Single Payer "IS ON THE TABLE"...here's how...kinda, sorta...

[Bread and Circus]

First off, just to wave off the "you're a freeper" comments I get here from time to time (god knows why, I consider my self a proud unabashed liberal), let me unequivocally state that "I AM 100% for true/real/bonafide SINGLE PAYER HEALTH CARE" here in the good 'ol US of A.... YOU-ESS-AY! YOU-ESS-AY!'

Again... I AM 100% for true/real/bonafide SINGLE PAYER HEALTH CARE!

As a Family Doctor and someone who has studied the issue back since I was in college (as a psych and sociology major), I'm firmly of the mind that Single Payer is the most cost effective, efficient, and fair way to deliver health care. I am part of PNHP.org so count me in as one of the doctors who support what the brave nurses, patients, and physicians are trying to achieve.

With all that said, I want to say that to a certain extent Single Payer health care is on the table in a sorta...kinda...not really...but kinda-really way.

It's called the Public Health Insurance option.

Along with getting rid of denial of coverage for pre-existing (or existing) conditions, it's part of the dynamic duo of two issues that will fundamentally change our system for the better.

I cannot overstate the importance of it.

Public Health Insurance basically means "single payer health care" for anyone in the country that wants it. And since a majority of people already support the notion, as well as the majority of physicians and nurses, it will likely be widely adopted. And with that it will provide a huge test and proof of concept once it is implemented.

It boils down to this. If we who believe government health insurance is more cost efficient than private insurance are correct, then this is our chance to prove it.

We have a few things providing wind at our back.

1.) We eliminate the profit motive and excessive administrative fees.
2.) We leverage economies of scale due to the mass of patients.
3.) We can bargain for the best drug and fee schedules because of the number of patients involved and the power of the federal government.

The insurance and drug companies are dead scared of the Public Insuarance option. They are mobilizing milions of dollars and political leverage to try to kill it. And if it passes, they want to do anything they can to water it down and corrupt its purpose and advantages to the point of making it as inefficient and as lame as what they have to offer. The reason for this is they know that if the gov't option offers the same services with more security and less of a price, employers and individuals will flock to it. They also know they can't compete with a system that literally does not care about profits, CEO's, or shareholders.

There are many other countries that have a hybrid public, private system and they work quite well with better cost efficiency, equal or better patient outcomes, and better patient/health care staff satisfaction than we do. So, despite Single Payer in many ways being the most efficient, there are public-private systems that rival it.

Just watch the documentary "Sick Around the World" for a good review of all the different systems.

Is "Public Health Insurance" a compromise, a middle ground? Yeah...but it's likely to be the best we are going to get right now. But it paves the way for a more public, if not fully public system at some point.

The proof of the pudding is in the tasting and as long as the public system is as good or better, people's attitude toward public health insurance and a single payer system will grow warmer over time.

But if not now, then never? or least a long time? Well maybe.

But at any rate, once public health insurance is in place, anyone who wants "single payer" gets it and that should be the majority of us. Just buy the Public Health Insurance. Vote with your premium.

But, but...what about people who can't afford to pay the premium? Isn't "single payer" free? Well, nothing is really free, obviously, somewhere someone is picking up the tab. As long as we use a sliding scale on ability-to-pay with supplements for those who can't afford the premium outright then in effect for those who can't afford it will get it free. For the rest of us, we will be paying in premiums instead of taxes. As it both goes to the government, the effect is the same.

But, but...everything is so expensive, won't this all bankrupt us? I guess maybe...but for all the kvetching about health care expenditures people seem to fail to realize that most of the health care dollar is spent right here at home, on doctors, nurses, PA's, FNP's, hospital staff, medical equipment (a lot is still made in the USA) and so forth. I think Walmart peddling all that Chinese crap is a bigger exporter and drain of wealth than our crazy expensive health care system, even as it is.

Well, anyway...expect a big fight on the Public Health Insurance option. It's our trojan horse for Single Payer or something like it. Expect the GOP and the corrupted Dems (some of them are corrupt sadly) to try to bury it or work it in such a way to make it not work well. Witness Medicare Part D as a classic example of how to fuck up health policy in the worst way (thanks Republicans, you assholes).

I say keep on hollering and fighting for Single Payer now...but don't consider the Public Health Insurance option a failure if we can get it passed. It will still be a HUGE accomplishment.

Don't let Paul Krugman tell you otherwise ;)

[sandyd921]

1. But don't you think the health insurance cartel

is on to this? What makes you think that they're going to allow this or not fight it tooth and nail as much as they will fight single payer? So then why not just come out and fight for single payer?

[Dragonfli]

2. Shumer has it covered for them - Is writing a version that "competes"

with the private plans in a "fair" way. One I might add he is loading with co-pays and claims will need to use no public money.

It will be public in name only, so yes the cartels have thought of that and have someone on the inside working that angel as well.

A shame really, a true public option would work much like the OP suggests, it would be refusing at least 30% of the savings of a Single payer plan (multiple payer overhead left in place) but would beat the crap out of those that require such heavy profits to stay in business IMHO.

[drm604]

4. Fuck that.

We need to let Shumer know that is not acceptable and that he does not work for the insurance companies. He is not obligated to make sure that it will "compete in a fair way". That is completely irrelevant to what he was hired for. His ONLY obligation is to make sure that it meets the needs of his constituency as effectively and efficiently as possible. Anything else is malfeasance, plain and simple.

[Dragonfli]

10. He is my Senator and I tried but they don't care what we want.

The farthest I got was a bitchy child staffer claiming to "take down my concerns" in a tone that did not imply a note would even be taken.

Sort of like when I get the old "your concern has been noted" :eyes: around here if I question any edict ever made by Obama.
You do know Chuckles is an unapologetic corporatist don't you?

[drm604]

11. Yes, I know that

but that fact just makes me angrier.

[backscatter712]

15. Overton strategy is why.

Think of it as a tug of war to pull that Overton Window to the point where things like single-payer become politically feasible.

And in order to pull most effectively, we need BOTH single-payer and public-option advocates. Disagree about how you want reform to happen, but at least recognize that we all think the current murder-by-spreadsheet system that kills 100,000 people a year through denial of health care is completely unacceptable.

Once you recognize that even your rivals want the same thing you want, start pulling in the same direction.

Don't think the rethugs don't understand this. They have the "moderates" who are saying "Sure we need reform, but do we really need a public option?" to the "Drown government in the bathtub and leave it all to the private sector - if you can't afford your chemotherapy, TOO BAD!" They're coordinating and pulling that Overton window to the right.

We need to get our shit together and pull that window back towards sanity.

[drm604]

3. We need to FIGHT for a proper public option.

We can't allow any watered down crap. If we can't get true single payer then somehow we HAVE to at least get a public option whose goal is the good of the people, and not one that is designed to "compete fairly" with the private plans.

The fact that the private insurers are so frightened of it puts the lie to everything they've been saying about single payer. If it's such a lousy bureaucratic inefficient way of doing things, and if the private insurers are so wonderful and efficient, then they should have no trouble competing against it, right?

The problem is, how do we get the message out to the people? How do we outshout someone who has millions of advertising dollars? And how do we pressure our so-called representatives into doing the right thing when they're so beholden to the insurance companies?

[PHIMG]

8. We can get single payer

It starts with telling the truth about the PUBLIC OPTION. It is a scam to get Progressives On Board with the bullshit process that is taking place in D.C. This total charade that is being orchestrated by Baucus.

Democratic leaders want A BILL, ANY BILL. They are too cowardly to DEFEAT the private insurers so they are basically giving them everything they want. If the PUBLIC PLAN gets into the bill it will be slowly chipped away just like MEDICARE AND MEDICAID.

The first step to getting single payer is to tell the truth. The public option is a scam. Plain and simple.

[drm604]

9. I hear you

but how do we do it? What is our course of action? Can we somehow shame people like Shumer into doing the right thing?

What can we do? Any action we try to take is thwarted. See this thread for an example: http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x5708645

We have to do something, but what?

[PHIMG]

12. CIVIL RIGHTS + ACT-UP models

So yes, we need an army of people willing to get arrested getting in these sold-out jokers faces everywhere they go saying....SCHUMER why don't YOU put it on the table. You are a powerful man SEN SCHUMER. SEN SCHUMER why do you take so much money from the INSURANCE indusry. Why do you take money from people who sell a DEFECTIVE PRODUCT. SEN SCHUMER how many more people have to die before you stand up for what is right? SEN SCHUMER the only think UNIQUELY AMERICAN about our profits-first system is that TENS OF THOUSANDS are dieing.

Regardless of what happens this year, this is what needs to happen.

The single payer movement will end only when we get single payer. It's never been stronger. That's why the jokers in D.C have to have people arrested to silence our voices. Because the people on our side.

So the solution is GOOD COPS - PNHP and Healthcare Now types who are doing the Civil Rights angle but also a BAD COP approach following the ACT UP model of media savy direct actions most especially bird dogging.

Thats what Single Payer Action and my group have been trying to build.

[depakid]

14. Sorry to say- I'm sort of questioning your motives with this post

[PHIMG]

17. Oh do TELL!

My motive is to have a health care system that works for patients and not profits.

19,000 physicians advocating for single payer.

vs.

30 or so sold out conservative democrats fighting for fake reform that makes private insurers stronger than ever.

So yeah go ahead and question my motives.

Lets not forget that politicians care most about protecting thier majority.

You think Hary Reid and Pelosi are worried about fixing healthcare? No they want a bill. And that means lets give the insurance industry everything they want in the hopes that none of will do Harry and Louise (they already are)... and it means....lets create a bright shiny thing that guillable progressives can feel happy about supporting even tho the rest of the bill is a total wet dream for the big insurers and the drug companies.

That's your public option. And if you speak the truth, you get your motivations questioned.

What's your motivation?

[eridani]

5. Unfortionately you don't eliminate the middlemen

If we allow private for profit insurance to duplicate public coverage (instead of being strictly for extra bells and whistles), the whole administrative mess will remain in place.

Official Transcript: http://edlabor.house.gov/documents/111/pdf/testimony/20090423DavidHimmelsteinTestimony.pdf

Video of testimony: http://www.youtube.com/watch?v=p-mpadKoFB4&feature=channel_page

Unfortunately, these massive potential savings on bureaucracy can only be achieved through a single payer reform. A health reform plan that includes a public plan option might realize some savings on insurance overhead. However, as long as multiple private plans coexist with the public plan, hospitals and doctors would have to maintain their costly billing and internal cost tracking apparatus. Indeed, my colleagues and I estimate that even if half of all privately insured Americans switched to a public plan with overhead at Medicare’s level, the administrative savings would amount to only 9% of the savings under single payer.

While administrative savings from a reform that includes a Medicare-like public plan option are modest, at least they’re real. In contrast, other widely touted cost control measures are completely illusory. A raft of studies shows that prevention saves lives, but usually costs money. The recently-completed Medicare demonstration project found no cost savings from chronic disease management programs. And the claim that computers will save money is based on pure conjecture. Indeed, in a study of 3000 U.S. hospitals that my colleagues and I have recently completed, the most computerized hospitals had, if anything, slightly higher costs.

[creeksneakers2]

34. The plan that allows the public and private to compete

can mandate some uniformity. Also, if the public option is even a little better than private it will grow beyond 50%. How many are already on government health care? While the total costs of health care might might not shrink much because of private insurance complexities, isn't it possible that a less complex public system could bring down its own costs and the costs of the people who have taken the public option?

[eridani]

35. The savings of public option are real--just a lot smaller than with single payer

A change in growth factor could, of course, throw the 9% estimate way off. Still, the only way to get a good public option is to keep insisting on single payer. If you want $3000 for your used care, you'd better ask for at least $5000.

[creeksneakers2]

39. Its not a used car

And if it was, that isn't necessarily a good sales strategy. If your car is only worth $3000 and you ask for $5000 in your ad, lots of people who look at the ad who would have paid $3000 will pass by your car without a further look because its overpriced. You are sort of relying on a customer to go to the trouble of finding out if they can haggle down. Many won't. Better to ask for something reasonable, like $3500.

But this is unlike a used car, except that if you supply an unpopular alternative from the start, your movement will never get inertia behind it. It will never get off the ground.

[eridani]

49. Single payer happens to be very popular with the public

Pew Foundation regularly puts support for government guaranteed health care at 70%. Are we just supposed to passively wilt in front of the forces with big money who have bribed our supposed representatives?

[eridani]

6. We really must continue to fight for single payer

--if only to insure that the public option will be worthwhile, and not just a dumping grounds for the poor and sick.

[PHIMG]

7. I call Bullshit. Public Option is far from Single Payer

From the people who wrote the proposal that is the basis of the single payer bill - HR 676 (PNHP)


"No details have been released by either Congress or the administration about the specifics of a potential public insurance option that could be offered in competition within a market of private health plans. Nevertheless, to provide an analysis of how such a plan might work, The Lewin Group used certain assumptions to prepare this simulation.

Under this analysis, hospitals would be paid 30 percent less than the reimbursement rates of private insurers, and physicians would be paid 20 percent less. Using these and other assumptions, premiums for the public plan would be 30 percent less than comparable coverage by private plans.

Supporters of the public option are likely to claim that it is an essential component of reform since it will lower the cost of insurance while expanding coverage to over 100 million more people.

Opponents of the public option are already claiming that the government would be an unfair competitor to the private plans because of its ability to dictate rates that are lower than what the private plans must charge.

This simulation may very well also increase the opposition by physicians and hospital administrators because of concern about the possibility of shifting large numbers of patients from the private plans to the government plan with its considerably lower reimbursement rates. In the heat of the debate, it may be forgotten that these fee reductions were an assumption made by the authors of this report for simulation purposes, and not a feature of any actual legislative proposal.

Unfortunately, this study only fuels a debate that has diverted us from the discussion that we should be having. Instead of arguing over a controversial, yet-to-be-defined measure that cannot possibly lead to the efficiencies, equity and effectiveness of the single payer model, we should be discussing what actually would work - true single payer reform."

http://www.pnhp.org/blog/2009/04/08/lewin-report-on-the-public-option/

[depakid]

13. While I agree to an extent- the bottom line that our friend Panem et Circenses points out is

that the public option is the best we're going to get (and that's still an iffy proposition) with the current corrupted set of Senators.

That may change down the line- or it could be that the public option gets poison pilled. We shall see.

[PHIMG]

16. Pass healthcare this year and you set back Single Payer 20 years

Kill that bill this year and build the momentum for single payer. Make being against single payer political suicide for these assholes. That's how you fix healthcare.

Falling for the b.s. public option is not how you fix healthcare.

Public option is to get progressives to not fight against a bad bill. It is a scam. Look at who is for the public option. One of the most corporate friend unions ever and your friends in the drug industry.

That's all you really need to know right there.

The democrats want A BILL, any BILL. Same thing happened in MASS. Its been a failure and this is the model they are using for the nation.

Single Payer is the solution and we need to call out this public option scam for what it is.

A diversion, a scam. The real story is Mandate and Subsidize. Lets force more people to buy the insurers' defective product.

IT's time to kill the private insurers with HR-676. Pay off the shareholders of the big insurers and move everyone into Medicare and properly structure and fund it.

[depakid]

18. When you start calling the public option a scam- that sounds an awful lot like right wing agitprop

Now, I'm all for acting up and putting the pressure on those involved in the process- but NOT to the extent that thoroughly undermires or destroys the fallback position- which is the best Americans are likely to get at the moment.

[PHIMG]

19. When you GIVE UP, say that GARBAGE is the "best" we can get you sound like a right winger

Telling us to go along to get along, to surrender to corporate power, to just go along with the Democratic leadership in D.C. that have rigged the debate by excluding the best option because it jeopardizes thier campaign contribution largess, and when you suggest we should all be followers instead of leading, and demanding from our government THE BEST SOLUTION, not just the easiest for sold-out politicians, I"M SORRY but to me that sounds a lot more RIGHT WING than calling the public option for what it is.

No doubt some people belive it is a good option, but i'm telling you the reason it is even being discussed at all is to get progressives on board with a BAD bill and to pull them away from SINGLE PAYER advocacy. That's what it is for.

If you think that saying that makes me sound like a right-winger, then I don't know what to say about your judgment.

[depakid]

20. The reality is what it is...

And the fact is, Americans will probably be lucky if they get that much.

That said- people are much more likely to get a better deal on that if folks who support single payer don't run around calling the public option "just a scam" (as opposed to a potentil vehicle where down the line, single payer becomes ever more attractive and feasible).

To be perfectly honest- I can can easily see this turning out where people get almost nothing except a few band aid style mandates without meaninful enforcement. Indeed, considering what we've seen to date from "our" Senate- that outcome wouldn't surprise me in the slightest.

[PHIMG]

21. When public option advocates stop calling Public Option Single Payer

Then I'll stop calling the Public Option a scam. Ok? How about that? Deal?

You have to realize that when this bill gets passed the entire media is going to say: "MISSION ACCOMPLISHED" and ignore all the other problems with the healthcare system. Largest being that having health insurance does not mean having healthcare and that you have insurer middlemen sucking 30% out of the system.

I'm sorry but single payer should be the MINIMUM we consider. Anything less than that is just a joke. And having this child like FAITH in the public option is naive at best.

It's not going to be Medicare. You've seen what SCHUMER has proposed. The trigger, etc. Its a stupid place to begin your negotiating position. And even if it gets passed in a form that will be useful it will be constantly under attack by the private insurers.

"A single payer doc in Ohio - Dr. Johnathon Ross - put it this way to me last year.

The health insurance industry is like a vicious dog, Dr. Ross said.

Those who would create a public plan to compete with the health insurance are just kicking the dog in the face.

The dog is going to counterattack and rip your face off."

Better to put the dog out of his misery.

[depakid]

23. You can holler and scream- and stamp your feet all you like

but like a child wanting something for Christmas that they know that they're not getting this year- it'll hardly be productive.

And in this case, yours and (hopefully not many) others' petulance may end up getting you a much worse gift.

Nope- sorry, if you can't see that, then again I have to question what motives are- or how much experience you have in politics.

[PHIMG]

24. Why is it THIS YEAR?

Who puts passing a crappy bill THIS YEAR and by doing so squandering a twenty year opportunity to really fix healthcare above of need to do the right thing?

Politicians. The Democratic leadership. And People who want to ensure that single payer (the real solution) is set aside for another twenty years.

Who defends this? You do.

So yes, some yelling and screaming is called for. Join us.

[depakid]

25. Join us?

A lot of us out here have been working on health care and related issues for decades-

So for most of us- it's not about single payer now! or nothing at all. It's about making the most substantial progress that we can toward that goal (which most of us also understand is where health care is headed in the states, through economic necessity).

[PHIMG]

26. Ok well then in 100 or so years we'll have a decent healthcare system.

Incrementalism worked out really well in 1992 right?

Hell why don't we go back to the creation of Medicare. Maybe if the liberals had dug thier feet into the sand and waited another little while we would have Medicare for all now? Political expediency won out then and you advocate for it now.

We can keep fighting vested power every 20 years to try for a 10% improvement, sure.

We can try not to rock the boat too much, produce a 1200 page bill nobody can understand let alone defend or advocate for, and hope that we'll get it thru the congress and the system will be 10% better.

We can leave this to the politicians and the Democratic leadership who care most about themselves and keeping thier majority. And the tens of thousands who die under this broken system, a system they want to leave in place with very minor tweaks, well they'll be secure knowing that their sacrifice helped re elect sold out Democrats to the Congress.

Or you can join the single payer movement where smart people say lets fight like hell for a REAL solution that everyone can understand (everyone in, nobody out, cradle to grave, zero out of pocket expense), that actually generates cost savings to pay for it.

We need to go for the whole enchilada, it might take 10 years, but at least it will be worth fighting for.

If the Democratic party wasn't sold out to corporate interest Single Payer would have been the party platform after the failed Clinton healthcare reform.

But being a conservadem means never admitting you were wrong, just finding a more devious way to get what your campaign donors want accomplished (leave the private insurers in place.)

Last time it was called Hillarycare. This time around its Baucuscare. Mandate and subsidize the private insurers defective product and hold out a carrot for guillable progressive to reach for called the public option so they'll get behind it.

The most corporate friendly union and the big drug companies are funding activism for the public option? Why? To suck the oxygen out of the single payer movement. Take it to the bank.

[creeksneakers2]

31. If I remember right

Single payer advocates played an important role in killing '93 health care too. How did that work out?

I read the comments on this board and I suspect many people are more interested in getting even with wealthy elites than getting health care for people who need it. Whether somebody makes a buck or not is not the most important thing. Peoples' lives are.

[PHIMG]

33. Yes that's a nice canard from the conservadems

Read the history about that bill and you'll see it was conservative democrats making a big show of thier fear of a backlash to the "big government" charge.

Now the country is far less enthralled to this Reagan revolution rhetoric, solidly behind single payer... but the Congress still is making a big show of trying to avoid charges of advocating for "big government."

Its just a fig leaf to cover up thier real fear... pissing off their corporate campaign donors by doing the right thing.

[depakid]

36. If it's up to "conservadems" - you won't even get a decent public option

Something to bear in mind when you cast about aspersions.

[PHIMG]

40. Decent public option

What is that exactly? That even more people the insurers don't make enough money off of get dumped into a public system that is systematically underfunded by Republicans and Conservadems in Congress?

That's what we should fight for?

No. Let's fight for EVERYONE IN, NOBODY OUT, health care reform worth fighting for.

You advocate for more separate and not equal and the continuation of health care as a commodity because you accept what conservadems in Congress say is political feasible. That's just wrong. They represent us! They don't represent AHIP. Americans wants single payer. And single payer saves Hundreds of BILLIONS.

Instead of bowing to what these sold out jerks think is political feasible lets force them to do what's right.

Advocating for public option incrementalism is a tactical mistake and morally bankrupt.

Calling it single payer is just plain out dishonest.

[creeksneakers2]

44. How do you plan to force them?

[PHIMG]

45. Civil Rights era?

I doubt that Insurers, with public approval a little higher than the Tobacco industry are more powerful than the institution of Racism in America, yet the Civil Rights act was passed. It took a huge movement to give leaders cover to support it.

[Name removed]

29. Deleted message

Message removed by moderator. Click here to review the message board rules.

[PHIMG]

42. Calling people trolls is against the TOS of DU

Apparently tho, its ok to do that if the target has an oddly punctuated quote or a mispelling.

[creeksneakers2]

30. Public option will make single payer more likely in the future

That's why the insurance companies are terrified of it.

Sure, you can run a poll and find 55% initial support for a single payer system. But 157 million Americans rely on employer provided health insurance. A multi-million dollar advertising campaign is all it will take to frighten all those people into thinking that if they switch to a government plan they'll bleed to death in an emergency room waiting for paper work to get filled out. With the public option, we can establish government insurance as a safe alternative. Then people won't be such easy marks for private health insurance company ads.

The public option has one other thing going for it that wasn't around in '93. The big business community who is often theorized on DU to be calling the shots on every decision is fed up with private insurance costs. They want the public to do something to. The best way to get the health insurance companies to behave is to give them competition.

We also have a president on our side.

Also, politics doesn't work like haggling over a used car. One must start out with a base and build support. If one starts out asking for the moon, he'll never build a base or gain support. He'll wind up with no negotiating power at all. Its better to start with a plan and work together to advocate what is proposed. That way we draw people in rather than scaring them away.

[PHIMG]

43. You don't think they will run the ad campaign against the Public Option?

Do you know there are 1,200 private insurers and it only takes one of them to spend $5 million to do a new Harry and Louise? So why do we start off with such a weak position? Why not go for Single Payer and settle for the Public Option? Because these jokers OWN the Congress.

If we want a real solution we have to be more of a pain to these jokers than AHIP can be. But we have HCAN saying, no no lets just go along with the public option.

It's a huge tactical blunder. Then when you have people calling the public option single payer, you just expect people who know what single payer is to be silent?

[creeksneakers2]

47. Harry and Louise won't be anything like as effective

If proponents of the public plan can promise those who that are frightened that they can choose to keep what they have and won't be forced into a public system.

We aren't starting off in a weak position. We are starting out with a sizable majority behind us and the president on our side.

[PHIMG]

48. And yet its not going to be in the Senate bill.

Baucus said so. Do you think it will survive conference committee? And a solid majority support Single Payer and Obama supported it before he decided he needed big money to run for President.

[quiller4]

27. I beg to differ. Public option can and likely will be a path

to single payer.

[PHIMG]

28. Yes just like Medicare was a pathaway to Universal Healthcare.

Didn't happen then, won't happen now. Nice rose colored glasses. Paid for by big PhRMA. They fund HCAN.

It's amazing how gullible people can be. Drug companies want the public option. Why? Why??

[tkmorris]

32. You REALLY need to be more civil

We aren't your enemies here. Even those of us who have a different point of you than you do for the most part agree on the goals, our only difference might be on how to achieve them. I am interested in hearing your perspective, especially your opinion that passage of a public option will not in fact lead to single-payer, but rather will put it off even further. However that is VERY hard to do when you are so vitriolic to other DU'ers, people who for the most part have the same ideals we do.

Tone it down a couple notches would you? Save the anger for people like Baucus and Shuler and the Nelson twins.

[PHIMG]

37. Advocating the public option ENABLES Baucus and the Nelson twins

Those who are dishonestly selling the public option as something it is not may be misguided or worse but by all means, let us applaud them for their civility.

I feel the need to get the truth out there about what this Public Option is all about. A lot of people have been fooled into supporting it. Its been very successful at doing what it was intended to do. I almost fell for it myself when Dr. Dean came out for it. Whatever the public option actually winds up being, the reason it was devised was so that the Democrats could get a profits-first healthcare bill through the Congress and to divert progressive activism away from Single Payer.

That's the point here. If i come off as uncivil then I'm sorry to those who I may have offended.

[depakid]

52. Now you're being utterly inane- that aside from having no idea what you're talking about

The TROLL smell is overwhelming.

[grantcart]

22. Very informative - nominated

[AdHocSolver]

38. Good negotiation requires asking for MORE than one is willing to accept.

Then both sides are willing to concede something to get something in return that they really want.

By effectively eliminating single payer from negotiation, the people (through "our"(?) representatives) have already given away half the store.

This looks like it may turn out like the bailout money with no strings attached.

Face facts folks. The United States is now openly an autocratic plutocracy. The corporate ruling class and their minions in government are openly sabotaging health care reform. When close to 70 percent of the population wants some kind of health care reform, and "our" supposed government officials unilaterally take a major option off of the table, one can no longer consider the U.S. a democracy with a representative form of government.

There is more at stake than just getting universal health care. This country is headed toward bankruptcy because of the corporate offshoring of jobs. When 80 percent of what we buy is manufactured in other countries, money (the lubricant of an economy) is flowing out of the U.S. at a record pace. The enormous cost of for-profit health care is going to accelerate the collapse of the U.S. economy. Foreigners have been supporting our huge debt for years, and are starting to rebel.

Foreigners, who are not as stupid as our corporate plutocracy assumes Americans are, see health care costs as another drag on the economy that will prevent this country from ever paying back the money owed to them. That is why they will eventually write off the U.S. debt as uncollectible and cease doing business with us. The ensuing economic collapse will make the depression of the 1930's look like a picnic.

Sorry for dragging economic reality into the picture. Some people seem to have bought the canard by the corporatists that single payer health care will be too expensive. Just the opposite is true. The current for-profit system is killing the U.S. economy and is unsustainable. A Medicare style single payer system would save money, and say to the world that this country is serious about fixing its economic problems.

[creeksneakers2]

50. That's not a good negotiating strategy for this type of thing

The strategy you are advocating is a war of nerves contest which is likely to end with both parties refusing to yield and nobody getting what they want. And advocating a single payer system isn't much of a threat, since everybody already knows its not in the cards.

Political negotiations are usually factually based. You win points by creating respect for your position. The effort is to come up with something both sides can live with. Then everybody wins.

[AdHocSolver]

51. Per your response, I suggest that you read a good book on negotiation.

Most people lose in negotiation because they think that good negotiating requires a "war of nerves".

Good negotiation occurs when both negotiating parties look to achieve a win-win situation. The insurance companies have already declared war on America by refusing even to allow our supposed negotiators to even bring up the possibility of a single payer system.

It is only off the table because the insurance industry has already bought Congress. The corporations show their contempt, and Congress shows its contempt for a majority of the American people, by disallowing single-payer advocates from even being at the table.

What we see occurring in Congress concerning health care reform is NOT negotiation, but extortion.

Successful negotiation requires both parties agreeing to trade off elements of their negotiating position. "Our" side has already given away the store and gotten nothing in return.

They are using the same tactics as they used in providing the "bailout" money.

[creeksneakers2]

53. I have read a book on negotiation

[ContinentalOp]

41. I have some questions that maybe you'll have some insight into as a doctor.

1. How can we prevent the public plan from becoming a dumping ground for all of the sick people the private insurance industry doesn't want to cover, thus canceling out any potential savings?

2. Won't private insurers cut costs and profits to create inexpensive rates for young healthy people so that they can stay competitive? Again, with the ultimate effect of making private insurance a lucrative, relatively risk-free field, while shifting the undesirable customers onto the public plan?

3. Will this public plan, like Medicare, still be restricted from bargaining with pharma companies over prescription drug prices?

4. How will this public plan be any cheaper than existing non-profit insurers, especially if it's still competing with private industry and unable to achieve the massive economies of scale and the cost benefit of cradle to grave coverage that single payer systems are able to achieve?

5. Will all health care providers be required to accept the government insurance? In a purely single payer system the vast majority of doctors would presumably accept the government health insurance with maybe a few specialty doctors requiring cash only (cosmetic surgeons for example). But if doctors are allowed to decline public health insurance as they currently are with Medicare, won't we just have a two-tiered system divided into haves and have nots?

[PHIMG]

46. Excellent points.

The case against the public option from a POLITICAL standpoint and a POLICY standpoint is overwhelming.

That it is even being floated is a real indictment against our broken political system. A system that must be challenged. Not appeased.