a nod to federalism — with the proviso that if a state (think a deep red one in the South) refused to adopt the plan, the feds could step in and set it up. 

The Kucinich amendment is really key. If it were to survive the legislative sausage-making and be enacted into law, the we could expect a progressive state to take advantage of the opportunity and enact a single-payer system in short order. And, if those of us who have been pushing such an arrangement are correct, the result will be greater access and better outcomes at a lower price tag for that state’s residents.  

And then we can move from an often ill-informed argument over the Canadian or British systems to a debate in which we can hold up a model in which millions of real Americans see very tangible benefits from an actual single-payer system in action. 

Thanks, Dennis! Now let’s see what comes out of the Senate.

One thought on “US Congress “Public Option” Healthcare Compromise with Insurance Companies Does not Live Up to Promises to American People”

  1. AMERICA’S NATIONAL HEALTHCARE EMERGENCY!

    It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.

    STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.

    We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

    And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

    Progressive democrats the Tri-Caucus and others should stand firm in their demand for a robust government-run public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and request that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

    Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

    In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

    If President Obama has to declare a NATIONAL STATE OF EMERGENCY to rescue the American people from our healthcare crisis, he will need all the sustained support you can give him. STICK WITH HIM! He’s doing a brilliant job.

    THIS IS THE BIG ONE!

    THE BATTLE OF GOOD Vs EVIL!

    Join the fight.

    Contact congress and your representatives NOW! AND SPREAD THE WORD!

    (http://action.firedoglake.com/page/s/publicoption) (http://www.actblue.com/page/healthcareheroes)

    God Bless You

    Jacksmith – WORKING CLASS

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