Understanding the Public Option

I spent several days reading the 1000+ current health care reform bill with the goal of breaking it down into digestible pieces. The truth is, the thing is clunky and refers to other bills that have to be cross referenced to get it, this does not impact the actual healthcare reform but makes it hard for me to just throw up some bullet points to the blog. There have also been several promised changes to the bill since written, and there is a 4 member bi-partisan group in Congress meeting with the goal of slimming down the current bill’s budget by a $100,000,000 with the goal of submitting a modified bill for review on Sept. 4, 2009. So it also seems like breaking down the bill at this point is a little dubious b/c it isn’t likely to be the bill they vote on.

Instead, here is a handy chart from Cure This about who is covered and how:

healthcarereformchart - Copy

Note that the bottom bubble is empty because the debate is still raging about a public option. As we know, the President has been waffling on the public option and several Democrats, including Speaker Pelosi have said that they will not vote for reform and/or it cannot pass without the public option while Republicans have argued both against the public option and against most of the reforms proposed.

Flow chart not your thing? Here is a basic explanation of how insurance currently works and how health care reform involving a government option would help avoid these problems:

Here are some basic corrections to misinformation about what is covered:

  • There may or may not be a public option when the bill finally goes to a vote, the president has waffled on this
  • pre-existing conditions will be done away with so you can get and keep your insurance no matter what
  • people will not be dropped from coverage for sustaining injuries leading to chronic conditions or the discovery of costly health issues
  • it provides insurance to uninsured and does not require that ensured people switch plans
  • it was projected to save money over time while initial costs were high
  • The bill does not cover reproductive health like abortion
  • it does not cover undocumented immigrants regardless of their age or years in this country
  • it no longer provides for end of life counseling – which was suppose to pay for people to have conversations about what kind of care they wanted in their final days and/or write out a living will, sign donor cards, etc.
  • things like elective surgeries , dental, etc. are not covered by this plan

For those concerned about the coop option replacing the universal health care plan:

  • for those familiar with coop grocers or child care facilities coop should make more sense – you buy in as a group and have say in what and how things are covered – to learn more about coop basics click here
  • coop will not cover all people who need health care in this country – see flow chart
  • coops are less likely to hold down costs of health care
  • coops do not offer a wide range of plans but do offer members the chance to ask for and vote on what they want to be covered
  • only examples of solvent coops we have are actually based on the HMO model – managed care has been managing to keep us from care for far too long as it is
  • coops do not have a very strong track record of survival – they were sponsored by the government in the 1930s and 40s but were riddled with problems including doctor strikes, failing to cover certain procedures and patients, etc. and ultimately lost government confidence

Obviously, I think several of the things and/or groups not covered by the current plan should be covered. I don’t think we can afford to skimp on the health of the N. American people regardless of citizenship or gender identity nor do I think that the government should be providing competitive health care that does not provide comprehensive women’s health, including reproductive choices. For me, it seems fairly simple: take out the clause in the medicare bill that says medicare is only for people 65 and older and replace it with a clause that says it is only for people, regardless of age, without alternative coverage. Problem solved.

7 thoughts on “Understanding the Public Option

  1. [this comment was edited by blog author to be on pt; remember communication guidelines – comments welcome but full length posts belong on yr own blog w/a trackback to our comment section if you want us to read them]

    NO CO-OP’S!

    . . .

    FDR proposed a Government-run health insurance plan to go with Social Security. To assure all Americans high quality, easily accessible, affordable, National Healthcare security. Regardless of where you lived, worked, or your ability to pay. But the AMA riled against it. Using all manor of scare tactics, like Calling it SOCIALIZED MEDICINE!! :-0

    So FDR established thousands of co-op’s around the country in rural America. And all of them failed. The biggest of these co-op organizations would become the grandfather of the predatory monster that all of you know today as the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry. And the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry.

    This former co-op would grow so powerful that it would corrupt every aspect of healthcare delivery in America. Even corrupting the Government of the United States.

    This former co-op’s name is BLUE CROSS/BLUE SHIELD.

    Do you see now why even the suggestion of co-op’s is ridiculous. It makes me so ANGRY! Co-op’s are not a substitute for a government-run public option.

    . . .

    An insurance mandate and subsidies without a strong government-run public option choice available on day one would be worse than the healthcare catastrophe we have now.

    . . .

    A healthcare reform bill with mandates and subsidies but without a STRONG government-run public option choice on day one, would be much worse than NO healthcare reform at all. So you must be strong and KILL IT! if you have too. And let the chips fall where they may. You can do insurance reform without mandates, subsidies, or taxpayer expense.

    Actually, no tax payer funds should be use to subsidize any private for profit insurance plans. Tax payer funds should only be used to subsidize the public plans. Healthcare reform should be 100% for the American people. Not another taxpayer bailout of the private for profit insurance industry, disguised as healthcare reform for the people.

    God Bless You

    Jacksmith — Working Class

    Twitter search #welovetheNHS #NHS Check it out

    (http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/)

    (http://www.youtube.com/watch?v=IbWw23XwO5o) CYBER WARRIORS!! – TAKE THIS VIRAL

    • welcome to the blog Jacksmith. I don’t know that I am ready to “let the chips fall where they may” as I think they are going to fall on the backs of the most in need among us and ultimately on those who may think they do not need as much but will find out differently when/if they become chronically ill and get exploited or dropped by their insurance. Now is the time to figure out what we do want and then let that be known to our representatives.

      Also it’s my understanding that Kaiser, not Blue Cross, suggested the HMO plan to Nixon who helped implement it. Either way, managed care’s emphasis on profit has denied far too many people needed care. I think most of us agree on that.

  2. Hi, Prof.

    Thank you for breaking this down. Mad props to you.

    As my Dear Brother was saying just the other day over lunch – all of us are going to need a public option health care plan at some point. The private option ends for many when employment ends.

    • good point. Your brother is absolutely right. with the national unemployment rate @ 9.7% (BLS) last month & the highest state unemployment rate is 11.4% (CA; LAT) w/ black and Latin@ unemployment as high as 13-14% (NY; NYT) we’re talking millions of people with long term lack of access to health care. Add that to the number of ppl who’ve become re-employed but are excluded from coverage b/c of “pre-existing conditions” and those dropped from their insurance thru loopholes or denied coverage of services or meds that lead to chronic debt & we’re talking the majority in this country. It’s ridiculous to believe there will never be a time when every person in this country will not need help/ a public option.

  3. For me, it seems fairly simple: take out the clause in the medicare bill that says medicare is only for people 65 and older and replace it with a clause that says it is only for people, regardless of age, without alternative coverage. Problem solved.

    Yes. Now, why do they not admit this … do they say it would be too expensive?

    • hi profacero. I think it depends on the “they”; Republicans have been complaining that it is both too expensive and will bankrupt medicare by expanding it beyond its purpose. This is where the rumor that ppl would “lose their medicare” comes from. I think Democrats have been concerned about expense with all of the plans but it makes no sense b/c they keep approving billions of dollars for wars in the Middle East without a single complaint about how expensive that is (except for Barney Frank who has been very clear we need to end the wars & re-evaluate defense spending in general)

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