Heritage Foundation On Fair Public-Private Health Competition: ‘The Design Features Are Correct’
Heritage Foundation On Fair Public-Private Health Competition: ‘The Design Features Are Correct’
Len Nichols’ “modest proposal” for a competing public health plan requires the public plan to play by the same rules as private insurers. Operating within a new framework, both plans would offer standard benefit packages, “guaranteed issue, guaranteed renewal, no pre-existing condition exclusions, modified community rating, risk adjustment.”
The public plan would also adhere to the following conditions of fair competition: it would have to be actuarially sound, would not leverage Medicare to force providers to participate or use Medicare payment rates, and would have to adhere to the same rules regarding reserve funds.
Today, during a conference call with reporters, the Heritage Foundation’s Stuart Butler — a vocal critic of the public option — agreed with Nichols’ framework in theory, but argued that government would rig the system in practice:
The design features are correct, this theoretical model of what you would have to do … but what I’m very skeptical if one sees this on a number of states whether one sees the federal government giving up control of public plan or whether they will just feel the impulse to manipulate it. I just can’t imagine [Rep. Pete] Stark and [Rep. Henry] Waxman and others giving up the option of giving up that plan. … I think they will start relaxing requirements on the public plan… maybe you don’t have to finance yourself completely like private plans do.. We’ll just start rewriting the rules there…They will start relaxing them, in the public interest.
“In my view, the right answer is to push or require the private sector on the state level to come up with some arrangement through private plans which is the functional equivalent of the public plan model,” Butler explained on the call.
But Butler’s argument — let the marketplace handle it — kind of misses the point of the public option. The marketplace has contributed to skyrocketing premiums and huge cost-shifts to families through higher deductibles and copayments. It’s what needs reforming. In fact, even if the private market somehow self-designs a framework of regulation, it would likely not lower costs as quickly as public/private completion.
This is because the whole point of allowing a public plan option to compete with private insurers is that if you reform the way Medicare and the public option reimburses for services (move away from fee-for-service and towards bundled payment, primary care, and care coordination) and if those programs become more efficient, the private insurers — who are now competing directly with the new public plan — would also have to adopt more efficient payment practices.
By using the public plan as a vehicle for reforming the private insurance market, you can dramatically lower health care costs. My fear isn’t that the government won’t be able to keep its hands off the public plan; I fear that without a public plan we won’t be able to lower our skyrocketing health care costs and address the economic crisis.
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Of course you want the government to manipulate their public plan, just as you would expect citizen-like private insurers to adjust reimbursements such that we end up with a reasonable number of general practitioners and gerontologists, for example as the ‘boomers retire, and no glut of unneeded specialists. Sadly, the private insurers have been too busy concentrating on trying to lobby the public option away instead of taking actions to reasonably lower their expected costs years down the road, because Wall Street regulators have been allowing the kind of takeovers and leveraged buyouts which reward little more than next quarter’s profits.
March 23rd, 2009 at 12:46 pmOn Wednesday, April 1, a briefing and forum will be hosted by Physicians for a National Health Program and the Leadership Conference for Guaranteed Health Care. It starts at 2:00 p.m. in room 2226 of the Rayburn House Office Building, and will run for a couple hours until 4:00 p.m. The topic is “National Lessons for Health Reform: U.S. Health Insurance Examined,” and it will explain why the public option — such as Stark’s bill or Conyers’ H.R. 676 — that the president has mentioned so many times during the debates means the least cost for consumers, and therefore the most government revenue, and thus the best budget scoring. It is intended for congressmembers and their staff but is open to the public, and light refreshments will be served. For headcount purposes, please RSVP to Jessica Yarbrough, jyarbrough at calnurses dot org, or (202) 974-8300.
March 23rd, 2009 at 4:30 pmFinally, the time has arrived to fix Americas Healthcare crisis, and Americas healthcare nightmare. Hundreds of thousands of you are killed needlessly every year by your healthcare delivery system in a rush to profit. And because of a rush to profit Hundreds of thousands more of you are needlessly dying from treatable illness that people in other developed and civilized countries don’t DIE! from. Rich, middle class, and poor alike. Insured, and uninsured. Men, women, children, and babies.
Additionally, thousands more of you are driven into financial ruin, and bankruptcy just because you, or one of your loved ones got sick or injured. And all of this is happening at a time when America spends twice as much of it’s GDP (Gross Domestic Productivity) on health care than any other country in the developed world. Individual Americans spend about ten times as much on health care as any other people in the developed world. This is a CRIME AGAINST HUMANITY. AND IT MUST END!
But before we can truly fix this healthcare crisis and disgrace, everyone needs to clearly understand what the problem is. And everyone needs to clearly understand the real enormity of the problem. The problem is that HEALTHCARE AND MEDICAL DELIVERY IN AMERICA IS SEVERELY CORRUPTED AND COMPROMISED BY GREED! AND THE PRIVATE FOR PROFIT MOTIVE. And it is corrupted, and compromised IN EVERY ASPECT, AND EVERY PLACE OF HEALTHCARE AND MEDICAL DELIVERY. Unfortunately for all Americans, compromised healthcare ALWAYS results in needless suffering, injury, disability, and or death. Which is exactly what is happening now in America in shocking numbers.
Health care is NOT! a private for profit business. Healthcare is an essential public service. Like police, and fire. And healthcare is also a human right! PRIVATE FOR PROFIT HEALTHCARE IS AN OXYMORON, AND AN IMMORAL AND UNETHICAL PERVERSION OF HEALTHCARE AND HUMAN RIGHTS.
So how do we fix this healthcare disgrace? I believe the fix for Americas healthcare disaster is essentially the same thing that every other developed country in the World has essentially done. “NOT FOR PROFIT, TAX PAYER SUPPORTED, SINGLE PAYER, AUTOMATIC, FREE UNIVERSAL HEALTHCARE FOR ALL”. Essentially HR676 (enhanced, and improved medicare for all). Just like every other CIVILIZED! country in the developed World has. There is no other way to truly fix and reform our current disastrous healthcare delivery system.
All Universal health care systems work best when everyone participates. But I know that the healthcare lobby, and some politicians will try and undermine “Not For Profit, Tax payer supported, Single payer, Automatic, Free Universal Healthcare for all” by falsely claiming that it will limit your choice, and require you to participate.
So, I propose that everyone be included in the national plan unless they choose to opt out. If you opt out and need medical care the national plan will insure your provider that they will be reimbursed under the rules for members in the national plan. But those who opted out, and their insurer will be responsible for the FULL! cost to the national plan for providing your care if you or your private insurer fails to reimburse the provider or the national plan in a timely manor to at least the standards of the national plan.
Including reporting you to credit agencies, withholding of taxes, leans, and garnishment of wages for unpaid medical bills. Just like you have now under private for profit healthcare, and private for profit health insurance.
Further, people who opted out will be required to provide proof of financial responsibility for future illness or be required to participate in the national plan. And everyone with children will be required to participate in the national plan. Or provide proof of insurance coverage on each child to the standards of the national plan. It will be against the law to report anyone in the national plan to a credit agency for unpaid medical bills.
Frankly, only a dope would want to opt out of the national plan and opt to keep our current disastrous private for profit medical, and insurance plans. But they will be free to choose. The most important thing is that the vast majority of Americans that want the protection, benefits, and higher quality of a universal national plan have that choice.
You see, one of the most important aspects of a universal healthcare system is easy access, and patient protection. This is accomplished by having a single payer without a conflict of interest in patient care. And by having a payer who has the power to enforce minimum standards of excellence in healthcare delivery for everyone in the plan. This is much of what Medicare does now for senors. “Aeger Primo” (The patient comes first). Unfortunately in our healthcare system the patient comes last. We are just a peace of meat to them. Cash cows to be slaughtered for profit.
So this is IT! my fellow Americans, My fellow human beings, My fellow World Citizens. And my fellow Cyber Warriors. :-) The time has come. D day. H hour. HEALTHCARE REFORM THIS YEAR! Let no one stand in our way. Contact your representative and tell them you want “Not For Profit, Tax Payer Supported, Single Payer, Automatic, Free Universal healthcare for all. And tell them you want that choice now. Tell them you want President Obama’s budget passed without delay. President Obama’s budget is brilliant. And exactly what is needed now.
President Obama, and his allies will need all the support you can give them. The healthcare lobby will try to take out his people if they can, like they did with Tom Daschle and Nancy Killefer. And they will try to neutralize President Obama’s popularity, and political power. Or they will try to take him down someway. Don’t stand for it. If they attack him. Go after them ten times harder and remove them from office. We had an election. And you the people chose President Obama’s leadership, and change agenda. Let no one in government disrespect the will of the American people and remain in office.
SPREAD THE WORD! And talk it up with your families, friends, and coworkers. Keep ratcheting up the pressure until there is a ROAR! across America for “NOT FOR PROFIT, TAX PAYER SUPPORTED, SINGLE PAYER, AUTOMATIC, FREE UNIVERSAL HEALTHCARE FOR ALL”.
Let’s get this healthcare reform done now my fellow Americans. This year. Take no prisoners.
God Bless All Of You
Jack Smith — Working Class :-)
http://jacksmithworkingclass.blogspot.com/
March 28th, 2009 at 10:35 pm(http://jacksmithworkingclass.blogspot.com/)