David : Seems to me that criticism of private insurance companies in the medical sector --this has nothing to do with homeowner insurance, or automobiles, or anything else-- is entirely justifiable. Generally I favor market solutions to just about anything, but here is a case , financial institutions is another, where the market clearly has broken down and the best available solution is the public sector. The argument that a public option would destroy private insurance companies is false as I see it, for much the same reason that toll roads and toll bridges continue to exist despite the existence of the Interstate or , for that matter, other public highways or bridges. Consider these remarks from : Donald Cohen, Executive Director, Center on Policy Initiatives in the Huffington Post for March 23, 2010, originally from last year. " Since health insurance costs are rising at nearly twice the inflation rate, there couldn't be a more important time to eliminate non-essential overhead through healthy competition. Families and employers are being crushed under the burden of increased health care costs. Since the year 2000, employer-sponsored health coverage premiums have increased by 87 percent. It's no wonder, though, that the Health Insurers are frantically trying to head off competing with a public plan. Private insurance overhead and profits eat up 20% and more of health care premiums while Medicare overhead (and no profit) is closer to 3%. There is big money to be made in health insurance. The top 7 "for profit" health insurers made a combined $12.6 billion in 2007-- an increase of 170.2% from 2003. The same year, the _average CEO compensation package _ (http://www.insurancecompanyrules.org/pages/insurance_company_ceo_compensation_2006_2007) for these health insurance companies was $14.3 million. Pay packages ranged from $3.7 million to $25.8 million. " I simply cannot work up much or any sympathy for any business which is usurious in essence Moreover from what I have read elsewhere, insurance company profits grew even more than usual in 2009 despite the recession for the simple reason that several million people dropped their private plans because they could no longer afford them, and many of this pool of people were those with higher costs due to health issues. In such a case inflation of profits is immoral. There was also a Sanjay Gupta piece on CNN which showed the obscene prices for medical equipment that are commonplace in the "industry." And you thought that military toilet seats at $ 1000 were bad, that kind of pricing occurs up and down the line for everything from catheters to bedpans, Clearly hospitals, if not also doctors, don't give a damn about such pricing ( even if some do ) and are more than willing to require people to pay through the nose. Even if families are bankrupted in the process. In what way is that good ? The article below explains "public option" for anyone unclear on the concept. I am anything but anti-capitalist, but I am very much anti-gouging and do not regard the government as evil by design. So, when a government option can do a better job, OK with me. Today about 17% of GDP goes to health care, twice the rate in 90% of modern nations This trend has gotten worse with, ironically, more competition, or presumably more competition, from the time about 20 years ago when it stood at about 10 %. The nation cannot afford more of this nonsense and anything that will stop this is long overdue. Billy ---------------------------------------------------------------------
OpenCongress blog What is the Public Option? August 20, 2009 - by Donny Shaw The public option as proposed in the _House health care bill_ (http://www.opencongress.org/bill/111-h3200/show) , is a government-run health insurance plan, like Medicare, that would compete along side private insurers in a new Health Insurance Exchange that the bill would set up. The exchange is basically a place where people who aren’t on Medicare or Medicaid and don’t have insurance through their employers would go to comparison shop for a health plan. One of the plans available on the exchange would be the public option. Like all plans on the exchange, the public plan would have to meet certain minimum standards for care – minimum services that must be covered, mental health benefits parity, a fair grievance and appeals mechanism, etc. The public option and the private insurers on the exchange could still offer different levels of care – from catastrophic-only to comprehensive – but plans would be relatively standardized by type so that comparison shopping is easier for consumers. The exchange would be available to the public as a website and a toll-free hotline, and would be focused on making information about the plans more transparent. Conservatives argue that the government-run public option plan would drive private insurers out of business because, not being burdened by the need to generate profit, they could offer the same level of care at a lower price. They fear that this would happen to such an extent that eventually there would not be any private insurers left. Liberals on the other hand see the competitive advantage of a public plan as a way to bring costs down throughout the industry, thereby increasing the number of affordable health insurance choices for consumers. Without the public option there will be no real change to the current system that has kept health insurance out of reach for millions of Americans, they argue. Who’s right? The Congressional Budget Office (CBO), a politically independent, non-partisan government agency whose job is to provide economic data to Congress on the bills they propose, has done some _analysis_ (http://www.cbo.gov/ftpdocs/104xx/doc10430/House_Tri-Committee-Rangel.pdf) (.pdf) of the public option’s likely effects. This is as close as we can get to an unbiased, scientific take. Based on how the CBO sees the public option working, it’s safe to say that even if the conservatives are right and the goal is to crowd out the private insurers, as written into the bill, it’s not going to have that effect: Another significant feature of the insurance exchanges is that they would include a public plan that largely pays Medicare-based rates for medical goods and services. CBO estimates that the premiums for that plan would generally be lower than the premiums of the private plans against which it would be competing. Because all plans offered in the exchanges would vary their premiums to reflect the costs incurred in each area, the difference in premiums between private plans and the public plan would vary geographically— but on average the public plan would be about 10 percent cheaper than a typical private plan offered in the exchanges. That difference in premiums is itself the net effect of differences in the major factors that affect all insurance plans’ premiums, including their payment rates to providers, their administrative costs, the degree of benefit management they apply to control spending, and the pool of enrollees they attract (the effects of which would be partly offset by the risk-adjustment provisions described above).
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