Why is just starting out with a public option so bad?

[Shagbark Hickory]

I am a supporter of not only single payer but also state run healthcare.
I'd like to see single payer more than most but yet I don't understand why so many are dissatisfied with having a public option running side by side with private insurance companies.

President Obama cannot just rapidly change the system that would essentially shut down the health insurance companies. He won't have to though. If there is a public option, the private insurance companies will gradually shut down because they won't be able to compete with a public option.

Why is just starting out with a public option and getting costs under control so bad? Someone please explain that to me.
A public option that anyone can qualify for and afford, is essentially single payer, is it not? What's the big deal if the private insurance companies are still trying to rip people off at the same time? They're going to try and they're going to lose. By that time there will be no going back and we will eventually transition to a true single payer system.

[Triana]

1. It would hurt the insurance corporations who own our politicians

and the politicians would no longer get those huge sums of money from that industry because it would be dead.

[Fovea]

2. I ask the other question

what about leaving a private option would be good?

They make most people take out loans for college.
What's so wrong about taking out a loan for botox or liposuction?

[Shagbark Hickory]

5. Comparing to other things...

If you use the post office analogy, one could argue the private companies like fedex and ups are more profitable and more expensive but better service.

The problem is if you're running your health insurance business correctly, you will be many millions in the red very quickly because providing healthcare loses money.

There is no room for profit with healthcare. Why do we need a middleman?

[Fovea]

17. Better is better in some ways, less better in others.

yes. I agree that profit is an evil motive in healthcare.
Using my anology again, every town gets a post office.
The ubiquitousness and scale of the system hold costs down like the post offices granularity over say FedEx.

Service may be more gold plated, but getting a letter to somewhere in the boonies via fedex is more costly in several ways, I suspect.
Gold plated health care will be with us always. But socialized medicine will be the death of the conservative movement's great myth
of rugged individualists and private enterprise as the only real solution to every problem.

[Coyote_Bandit]

3. "Getting costs under control"

is something that goes far beyond insurance costs. Insurance companies are not the only ones to be faulted. Everyone who earns a profit or a livlihood in the health care industry can be said to contribute to those costs. So can users who clearly take advantage. And third parties who exploit the system.

Why is considering a public option so bad? Because it validates government participation as an option.

Not that I think a public option is a good idea. In effect it will turn out to be a pool of last resort. It will end up with high rates for minimum coverage because many of the participants will be those high risk people who cannot otherwise secure insurance. Single payer is attractive because of the administrative cost savings realized through volume. Those cost savings will not be reallized in a public option. The only thing a public option wll achieve is the creation of a national pool of last resort. While it will provide a option for some to obtain coverage there is no reason to think it will be affordable. Even with a public option you will still have millions going without health care because they cannot afford it.

Public option is a con. It cannot afford the benefits of single payer.

[Shagbark Hickory]

4. not exactly

I would prefer a public option, not because I am high risk, but instead because I don't trust the private insurance companies.
I would have to have an individual plan because I don't get insurance from an employer. Individual plans = worthless.

I think a lot of people feel the same way and there would be a rather large pool.

[Coyote_Bandit]

8. Ummmm......

I recommend the following for your consideration:

http://www.counterpunch.org/redmond04232009.html

http://www.democracyforamerica.com/blog_posts/28469-why-the-public-option-wont-work-how-single-payer-will-save-democracy-in-america

http://www.socialmedicine.org/2009/04/24/health-activism/the-health-care-debate-single-payer-vs-public-option/


Who's going to opt into that public option? Not anybody who secures health insurance for themselves and their family through their employer. Not anybody who cannot afford the buy in premiums. Not anybody who has the option of securing state subsidized insurance for self-employed/small business. Not anyone who can secure private insurance cheaper. Not anyone who already quyalifies for and receives Medicare (some but not all public option proposals are defined as the ability to buy into Medicare).

Let's assume we are talking about a public option plan which is defined as the ability to buy into Medicare. Sounds great, eh? But who exactly is included in that insurance pool? People who cannot otherwise secure health insurance at a lesser cost (if at all) AND who can afford the premium for the buy-in AND who likely can afford the supplemental private insurance needed. If that buy in is rated to reflect the risk of the insurance pool then the buy in will likely cost MORE than any private insurance that might be available (assuming comparable coverage). Why? Because a disproportionate number of people opting to buy into the public insurance pool will be folks who have medical conditions that prevent them from otherwise securing health insurance - or cheaper coverage. People who cannot afford the premium for individual policies will not find their liklihood of securing affordable coverage improved. Even with a puiblic option there will still be millions of Americans that are forced to go without health care. The existence of a public option will also make it more acceptable for private insurers to cherry pick their insureds making far more folks uninsurable under their standards.

You say you don't trust private insureres. Do you trust the drug companies? The government regulators that approve health insurance rates and pharmaceutical availablility? What about doctors that demand (and receive) salaries paid on a national scale even when that wage is grossly excessive relative to the local cost of living? What about the hospitals and clinics who serve a for profit purpose rather than a humanitarian or benevolent purpose? And what about the tort lawuers and juries who raise costs by attaching outlandish verdicts for damages that simply cannot be accurately quantified in dollars? You are wrong not to distrust every singe participant in the health care system. Yet you prefer to single out the one easiest to blame.

FWIW, I have one of those worthless individual plans. It carries a $10,000 deductible and a co-pay above that. I personally haven't seen a doctor for any reason since 1996. I don't expect to fare any better under a public option plan. I actually expect my private insurer to be more aggressive in cancelling my private coverage as I age to force me into the public pool.

Public option health care is a cop out. Nothing more than a moldy crumb intended to nourish the starving. And it is deceptive. I won't support it. And I have no respect for elected officials who do not support single payer. They are selfish, cruel bastards who require taxpayers to fund their health care but deny many of them the opportunity for even basic care.

[RC]

7. You can apply your argument to evey other service the government provides.

Public option is a necessary step to rein in the insurance companies.

From reading your post, it doesn't look as if you have a real grasp of what single payer is and why it is needed. Forget the insurance. That's just a wasteful extravagance that benefits the people running the insurance companies. Middle men, read con men that are selling us a lot of snake oil. No one really needs health insurance for health care. Every one needs access to health care. The government takes care care of the payments at around 3% or so administrative costs. Private insurance burns up 30% or so in administrative overhead. Why the difference? Government doesn't have all expense paid junkets to expensive tourists resorts. Stock holders to keep happy. Obscene bonuses for the upper management. Government doesn't have the expense of making sure their bought congress critters stay bought year after year. We are dealing with insurance companies that are betting your life using your money, that they won't have to pay out for claims. Then they stack the deck by denying promised claims. Private insurance is the problem with our health care.

Edited to add:

What your health care premiums are used for other than your health care.
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5717148&mesg_id=5717148

[Shagbark Hickory]

9. Medicare is totally unaceptable, sorry. You can still EASILY go broke with a bee sting on medicare.

Because it only pays 80%

[RC]

13. With co-pays, minimum charges and what ever, private insurance is better, how?

Not to mention denial of claims for profit reasons...

[YewNork]

6. Because it would cut into the profits of the insurance companies.

I think that the president would really like to implement a single payer system, but
he and most other politicians realize that the insurance companies would mount the
biggest propaganda campaign against them, and they would also cut off funding to any
politician that supported single payer, while increasing funding to those who oppose it.

Ultimately, I think single payer is Obama's goal, but he knows that we've got to take
baby steps to get there and not one giant leap.

[Shagbark Hickory]

10. I agree 100%

The insurance companies dicked over his mother when she was dying.
P.O., unlike our last president, is a very smart guy. He knows what's best for our country and he knows how to get it done.

[sandyd921]

12. Problem is those same insurance companies

are not going to allow us to have a public option that is worth anything and the corporatist Dems (many of whom have received political contributions from them) are likely to buy into this. I would actually be fine with a really strong public option that is very attractive to individuals and businesses. If it was a strong option it would likely crush the insurance industry. But of course the health insurance cartel and their minions (like Baucus, Ron Wyden, other corporatist Democrats, and of course all of the repukes) are not going to let this happen. If they do allow a public option at all it will be very watered down so as to preserve private health insurance. So this is the conundrum.

I believe that further pressure has to be put on the Democrats from the left for a true single payer system. This will provide for stronger push-back against the status quo options that are now being pushed. If a strong public option is then actually put on the table even some of the corporatist Dems will be able to rationalize voting for it as a compromise position. Right now they're being pushed in a direction in which the compromise is a weak public option or a mandate situation in which the choice is among private insurance products only (exactly the same as "Romney Care" in Mass, which has been a big failure).

[silverweb]

11. Because we'd like it.

I've read that insurance companies are fighting tooth and nail to kill any public option because people will like it too much and it will cut into their profits.

[mopinko]

14. i'm with you. and we should be able to invest extra money in social security, too.

lots of healthy people who go without insurance now. lots of people are tied to jobs they hate by insurance. small businesses would buy in, entrepreneurs would buy in. and the insurance companies do need to be wound down slowly. axing that many jobs, slicing off that much stock value. that is gonna causes some serious economic turmoil.
i think we also should be able to have the yearly maximum social security deducted from paychecks so that anyone who wants to can have the max retirement and disability.

[eridani]

15. Starting out asking only for a public option is a good way to guarantee

--that it will be a crappy dumping grounds for the poor and sick. Demand single payer, and if we get a public option it will be more likely to be good.

[Shagbark Hickory]

16. makes sense

roger that.

[eridani]

18. That scenario will never come to pass if insurance companies dictate the shape of the public option

They want to make it an underfunded dumping grounds for the poor and the sick which is set up to fail. Keep advocating single payer, and it is less likely that their version will get enacted. That would be a disaster which we must prevent at all costs.