Should Any Major Healthcare Reform By The Govt Include A Public Insurance Option?

Hi ohiogal, many of these so-called "congressional leaders" are beginning to argue for something they call "a co-op approach". In this unacceptable version (for me), there would be co-ops formed that would act in lieu of a government plan.

But the concern for me with the co-op alternative is that these co-ops would not have enough leverage, finances and/or power to compete with the private insurers. I feel that these "co-ops" would, in fact, become Co-OPTED (bullied into non-existence or "in name only") by the more powerful private insurance companies.

I don't see the co-op notion as an acceptable alternative to a government sponsored and controlled Health Care Optional Plan.

They only want a co-op because they are catering to the private sector's lobbyists. They'd be wise to remember who sent them to D.C. in the first place.

They only want a co-op because they are catering to the private sector's lobbyists. They'd be wise to remember who sent them to D.C. in the first place

Rest assured each Congessman and Senator representing his or own district or state knows who elected them. I think that some people forgot who voted for those representavies and the president, a large percentage who are independents.

Rest assured each Congessman and Senator representing his or own district or state knows who elected them

Really? Then why is Boehner acting like a bone head? Cuz the majority of his district wants a public option.

Really? Then why is Boehner acting like a bone head? Cuz the majority of his district wants a public option

First let me say I am an

independent and have never had party affiliation. I have seen parties rise, parties fall, some veer to the right, some to the left, predictions that X party is dead, or that party Y is the "majority" party.I am concerned that one party has the other over a barrel and that the Republicans are in disarray, perhaps because Bush pushed the "boneheads" to the far right with some in the party thinking he didnt go far right enough.

As far as the polls and the public option. Obviously it will be seen as a sell out if there is no public option because lobbyists influence politicians, nothing new there, been going on since parties existed. 70 pct of people in the U.S. have expressed a desire for a single payer system, thinking that rates will go down and all their troubles will disappear. I could just as well asked the public, who wants a new car? or I could say who wants a new car and pay for it? Yes simplistic analogy but some sort of truth in there. I actually did a poll on the vine and asked How many people want single payer? Results 80 pct yes. Next poll I did with 400 responses. Would you be willing to pay a tax on gas for universal health care for all, result 75pct no. Taxes as you know get people riled. Did another poll on the vine, What kind of tax would you be willing to pay for health care for all. Result: most said, tax someone else. Its all well and good to express a desire for something but it has to be paid for. I am willing to pay for someone else and I did in the U.K. for 10 years, and 6 years in Australia. System in the U.K., my opinion, I let you guess, as I bought private coverage. System in Australia, excellent until they ran out of money and had to bring in private insurers and 43 pct now have private. The rest are on single payer system but want the private coverage. Unfortunatley you have to pay for the private coverge. Put in a public option, people will be happy with it for awhile cause they didnt have coverage before and ten minutes later will want to know why they cant have the private coverage like the fat cats have. It is a recipe for disaster. And to make it more insulting the "cost savings" that they found all of a sudden from Medicare are going to be diverted to pay for the new program while Medicare is going down the tubes. That is a diversionary tactic by the government. We can fix what we have by regulating insurance companies, limiting their profit, making them take everyone, making coverage mandatory and subsidizing those who can afford it. To make sure the insurance companies dont make a windfall on all those new subscribers enact a windfall tax on that.

Back to the Republican Party, seen as the party of no. At least 2 reasons for that !. They dont have the votes so why bother coming up with any plans that have absoulutely no chance of passing. 2: Sometimes as a parent you just have to say no, as in Johnny get your hand out of the fire, so that no simply means no.

Hi Lampell, thank you for your careful analysis. When you say: ".. Back to the Republican Party, seen as the party of no. At least 2 reasons for that !. They dont have the votes so why bother coming up with any plans that have absoulutely no chance of passing. 2: Sometimes as a parent you just have to say no, as in Johnny get your hand out of the fire, so that no simply means no...."

But aren't these Repugs elected to represent their constituents? Whether they can win their viewpoint or not? Why are they getting PAID handsomely to just sit and say "no". So, in other words, when one party is in control, the other party has no responsibility to represent their constituents? Also, note that "johnny get your hand out of the fire, is a disciplinary function of raising children, but these Grown Men are not children. And if what you say is true about "you just have to say no", you are saying No just to be saying No. That's unintelligent to say the least. I don't accept that narrow view because if this is the case, then why do you need representatives of the minority party in the first place? I know "this is the way it has been done" but it doesn't make it right. I would expect my representatives to offer SOMETHING, even if it gets shot down.

So I guess it is true: Americans get the type of government they deserve!

I would expect my representatives to offer SOMETHING, even if it gets shot down.

So I guess it is true: Americans get the type of government they deserve!

It would be nice if the representatives in Congress acted like adults. The Republicans that are left, I believe, are representing their constiuency by saying no, to deficits, and the type of ill conceived plans put out by the party currently in power. They have come up with their own plans, which in my opinion are also a bit ill conceived. It remains to be seen if the party in power are representing their voters since many of them are independents, not Democrats. The largest bloc of votes are centrists and perhaps they are the ones getting short changed from the current thought of We won, you lost.

Oh!

;-)

If the Senators and Congressman in the Federal government have "government health insurance" then we should too....

Actually they have private insurance purchased through a pool

Actually they have private insurance purchased through a pool

Paid by who again?

Paid by who again?

I dont understand the question, I thought you were intimating that the congressmen had some sort of government insurance.

I thought you were intimating that the congressmen had some sort of government insurance.

I'm sorry. It is my fault. For a second there i thought the tax payers paid their salaries, provided them the security of their insurance pool, and put them in a position that they can vote on how to use our money to provide a themselves a gold plated benefits package.

Apparently I must have confused a glorious tax-paid public official right to healthcare with a run of the mill lowly un-deserving of non-right to healthcare average american serf.

How can there be "major health care reform" without a public option or single payer

Eaisily, the objective for reform was universal health care, everybody covered. You dont need a government program in order to regulate what is in place, make the companies take everyone, make coverage mandatory, limit insurance companies profits. With a new federal agency we will in a sense be robbing peter to pay paul as some of the so called savings will be coming from Medicare, thus further stressing that program, which the government admits will be going broke in a few years. Its a tactic of diversion, wins more votes building a new bridge when the old one needs fixing.

How can there be "major health care reform" without a public option or single payer?

Easy. See my #5.

And here’s the best part. The government pays up to 75 percent of the premium. That government, of course, is funded by taxpayers, the same taxpayers who often cannot afford health care themselves

Hate to be in the position of defending congress, however if we pay them nothing, it would encourage even more corruption. We pay for firemen, policmen, military, and if the government has its way half of the country will be federal employees

I recently changed statute. I was self-employed; then last January I began drawing an "asbestos pre-retirement".

When I was self-employed, I paid into two entities. The first, covering part of my health-care expenses, was a sort of mutual association of self-employed people. I had no choice in the matter. The second entity, covering the rest of my expenses, was a huge Italian private insurance company that operates all over Europe, which I chose among dozens of offers.

When I changed statute in January, my "pay in" automatically shifted to two other entities: the "salaried employees" regime for base coverage, and a mutualist insurer of my choice for the complementary.

To ensure that I am never "between chairs as the music stops", the former entities continue to accept charges until the end of 2009.

When I go to a doctor, or to the pharmacy, or to a lab for a blood test, ... I simply present a "smartcard" (exactly the same as the microprocessor-equipped credit cards that we have used for twenty years). The bill is automatically sent to both payers, and my medical history is updated.

This is real-world experience. French health-care system.

I wasn't implying that we shouldn't pay Congress (although I think it's stupid that they vote for their own raises). I was saying that they have EXCELLENT coverage for a very reasonable price. We should ALL have that kind of coverage.

Just because Obama hugged a cancer patient today does not mean his pushed plan is the answer

Yeah there isn't any way Obama would ever be sympathetic to cancer patients.

Why do you say that "Government [control] will doom us all"? Do you know this for a fact or is this just your opinion? Why do you think the government needs to insert itself into this fray? My answer: it is not being run as it should by the private sector. Favorites (rich people) are being given preference, ie., lower rates proportionately, than others making less. Other "favorites" i.e., no pre-existing condition, are also being favored. EVERYONE SHOULD be favored if we are ever going to get to a healthy environment and world.

Favorites (rich people) are being given preference, ie., lower rates proportionately, than others making less. Other "favorites" i.e., no pre-existing condition, are also being favored. EVERYONE SHOULD be favored if we are ever going to get to a healthy environment and world.

You can have universal health care without government run programs. Thats what we have regulations for, limit profits, make them take all comers, make coverage mandatory. As far as the rich are concerned there will always be rich people who have access to things an avereage person doesnt. If you have acess to care at a reasonable price we wont worry about what those things are.

I will agree with you on the last statement you made: "If you have access to care at a reasonable price we wont worry about what those things are."

Me neither; all I ask for is fairness.

I will agree with you on the last statement you made: "If you have access to care at a reasonable price we wont worry about what those things are."

Me neither; all I ask for is fairness

Now the fairness part is going to be tricky, even with countries with single payer systems with private options there will always be those who have better coverage or more comprehensive coverage. One step at a time. Everybody will have a car, just not the same car. Better than we now have with people still walking:) Sorry for my analagoies but I was in sales for 35 years:)

Lampell, I laughed so hard when I saw your response regarding "fairness" :-)

I, too, know that is the tricky part. It always is. But I guess when I ask for fairness, I really mean "get as close to it as you can for me", or in other words, don't take me for a complete fool.

And I don't mind the analogies either, if that's what it takes to get your point across. No foul meant, no foul taken.

And I don't mind the analogies either, if that's what it takes to get your point across. No foul meant, no foul taken.

Thank you and just for the record I was never a car salesman:) I was an investment banker who gave presentations to people all over the world, my aim was to make the point as fast as I could without people falling asleep:)

To #9: Why don't YOU come up with an acceptable Health Care Plan that covers everyone, and email it to your Congressman to be presented as an alternative?

I see that you are another one of those people who want us to "WAIT"; On What????The Repugs are not willing or unable to come up with a solution, you don't offer one, so who is left? The person WE elected to bring us solutions, President Barack Obama- in spite of the Repugs unwillingness to help him/his Administration.

You are quick to point out the "faults" of the President, but what have you done for your country lately- besides whine and complain- and say "no" to everything!?

So do me and everyone else a favor: lead, follow or get out of the way!

The problem inherent in the private health insurance industry, being controlled by bean counters rather than physicians, is that the people who most desperately need coverage are the people who are least likely to be accepted into an insurance program

Unfortunately bean counters exist in government programs. And not all insurance companies are the same, as obviously everyone has had different experiences. I did experience single payer systems as I lived and worked overseas for many years. Not saying bad or good, but they have a budget like everyone else. Bottom line is obviously we need reform, with regulations on those companies, however given our current situation it is easier to fix what exists than to start another program with "cost savings" from Medicare which is going broke.

ScienceGuy

Well said good job

Yes, always the "beans" $$$ first!

They can stay in business, but they will have to offer a quality product at an affordable price. Unfortunately, many of these companies are more interested in millions in pay, bonuses and perks to top executives than in quality care. They might have to take a pay cut, but even if their pay, etc., is cut in half, they will still be better off than 98% of us. But, I guess I'm asking too much. (Imagine an insurance actually paying a bill without trying to fight it! Imagine a company actually agreeing to cover someone who needs it. Wow.)

But, I guess I'm asking too much. (Imagine an insurance actually paying a bill without trying to fight it! Imagine a company actually agreeing to cover someone who needs it. Wow.)

I do not know what state you live in as each state has different regulations. In California they have a claims/payout ratio which is publicized, anything below 85 pct is unacceptable. Forget about the comparison of Medicare and private overheads, being 3 pct vs 13 pct. Medicare doenst count fraud as overhead, they just pay it out. Private company handles fraud better ( not talking about denying claims but double billing, bills for non existent services etc. Also private companies pay tax which raises overhead. Also many insurance companies are still not for profit.

Now as far as never paying a claim in your experience, it would be odd to stay with a company that never paid a claim, it might be your experience, who knows.

Here is my experience with the same company for 20 years, and I pay for it myself, being self employed ( actually retired, dont need to work much). Ill keep it short and only cite 3 examples. Dec 2000, my wife needed surgery on her back, scoliosis, 48 degree angle, was about to crush her organs. She interviewed 3 surgeons, picked the one that seemed to have the best qualifications. Scheduled surgery with that one, 2 days later insurance company approved procedure, one week later had 11 hour surgery having 13 vertabrae fused. Received material from insurance company before on how to handle sugery before and after procedure, insurance paid for a class regarding same. The bill just for the hospital after the company negoiated the rate down from the provider, 156,000 dollars. All durable equipment paid for afterwards, including a nurse to visit our home to see how things were progressing. OK that was one. Next: 2006, for my birthday my wife scheduled back surgery for me, which was arranged with surgeon one week earlier after going through physical therapy and being told surgery was the only option. I couldnt walk more than 4 feet for 6 months due to the pain in my legs so I had to have back surgery to relieve pressure. Same class, surgery was sucessful, only spent a day in the hospital, had follow up physical therapy etc. bill just for one day in hospital including surgeon fee, 50,000 dollars. Took surgeon one hour to obtain clearance with insurance company... Third and most minor incident, wife neede 14 stitches late on Christmas eve due to accident in our garage. Went to emergency room, they did stitches, gave her a pain pill and one special type of bandaid. We have high deductible of 4000 dollars to save cost. Bill came from hospital, 4000 dollars, insurance company sent explanation of benefits and said only pay 2000 dollars, insurance company saved us 2000 dollars. We still were puzzled by 100 misc bill. Went to the hospital, talked to the clerk who said it a straight face, well that was for a bandaid, to which we said WTF? to which she said , well sir we have to make up the cost somewhere as Medicare doesnt pay us enough and we dont get paid for people who come in here with no insurance.

Well, Lampell, you are lucky. It sounds like you have a decent insurance company and you have CHOICE. Also. you also live in California which actually has consumer protections in place. I wish some of their laws would be enacted in other states. (It was real shock when we moved out of the state.)

Yes, if I bought my insurance privately and had a company that did not play claims, I would switch insurers. However, most people get their insurance through their employer and have limited choices. Insurance companies know that and can play their games. My father once needed a test done and his PCP, neurologist and vascular surgeon all agreed that a proper treatment plan could not be made until he had that test; his insurance company denied it saying it was too expensive. (Note, they did not say it was unnecessary, just that it was too expensive.) Finally, I told him to repeat all the doctors who said it was necessary. And then add that his daughter the nurse and his son-- the lawyer -- also thought it was necessary. He got the test. I have no doubt the it was the "my son the lawyer" that got the test approved. And, the test showed he needed surgery to save his life (and he did.) I needed some minor surgery and got pre-approval and then the insurance company denied payment. It took almost a year to get them to pay and my account ended up in collections. (This happened around the time my husband died and my family income dropped by 60% I had no extra money to pay the bill, but I had to find a way. I have since changed jobs and insurance companies.)

Yes, Medicare does get a discount from hospitals, but so do private insurance companies. I just looked at a statement from my doctor's office -- they had a 50% discount given to the private insurance. (They don't contract with TriCare, so I have to bill them seperately.) So, the increase in some charges are to make up for ALL discounts, both Medicare and private.

And, yes, you read right, I do have two forms of medical insurance -- and I still want universal coverage, even if it means I get less. I am a Christian and believe we all have a responsibility to the "least of my brothers."

And, yes, you read right, I do have two forms of medical insurance -- and I still want universal coverage, even if it means I get less. I am a Christian and believe we all have a responsibility to the "least of my brothers."

Yes I too believe that there should be universal health care, what I dont want is a single payer system that could wind up like Medicare which is going broke. I would hate to think that I paid Medicare tax for 40 years and be told, just when I am eligible, that the rates went up, the deductible went up and less procedures are being approved because the "savings" from Medicare went to a new federal agency.

What would happen, Lampell, if we required everyone to be a part of the system, including young, healthy individuals? It might actually keep the system solvent. Currently, the people enrolled in Medicare are older and sicker than the average American. If we pool everyone, young and old, healthy and sick, it would keep prices down by spreading risk -- a basic principle of insurance. (And the young and healthy may not need insurance now, but someday they will, if they live long enough.)

What would happen, Lampell, if we required everyone to be a part of the system, including young, healthy individuals? It might actually keep the system solvent

Probalbly not since there wouldnt be enough doctors around. But here is the real reason we cant expand Medicare. It took years and years of people paying Medicare taxes in order to build up reserves so Medicare could pay claims which go up and up each year. When Medicare was started in 1965 the life expentancy was around 65 so the program was designed on a shoe string budget as no one expected to have that many people covered. To subsidize everyone as in Medicare would be an astromomical figure. Fix what we have now, regulate the insurance companies like utilities, make them take everyone, make covererage mandatory and subsidize those who fall below a certain income. Americans want single payer but dont want to be forced into purchasing insurance. In Australia you dont have a card, you dont get service, period.

Okay, I can agree with some of that (DEFINATELY regulate insurance companies; they won't regulate themselves), but I think that allowing younger people to buy into Medicare would help Medicare in the long (and possibly short) run. Notice I said "BUY INTO". Have people under 65 pay premiums based on income, somewhere between 1 to 5% AGI, for Part A (people over 65 can still get that part free). Have another premium for Part B (like they do now, but perhaps a little more for the under 65 crowd) and provide REAL prescription drug benefits rather than the current wind fall for big pharma (again, for a small premium). So, younger people would have a choice between what their companies offer (if any), a private plan or the government plan. Anything to make things better.

but I think that allowing younger people to buy into Medicare would help Medicare in the long (and possibly short) run.

Medicare already pays doctors and hospitals substantially less than the private sector does. Many doctors dont even want to accept Medicare as it is, making all their patients Medicare patients wouldnt really help them out to much. They did just that in Australia when I lived there back in the late 80s. In 1984 they created Medicare for all, even calling it Medicare. Worked pretty well for awhile. Then the doctors and hospitals threatend to go out on strike. The govt could have raised taxes again and given in but they wound up doing something else. The asked private insurance companies to come back in and as a result 43pct of the population now has private coverage and pays for it. They get a tax break for doing so. The rest are still on Medicare which is now subsidized to low income earners on a sliding scale. Of course now those on Medicare want to know why they cant have the good coverage that the other 43pct has. Nothing is easy.

Medicare already pays doctors and hospitals substantially less than the private sector does.

What do you mean by "stastantially less"? My private insurance extorts a 50% "discount" from my doctors. (But, I will agree that Medi-Care should increase their reimbursement rates. Perhaps with a larger pool, they will have enough money to do that.)

(But, I will agree that Medi-Care should increase their reimbursement rates. Perhaps with a larger pool, they will have enough money to do that.)

They havent raised their reimbursements for years and are being threatened with lower rates after 2011. It is a matter of record. A larger pool vis Medicare will not affect anything since Medicare already has a fixed pool of customers, over 65s

Medicare already has a fixed pool of customers, over 65s

That's the point, Lampell. These are the sickest and most expensive population. If we increase the pool to include younger and healthier subscribers, the per capita cost will decrease. This will allow more money into the system and therefore we will have more money to use for reimbursements (since the overhead is so low for Medicare compared to for-profit organizations.)

If we increase the pool to include younger and healthier subscribers, the per capita cost will decrease. This will allow more money into the system and therefore we will have more money to use for reimbursements

It is going to depend on how the government forces people to obtain coverage. Please read the link below to see what happened in Mass, as people are playing with the system. I fully support healthcare reform, the devil is in the details. Govt can make rules and people figure how to get around them.

http://lampell.newsvine.com/_news/2009/07/12/3019092-the-massachusetts-health-mess

There was no public option universally available in Mass. That is why the program failed. That is why we cannot have healthcare reform without a public option.

There was no public option universally available in Mass. That is why the program failed. That is why we cannot have healthcare reform without a public option

That is not why it failed, it failed because they didnt budget for it, just like the House is trying now, the difference is that the U.S. can print dollars, Mass cannot

I don't know how else to say this, but I don't want private insurance companies and their greedy owners to get a PENNY MORE of my money. I have seen what these greedy a$$holes have done to the U.S. economy and it makes me sick. I don't trust their shenanigans and lies, whatever they say.

We have a government program called Medicare, that consistently underpays doctors and hospitals so that many of the doctors wont take it anymore and if they do they charge over and above what Medicare allows and passes it on to you the patient. What is also scary is that Medicare is being allowed to go broke all in the name of reform. Not to mention Social Security and Medicaid whose benefits are being cut as we speak.

But if ALL of us are being asked to "tighten our belts", this would include doctors and hospitals too. And, my way of thinking is, IF DRUG/PHARMACEUTICAL COMPANIES WOULD NOT CHARGE THE EXORBITANT, OUTLANDISH FEES THEY DO, then the government would not have to "underpay" because the rates would be less. This, in turn, would mean that more doctors would accept this plan. It resembles the which came first scenario, the chicken or the egg? - or "catch 22". Somebody has to be first to try something NEW. It can't keep going the same way. Everyone loses.

IF DRUG/PHARMACEUTICAL COMPANIES WOULD NOT CHARGE THE EXORBITANT, OUTLANDISH FEES THEY DO, then the government would not have to "underpay" because the rates would be less.

Lets face it there are a lot of ifs out there. Wage and price controls work for awhile, then pressure builds up after time and prices go up at an accelerated rate. Unfortunately who is to say what the proper rate should be for a doctor visit or a test. There are doctors who barely make a living and charge "reasonable" rates and doctors who lost money in the stock market trying to make up thier losses so they can afford new golf clubs.

Hi all, in response to Sgt: But as you can plainly see, the private health insurers, do not want ANY any competition; they want to hold onto the monopoly - forever!

Hi all, in response to Sgt: But as you can plainly see, the private health insurers, do not want ANY any competition; they want to hold onto the monopoly - forever!

Perhaps in the state where you live there is little competition, in California there are dozens of insurance companies who definitely compete on rates and service. Generally the not for profit companies have lower rates than for profit concerns. If the governemtn comes in with a new agency, with unlimited funds, yes they will drive out the private companies, which will probably make you feel better for about a year, and then you will really have a monoploy that will raise rates so fast you wont know what hit you.

It is known as Intelligence and Logic. We haven't had this type of leadership for so long, or ever before, that it is hard to believe and understand at the moment. You can also find it referenced under K.I.S.S.

We haven't had this type of leadership for so long, or ever before, that it is hard to believe and understand at the moment.

No, I do not agree with that statement.

Jsbach, it seems to me they're looking at the cards on the table and knowing that health care as it stands today will not continue. Legislators have made it very clear to the health care insurers that business as usual won't continue, and that they are going to get some form of mandated health care, in one aspect or another. Walmart is being proactive in supporting this because it's the least damaging to their bottom line. If they are forced by law to hire a private based company, that would cost them billions. However, if they were forced to enroll everyone in a government run program like everyone else , then their cost is minimal. So in essence, Wal-Mart has seen the writing on the wall, and picked to support the option that costs them the least amount.

Wal-Mart sounds smart to me. And tell me again, why aren't others this smart?

And to jsbach, your disagreement with my last statement about our President's type of leadership, does not surprise me at all. And it is your right to disagree with anything I say and vice-versa. You did not hurt my feelings in the least bit, but it seemed to "rub you the wrong way".