I am with Billy in thinking that public option might be helpful.
In Montana, arguably one of the most libertarian states, we have a public
option for our workers comp insurance. It works well and coexists with private
insurers because it takes care of the segment the private insurers don’t want;
in this case, the large number of very small businesses. I can see how a
public option in health care would be helpful if it was crafted to fill a
similar role. I would be happier with the current bill if it had a
well-crafted public option that works like the MT workers compensation public
option.
Chris
-------------------------------------
Christopher P. Hahn, Ph.D.
Constructive Agreement, LLC
[email protected]
(406) 522-4143
P.O. Box 39, Bozeman, MT 59771
-------------------------------------
_____
From: [email protected]
[mailto:[email protected]] On Behalf Of [email protected]
Sent: Wednesday, March 24, 2010 12:58 AM
To: [email protected]
Subject: Re: [RC] Public Option
David:
I have no idea what public employees you have had the most dealings with
in your life but most ( not all, but most ) of the ones I have had dealings with
have been conscientious and have sought to do good work.
You have a point, entirely valid, about the BHO admin, but I'm thinking about
the people, professionals, who will actually carry out the work of the plan.
To REPEAT, this particular plan SUX. I do not like it. My argument is
essentially hypothetical since it is about public option.
But , while you make some points, at no place do you address the problems
which public option is most designed to remedy. Should an exec at Aetna, or
any other company , be paid $ 15,000,000 when their actions or inaction means
that
an average stiff must pay $ 500 per day for a hospital room, $ 5000 for a
medial procedure
that costs a doctor and his assistants $ 1000 to perform, or $ 50,000 over the
course of a decade for prescription drugs ?
Sure, aspire to wealth, it is legal and is useful in a hundred ways. But NOT
when
that kind of reward level means that I get shafted when I need surgery, or my
mother
gets robbed at surgical knifepoint, or Uncle Harry needs to shell out 25% of his
income on drugs that a pharmaceutical company sells at a 250% mark up.
Sometimes capitalism is legal robbery.
Mostly I like the capitalist system. But in all cases ? Not a chance.
Billy
================================================
In a message dated 3/23/2010 9:53:37 P.M. Pacific Daylight Time,
[email protected] writes:
Billy,
With the way this administration is working, I'm reminded of the Gang That
Couldn't Shoot Straight. I don't trust any administration with this. See how
wonderfully solvent Medicare and Social Security are. OOPS!!! Heck, just look
at the new deficit figures. And by the way, Government pay now leads private
sector pay in applications programming. So I could go get a government job and
make more money (couldn't look myself in the mirror any more, but hey).
The Toll Road argument is specious, the state owns both. Some highways are toll
until they are paid for: The Dallas-Fort Worth Turnpike, which is now the Tom
Landry Highway (I-30) and free. Under the control of the state of Texas for the
whole time. It wasn't ever private and then went public. It was public from the
beginning.
Citing the Huffington Post and a web site run by a pro-Obamacare group is not
persuasive to me. Not without hearing the old class warfare "evil Capitalist
Oppressors" memes in my head while doing so.
Frankly, executive pay like that is something to shoot for. I don't really
understand why it is wrong for the head of Aetna to make big bucks, but OK for
the head of GE to make big bucks. Oh, that's right, the head of GE donated to
Obama. I forgot.
I guess that all medical care should be charity driven.
But government will soon set pay guidelines and everything will be "fair." Just
like the old Soviet Union.
David
"A pleasant natural environment is a good - a luxury good, philosophical good,
a moral goody-good, a good time for all. Whatever, we want it. If we want
something, we should pay for it, with our labor or our cash. We shouldn't beg
it, steal it, sit around wishing for it, or euchre the government into taking
it by force."--P. J. O’Rourke
On 3/23/2010 10:33 PM, [email protected] wrote:
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
<http://www.insurancecompanyrules.org/pages/insurance_company_ceo_compensation_2006_2007>
average CEO compensation package 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
<http://www.opencongress.org/bill/111-h3200/show> health care bill, 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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