The Public Option Con: Selling Out Single-Payer

[avaistheone1]

… The health care reform proposals advocated by Jacob Hacker from the University of California at Berkeley are suddenly all the rage, but there is nothing new about them. He proposes a national health exchange of private plans with the addition of a public option (essentially Obama’s position.) Hacker, like HCAN, is careful to assuage the fears of the private insurers and says under his scheme, “More Americans have private insurance after reform than do before – either through their employer or through the national exchange.” Smells a bit like Massachusetts where 200,000 people remain uninsured and the costs to subsidize the program have doubled from $630 million to $1.3 billion.

Single-payer advocates oppose the creation of a public plan for a different set of reasons.
1. It doesn’t make health care a human right that can never be taken away.
2. It continues to divide, devalue, and define people by their health status.
3. It can’t address the endemic racial and gender disparities in the system, including the 12 million undocumented.
4. It leaves the employer based system of health care provision intact. That link has to be broken so workers are free to change jobs, go on strike and not fear loss of coverage.
5. The system would continue to have multiple payers and therefore the complexity and gaps in coverage that are inevitable when there are numerous bureaucracies to navigate.
6. Where will the money come from to finance the plan, especially in a time of economic recession, like right now? A public plan is not fiscally sustainable because it’s rooted in a multiple payer system that foregoes at least 84% of administrative savings.

Single-payer on the other hand, would immediately inject 400 billion into the system by eliminating bureaucracy, billing apparatus, administrative waste, advertising, corporate profits, and CEO compensation. That’s enough money to bring everyone into the system with no co-pays or deductibles.
We don’t need any more feasibility studies or examinations of single-payer in other countries. It’s a proven fact that a single-payer system can cover everyone and control costs. Period, end of discussion.

So the question becomes why don’t the Democrats and HCAN fight to get rid of the parasitic private health insurance industry (the source of the crisis) once and for all instead of constantly and unsuccessfully, decade after decade, trying to rein in, regulate, and do an end run around them?

Continued at-
http://www.counterpunch.org/redmond04232009.html



I think this is a helpful article to educate ourselves as the our elected leaders attempt to hoodwink us that the public option is just as good as single-payer. It clearly is not.

[madfloridian]

1. Yes, Dean is selling us out with the public option "con"

:sarcasm:

[ThomCat]

3. I think at the very least he's making the fatal mistake of

confusing univeral insurance with universal health care.

Universal insurance means that everyone pays insurance companies. It doesn't mean that you actually receive usable insurance as a result. If you end up with a cheap policy with high deductibles and copays then you still have no access to health care.

Universal health care is what we really need, and clearly this public option will not provide it.

I'm hoping Dean's position will evolve into something better.

[madfloridian]

4. No, it won't.

He is selling us out. Just ask Sirota and Nader.

:sarcasm:

Frankly I am letting them have the issue....cause if they get front and center we lose.

[Mass]

17. Why exactly? A good public option would. A weak will not.

[avaistheone1]

22. By not being forthright and truly having ALL the stakeholders as a part of the

decision-making theleadership and the administration is creating deep distrust of the public option.
By excluding single-payer from multiple decision-making sessions they only deepen suspicions about the public option. They have also been very tight lipped about what the public option will look like.

[Mass]

25. So, your point is you do not trust them. This does not mean a public option would not be possible.

I am all for single payer, but it will not happen and something needs to be done now. I prefer to fight for a GOOD public option that can happen than for a single payer option that will not.

The problem with single payer is that there is nobody who is ready to make a real campaign supporting it except during high stakes times like now. So, rather than getting people used to it slowly, like the other side does and explaining that single payer can be GOOD and does not mean you cannot choose your doctor (something you cannot do anyway with HMOs) and that you can still decide what care you get (at least as much than with the current system), you get people out yelling and insulting others just when decisions are made. Grow the movement bottom up and may be pols will move. For now, most people have not even a clue what single payer means (even for those who support it and think there is only ONE way to implement it), so there is no surprise it will not happen.

[avaistheone1]

27. A black U.S. president will not happen either.

Thanks for the reminder.

What has happened to the audacity of hope crowd?

[ThomCat]

2. If politicians don't have the spine to fight for universal health care now

then they lack the courage to ever fight for it. They are never likely to have suck public support.

The government is pouring trillions of dollars into propping up corporations and their profits. People want to see the government doing something to support PEOPLE for a change, and health care is consistently high on the list of what people want. People will rally around government provided health care now like never before.

Not only is this a sign of massive political cowardice, it's a sign of how corrupted politicians are by corporate lobbyists and money. They are inundated with corporate messages and out of touch with what their real constituents really want.

More importantly, they are so addicted to corporate money that they Don't Care what their real constituents want.

:grr:

[madfloridian]

5. Then have your single payer or nothing.

That's the way of the world.

[blindpig]

8. The alternatives other than single payer are nothing or worse.n/t

[vaberella]

11. It seems reality doesn't run strong for some people...n/t

[ThomCat]

12. Oh, and what reality am I missing?

Please enlighten me, oh wise one.

[vaberella]

18. Since you ask so nicely who am I to deny you.

Single payer will be shot out of the water before it even gets mentioned *again* on the house floor. Single payer is not a bad idea or wrong. I fully support it...however if you're looking for a successful change in the way health care is administered and functions this society is way to capitalist and as yous aid we have people who owned by Corporate entities that shit won't get done. That's the problem. O is trying to find an intelligent mediation for success and his methodology is correct.

Many here were against O's plan, until Dean started standing by it and Dean is not a dummy, he realizes how this is going to work and I wouldn't even be surprised if Dean worked out a plan with O to get things moving. Why? Because dean totally promoted Schumer's public option plan and we'll have to see how that goes. But it could also mean Dean is playing a role in how that is written. That's just the first thing.

The main issue is what will pass through legislation. SINGLE-PAYER will NEVER pass or at least it would never pass in the social structure we have now in the government. You have a brain right, and I hope this doesn't appear condescending...however with O was pushing his stimulus plan what happened?! Except for 3 all of them voted "Nay." You see to think the people who pass bills are logical and really care about us?! Obviously that was proved wrong in many considerations and most of them look after themselves. O is trying to make moves with what works and innoculate himself from getting his plan shot down BEFORE he has even a chance to get the American people on board.

You and I both know the American people are a fickle ass bunch..and a few good commercials could shoot down O's plan----especially if single payre before O could say M-. This was basically achieved with HRC's plan collapsing.

So look at this realistically. He's pushing a plan and most on here and others like to say it's the Mass plan without any damn proof. One person suggested it's the Mass plan but O knows perfectly well there are many problems with the Mass plan and that 46 million would not be insured under such a system. There will still be many excluded. That being said, I'm giving him the benefit of the doubt to propose the public choice with a detailed outline.

The key things with public option is that crowding out is inevitable. What does that mean...that means public option nudges the people to take it because of the incentive and it actually nudges small business to push for it because of the cheaper costs. This is all based on like Sustein (consitutional law friend and advisor of Os). You put the public option which basically is safe from strong opposition because as O has said and Dean repeated---"You get to keep your private option." In the long run with this public option works for a strong majority of people...those people will say how great it is and will promote it. It will force the hand of many more businesses...and even outsourced companies would come home to push their workers to the public option just for cost or make ties with the public option. Why? Because they lower their costs and they don't have to increase the minimum wage (but that leads to a fight of another kind). Then with that that crowding out people who originally paid might choose to dump paying of their own free will leading to the public option taking on a larger role and primary role. The affect is slow going but it happens and then the private insurance basically gets dismanteled and those people working in them would end up working for the guranteed pay and job sector provided by the government.

The whole thing is strategic and based on economic commonalities rather than assumptions, considering that these things do happen in the business sector. Think of Walmart as a public choice medicine. It goes into the area and basically devours the small sector mom and pop shops because all in all it offers the same things but cheaper. Horrible analogy but actually the most fitting one.

So rather than getting this thing shot dead he's being realistic and making things happen.

[ThomCat]

26. I can see and agree with all of that.

But even if I accept that it's all true, what's the result?

We end up with a plan that businesses accept. You can buy into is as your employer provided health insurance. SOME employers who don't offer insurance now MIGHT decide to start offering insurance IF it is now cheaper. But those are a lot of conditional statements.

Some employers is not all, so a lot of people will still be left out.

If it is cheaper, because it might not be. As long as the public option is competing with private insurance the lobbyists will make sure the public option NEVER undercuts the price of private insurance. Obama has already given assurances that nothing he does will threaten private insurance. So if private insurance is going to remain expensive, and the public option is mandated to not undercut that private insurance then the public option is going to end up priced to match the private insurance.

When private insurance raises their rates, the public option will have to raise their rates to match to make sure they don't undercut the private insurance, because that is the promise that has been given by Obama to the Insurance Industry.

So where is the savings? How are people going to afford this? How are more people going to end up with health care. It's going to look like what we have now except now the government is one of the insurance options. But it still won't be affordable enough to available to everyone?

The bottle neck is the promise to insurance companies that they will remain profitable. That is the entire source of our health care problems. If Obama was willing to let his public option undercut the private insurance companies then everything would be wonderful. The public option might really be good enough to, like you say, to change everything. That would be wonderful.

But that is all conditional on the ability to undercut the private insurance plans.

[Phoebe Loosinhouse]

31. I agree with everything you wrote. The handwriting is on the wall.

What kind of government writes a supposed drug benefits package that specificallly excludes the ability to negotiate drug prices and restricts the ability to bring import cheaper drugs? I'll answer my own question - A government that is more beholden to the corporate and moneyed interests than it is beholden to the welfare of the general citizenry. The obvious answer is the correct answer. There is literally NO WAY that a government entity that cared about fiscal responsibility or the wellbeing of its citizens could have written legislation like that.

[vaberella]

32. We end up with a plan SMALL BUSINESS accepts.

The other businesses just end up in later. And they don't get their tax breaks and subsidies for providing health insurance with private insurance companies.

Actually you're wrong to an extent. Sure there are conditions here...but it's most likely going to be people moving into the plan. If it opens itself up without regulations..that means everyone on medicaid gets moved to this plan...shoot it might even encompass those in medicare. Then you'll have the 46 million without insurance. Then you'll have the small businesses joining the plan. All that leaves is major companies. Basically everything is up in the air but your analysis is the most unlikely of the lot. Most large companies are outsourcing anyway...so the main companies to look at are the small companies and franchises...shoot even MacDonald's which is big will put all their people on that health plan.

Actually you have your information backwards on raising rates. It doesn't work like that. Monopoly is to set price...in a competitive market everyone is a price taker not a maker. However the public option will ALWAYS be cheaper that's the point. People who are paying cobra will forgo paying hte nominal fee cobra asks to take the public option that is cheaper and provides everything they need---dental and eye care which cobra doesn't provide in most cases.

So the private insurance raising their rates will not curb the demand...actually it wil curb the demand for their products and it will move people into the cheaper area. EVERYONE wants something cheaper, they don't want to pay more for the same service. So that idea is just crap and makes no sense. If the private insurance ups its price while the public insurance remains cheaper or free...everyone will take the public option. So what happens? the private insurance would lower it's price. This is what O is moving for. We give the public option---which forces the hand of the private insurance to lower it's price. However, how low will they be willing to go is the question. Probably not low enough to sustain themselves while the public option will have state and individual money to support it which will undercut the private insurance all together. Sure there will still be some companies standing but overall elminated. O knows this very well and that's his plan from what I've read. O never promised to undercut the insurance company. They just promised that people will be able to keep the health care if they like it. That's all he promised. I have read other people claiming otherwise, but I've never heard him say that. He just said competition is good and the government should be able to provide something to bring down costs. It won't undermine the private insurance for a while, considering 150 or so million people will still have private insurance.

As for costs, I already said the cost will be cheaper for those with insurance because of competition while for others who don't have it, it's cheap or free. O never promised they'd remain profitable. Just that people could keep it, allowing private insurance to stay alive for a while.

[avaistheone1]

6. I agree. Now is definitely the time for so many reasons.

The Democrats have the majorities in both houses and the White House. People are losing their insurance left and right with company layoffs. Many employers are dropping or decreasing their medical insurance to employees.

The threat of a pandemic flu also underscores that this is the time for single-payer.

It certainly is the right time given the both houses and particularly the Senate have been so generous to give the banks and Wall Street a blank check which already has a tab over a trillion dollars.

Now it is the right time to show some generosity to the people, do the right thing and a establish single-payer universal health for all Americans.

[dkf]

7. I didn't realize single payer would pay for people here illegally.

Can we go to Canada and get health care too?

[asphalt.jungle]

9. the my way or the highway purity crowd

always show their inability to read the political tea leaves when they say things like that. you don't promote your option as the best option by including that tidbit. that's a sure fire way to lose a PR war and this fight will be all about whose buzz words best resonate with the american people on the whole.

[ThomCat]

15. Right, because when building a health care system that works

it's best to spend all your time focusing on buzz words and prejudices. :eyes:

[asphalt.jungle]

24. Buzzwords matter. Issues are won or loss based on them.

Harry and Louise were all about winning the PR war. Republicons have been winning elections/issues just based on buzzwords. Luntz has made a career out of finding which words work to con the public into believing Republicon ideology is what's best for them.

It's a good thing the Obama admin also knows this.

http://www.latimes.com/news/nationworld/nation/la-na-obama-language11-2009may11,0,6330691.story

[ThomCat]

14. It wouldn't. If it's based on a valid social security number

then they wouldn't be able to use it. We would have a system like in Canada where citizens and legal immigrants have the state paying their health care bills, and everyone else has to pay for their health care. But even if you have to pay for your health care it's at a reasonable rate because costs are contained overall.

[vaberella]

10. You do know that Pres. O is fully aware of the problems the Mass plan has

and he's planning on changing the run of his public option. Second of all, we don't even know the full details of the plan to critique. Third is, Dean is supporting and pushing and seems to have some advisory role in this.

Lastly....I don't think you're educated enough based on the crap you're reading.

[ThomCat]

13. The problem is that Obama's teachers are lobbyists

from the insurance companies. So if they're the ones teaching him the problems with the Mass plan, his idea of the problems may not match our idea of the problems. It would be nice if he had a populist view but it's unlikely given his history so far.

Yes, he will certainly make changes, but again, his history so far is to give the lobbyists everything they want. So will they be changes that benfit low and middle income people, or insurance companies? Probably insurance companies. How many more billions can he shovel towards insurance companies this month do you think?

Lastly... You're in no position to question how educated I am given the stuff you post.

[vaberella]

19. ~sigh~

Lastly, I wasn't talking to you...~sigh~...Anyone can tell I was talking to the OP---which goes to show how much you claim to know.

[Zodiak]

34. I couldn't tell

And frankly, I should not have to.

Impugning someone's educational level is repugnant EVEN IF you think you have more of an education. In fact, especially under those circumstances.

Perhaps you should not have said it at all, regardless of whom you targeted.

Stick with arguing the facts and keep the personal stuff to yourself.

[vaberella]

36. Did you read the OPs post?!

Obviously not:

I think this is a helpful article to educate ourselves as the our elected leaders attempt to hoodwink us that the public option is just as good as single-payer. It clearly is not.

Now that implies those who are not as "die-hard" about single payer are not educated---and just spouting off at the mouth. I responded in kind. If he finds that reading that article is education then, I don't think he's educated as he claims he is and wants others to be.

[Zodiak]

38. No, you read with the worst possible connotation

...and then escalated it in an attempt to retaliate. There is no mention about die-hards or being uneducated, but there is the assertion that the public plan push is an attempt to hoodwink people. That is a legitimate thesis. All of that other stuff is your interpretation, which apparently you are so sure of that you felt the need to do it one better.

And like I said, one turn does NOT deserve another. You should lay off of the personal stuff.

[Mass]

16. We will not get single payer. So, I guess you and the person who wrote this have a decent healthcare

package and can wait longer. Some people CANNOT.

BTW, after the discussion I have had with people about single payer, some people are so close-minded that they do not realize there are many ways to obtain that. One is to get a public option that will be so good that everybody will go for it.

[vaberella]

20. Hi-Five...EXACTLY. That's why I'm fighting for the public option

and hoping it doesn't get watered down in ANY way.

[ThomCat]

21. If the public option has insurance companies

as a necessary party of the plan how exactly can it succeed and be so good that everyone will go for it?

The whole problem is that insurance companies are filtering out people like me who have disabilities so that people are stratified into different plans and treated differently based on our health. And, they pad the cost of health care by extracting their high overhead and profits.

If the government plan is set up so that it cannot/will not put the private plans out of business then it won't be solving these problems. It is a built-in structural flaw in any proposal before they even begin.

Removing insurance companies has to be a pre-condition for making a public option feasible. Otherwise it's just a new way of expanding profits for insurance companies while providing health care to some more people but not everyone.

[Mass]

23. Not if the public system is open to all and affordable. The govt does not need to

make the type of profit insurance companies are making. They have an existing structure with Medicare. Just open Medicare to all.

In fact, at this point, this is what insurance companies are afraid of. They are happy when people push single payer because they know they can use that to frighten people, but they are currently doing what they can to avoid a public option (helped by people like Nelson and Baucus). They are more than happy with people like you.

Get a public plan that people can understand and people will go there. I am all for single payer, but it will not happen anytime soon. I want a public option NOW so that my son can get insurance and healthcare that he will not get from a private insurance. He cannot wait for other people to catch on with single payer.

[ThomCat]

28. You are still making the big assumption

that it will be affordable, and that assumes that it will be priced less that existing insurance plans. But assurances have already been publicly given that the public option WILL NOT UNDERCUT existing insurance. Insurance companies were assured that they will remain profitable.

In order for that to happen the public plan will have to be priced at the same rate as existing insurance plans. It's a political bait and switch, like in Mass. Making more insurance available isn't the same as making it affordable. And making insurance available isn't the same as making health care available.

IF the public plan is allowed to be priced lower than private insurance, so that it can undercut insurance companies and put them out of business, then you are exactly right. But that is a huge unwarranted assumption. Nothing Obama has said or done indicates that he's going to let any government program put any insurance company out of business.

[Mass]

29. I do agree that private insurances need to be taken out of the equation, but

at this point, the public is not really sold to that. Many (including Democrats) have bought to the "socialism" argument and frightened (as always) by the fact that the government could decide who their doctor is (straw man, I agree, but effective one, sadly. I could choose my doctor more freely in France than I can in this country).

A public option open to all, if it can be achieved, is better than what is probably in the works, that is a mandate for private insurance only, with some subsidized system for those who earn less than a certain income. Even this would be better than the current system, but very insufficient.

[vaberella]

37. Yup, yup. n/t

[madfloridian]

30. This attack on the public option will doom any change at all.

Bottom line.

That article and Sirota's article calls public option a fraud. That is calling Dean a fraud, those who signed his petition a fraud, and ignoring the fact that the insurance companies are not going to completely go away.

This is really angering me, that single payer folks are calling us frauds.

[vaberella]

35. Exactly. They're using single payer die-hards to tear apart something that leads to universal care.

nt

[leftstreet]

33. K&R