to all of you who lament the demise of single payer... think about this

[Windy]

When the public option program goes into effect (hopefully) at a lesser cost than standard insurance, employers all over the country will opt to go with public insurance as opposed to private insurance as a result of cost savings. I believe that in the long run, we will end up with single payer as a result. Either that, or the private insurance companies will have no choice but to drop their premiums signficantly to compete. I can't see them doing that with the costs of doing business based upon their current rates.

Insurance companies eventually will become boutique options in the future, covering plastic surgery, chiropractic, etc...

[MrModerate]

1. Or like in Australia, where they offer "extras" cover that's a bit more than . . .

Just boutique, but which one can still get by quite comfortably without. Employers use extras cover to make themselves more attractive to potential employees by including it in benefits packages. It's kinda nice, not terribly expensive, and keeps insurance execs gainfully employeed thinking up marketing plans -- but not thinking up new ways to dump their policyholders.

[John Q. Citizen]

2. The house bill (The most liberal) calls for public option by 2013 and 10 million people in by 2020

Employers all over the country won't be able to go for the public option because it will be for individuals who have no other coverage from anywhere else.

Please read the house bill and quit dealing in flights of fantasy.

When our leaders threw the single payer advocates under the bus and wouldn't allow us intoi the process, they insured that the public option became the bargaing chip which they would bargain away, since single payer wasn't sitting on the table to bargain away.

Smart, eh, if you want less change. But bad if you want more change.

The mandate that forces everyone to purchase insurance and the public financing of private insurance companies with public tax dollars will insure that the private insurance companies are richer and stronger than ever before.

Why do you think they (the insurance industry) got a seat at the table? You don't think they are stupid, do you?

No they aren't. But we are.

[FormerDittoHead]

6. Here's a picture of their 'seat'

That's about what the rest of the market's doing.

The bottom line is the bottom line.

The ONLY meaningful reform in health insurance would express itself by making their profits (and their stocks) to go DOWN...

I'm not seeing it...

[John Q. Citizen]

8. That's a pretty good indicator that the insurance industry isn't worried a bit.

thanks for the different way of looking at the same thing, it's useful to me.

[WCGreen]

7. There will be no single payer...

Except Medicare. But then again, private companies are running those systems.

[kath]

19. Thanks for pointing this out - this "public option" is so watered down as to be a pathetic joke.

Only TEN MILLION people by 2019 or 2020??! - that's a drop in the bucket compared to what it should be.
So few people have paid enough attention to realize just how pitiful these bills are.

[Walk away]

3. What makes you think there will be a public option?

They are killing it now.

[Statistical]

4. Not based on reality.

One is the assumption that public option will be cheaper than most employees currently pay out of pocket.

For example my family health insurance is $50 per month for basic coverage or $200 per month comprehensive. However the true cost (employee + employer) is more like $800/$1100. I doubt the public option will be that subsidized. So my out of pocket costs will be massively higher with public option meaning I won't have the "choice" to switch.

Second the program prevents employers from dropping coverage without paying substantial fees. If the fees are anything like $500 per employee per month it doesn't cost much more to offer coverage.

To cut the cost of the program most plans seem to be pushing for big subsidies for the working poor and uninsured (which is good by itself) but I honestly don't expect any kind of real relief for the rest of us.

[Windy]

16. I beg to differ....

"Second the program prevents employers from dropping coverage without paying substantial fees. If the fees are anything like $500 per employee per month it doesn't cost much more to offer coverage."

I can tell you from experience in running a small business (my husband's electrical contractint firm), that it cost much more the 500 dollars per employee to provide healthcare. You're out of touch with reality.

[Statistical]

18. Small business maybe large business not so much.

The perceived benefit is worth the additional cost. Also the fee is more like $500 per month not a flat $500 and the employer is "off the hook" for life.

Most healthcare is already subsidized 70%-80% by the employer. I doubt (and reallllllllly hope I am wrong) that the "public option" will be subsidized that much for middle class.

When you combined the fact that most people will pay closer to true cost of health care via the public option with the penalty on employers for dropping coverage I just don't see it being a choice.

Either
a) your employer doesn't drop it because of the penalty and you have no choice.
b) your out of pocket costs are so high that the public option is no choice at all.

Now don't get me wrong I think it is better than nothing. For those with no coverage or paying private non-employer coverage, or small businesses with few employees or living near poverty line it will provide real value. For the rest of America, not so much.

[BlooInBloo]

5. How can something die, which was never alive in the first place?

One would do better to argue that it's coming into pre-natal form now.

[Sebastian Doyle]

9. depends on whether its a true public option or not

When I hear Howard Dean speak of the public option, its clear that his expectation of the long term outcome is the same as yours.

When I hear Chuck Schumer, the ADA, and other wishy washy types who were completely opposed to any change at all suddenly using the words "public option", I have my doubts. And when I hear anybody talking about "triggers" or waiting 5 or 10 years down the road, I yell FOUL!

Or if I hear anything about mandatory corporate coverage, I say do NOTHING, because that would only make it worse.

[HughMoran]

10. This IS the number one fear of the Republicans

...and why they want to throw themselves under a speeding train to stop this.

They have repeatedly said that insurance can't compete and this will push people to the public option.

In other words, they are scared to death that this WILL WORK!

[Windy]

15. Exactly... nt

[Kid Dynamite]

17. No they're scared to death of the IDEA

they KNOW this will fail, since it is designed to do so

[HughMoran]

22. Snarkasm noted

Won't you be the fool if it deos work.

(Just kidding, I've never met a DUer that admitted they were wrong, besides, you'll be long gone before this is implemented)

[Kid Dynamite]

23. If the definition of "works" revolves around scoring political points

then I guess you have a slim hope. If "works" means caring for the well being of all Americans, its so far gone its not even a foregone conclusion.

If your intimation is we'll all be long dead by the time "meaningful reform" happens, I don't doubt it

[kevinbgoode]

11. yes, but this ruins the insurance company game plan

I mean, after all, when medical bills skyrocketed and insurance companies tacked on higher deductibles and co-pays and ceiling limits, they suddenly found a way to make even MORE money by offering "supplemental" medical insurance. . .that's right. . .insurance which covers a portion of the stuff the original plan used to cover and doesn't any longer. . .and I'm certain their next plan was to roll out "supplemental-to-supplemental" insurance. . .so that households would be paying THREE premiums for health insurance each month.

The amazing thing to me is how so many Americans, who write checks or have withholding to donate to these companies every month, don't see how enslaved we are to them. We have no say in what they choose to cover. And worse, they have their fingers in every aspect of our lives. We need insurance for our lives, our travel, our cars, our boats, our homes, our property inside a home...hell, the gambit is so good that you can't even buy a damned small appliance without being pushed to purchase an "insurance" plan to get the thing fixed if it's broken (they just call it "extended warranty."

Seems to me that these scams are the ideal of Republican moneymaking schemes - to produce as little as possible (or nothing) in return for enslaving the public to pay them monthly. Then, when a claim is filed, use the small print to deny payment.

[dflprincess]

12. Steny Hoyer said that the premiums for the public option will be "market based"

and will not be priced to undercut the private plans because (wait for it) if they were it would mean people didn't have a real choice between public and private plans. They'd go with the public plans only because of price. (This was on NPR's "All Things Considered" last week - maybe Wednesday or Thursday).

Also, the public plan will not be opened to most of us for several years. It really looks to me like it's being set up to fail which will kill any shot at single payer. The for profits and their stooges in Congress will point to it and claim it proves "government" plans don't work. We'll probably be lucky if Medicare survives. I fear we'll be left with no plan for the elderly (just about the time I'll be eligible for it).

[ipaint]

14. The cbo in their latest estimate said the same thing regarding

insurance premiums. No significant difference between the public option and for profit insurance premiums.

[kath]

20. Even after !) YEARS it will only be open to a TINY minority of people - 10 million!

[kenny blankenship]

26. Good thing we avoided that "trigger" clause, huh?

[RC]

13. Why do people think that the Public Option would be the same as

private insurance is now, but with the government running things? That is what we want to get away from.
It done correctly it would be much more streamlined. The doctor does the doctoring, an underling fills out an electronic form, doctor gets paid. The money would come from taxes. The average citizen would have more money in their pocket because they would not be paying the insurance companies obscene premiums. They would be paying closer to the true cost, depending on income level. Need more money for the new system? Stop our wars and bring the troops home. Instead of spending money on war toys, spend it instead on space exploration. Hirer the newly unemployed war toys employees to build the needed space stuff. Less dead people if nothing else.
Oh, and the health insurance companies? Fraud, misappropriation of premium money, RICO!
What is so hard to comprehend?

[John Q. Citizen]

21. Have you read the actual bill that just came out of 3 committees in the house? Or are you

talking "in theory" here?

Because the actual bill as written that just passed three house committees would set up a public option by 2013, and by 2020 there would be 10 million people in it.

That would mean that the entire rest of the country would not be in the public option pool. The vast majority would be with private insurance companies.

That's what the bill says in black and white. You can read it online.

The house bill is likely to be the best bill we get because the Senate is far more conservative.

Hey, if wishes were fishes, we'd have a fish fry. But the truth is, we are going to subsidize private insurance companies and pass a law that people have to buy insurance from private insurance companies. That's wherew we going, like it or not.

[Juche]

24. Long term I think single payer is feasable

Here is my thinking.


The public option is cheaper than private options, about 10-30% cheaper. Since medical costs are a huge problem in the US people are going to gravitate to the cheapest plans that offer high quality care.

I found a study a while back that said around 100 million people would join the public option by 2020. The other 100 million would be in private plans and another 100 million covered by various government programs (medicaid, medicare, VA, SCHIP, etc). I don't remember who did the study, but with a public option we will have 2/3 of the public under public healthcare by 2020.

Various states in the US are pursuing single payer. California has passed single payer legislation twice in their congress, but governor Schwarzenegger vetoed it twice. When the dems get a single payer friendly governor in that state, then single payer has a chance. California has almost 1/9th of the entire US population in it so single payer in Cali will cover 36 millino Americans. Other large states like New York or Illinois are also working on single payer. States all over the US are under budget crisis, and single payer will save them money. I think Cali would save about $344 billion over 10 years with single payer. So as states go broke, single payer will become more appealing.

So combine the public option with states pushing single payer plans, and by 2020 you could have 75%+ of the public under either public healthcare (medicare, medicaid, VA, the public option, SCHIP, etc) or state run single payer plans in places like California, New York, Illinois, etc. At that point, it is easy to just collect those 70% under one plan and make it a single payer plan to cut costs even further by allowing more negotiations with drug and medical supply companies.



EDIT:

Shit, I didn't know the house public option was so wimpy. The 100 million figure was based on an open public option that was run well and as a result 20% cheaper.

Either way, I do think states are going to keep pursuing single payer plans.

[Kid Dynamite]

25. Windy

I think everyone would like to share your optimism, but in the face of the hard-hitting replies you've received so far, do you have any evidence to suggest that this your scenario is anything BUT unwarranted optimism?