We Need a REAL Public Option – Not a Poison-Pilled CORPORATE WELFARE “Public Option”

[Faryn Balyncd]

Like most Democrats, most Americans want Single Payer ON THE TABLE, and the doctors & nurses advocating Single Payer should be heard, not arrested. Americans agree when Howard Dean defines reform:

"If Barack Obama’s bill gets changed to exclude the public entities, it is not health insurance reform…it rises and falls on whether the public is allowed to choose Medicare if they’re under 65 or not. If they are allowed to choose Medicare as an option, this bill will be real health care reform. If they’re not, we will be back fighting about it for another 20 years before somebody tries again."





- Howard Dean

What we DON’T need is pseudo-“reform”.

What we DON’T need is a plan that gives Big Insurance a government mandated monopoly with NO PUBLIC OPTION(the Wyden plan).

And what we DON’T need is a poison-pilled crippled “public option” plan such as that being constructed by Max Baucus and Chuck Schumer - - which will allow insurance companies to continue to to use pre-existing conditions to to CHERRY PICK the profitable demographics, and CONTINUE DUMPING the less profitable demographics on the taxpayer-supported public programs.






The dirty secret of the insurance industry (despite their PR hype about "competition") is not simply that they use every corrupt trick in the book to SUPPRESS COMPETITION (which truly they do).

Rather, Big Insurance's dirtiest secret is that in 2009 they NO LONGER CREATE VALUE. Big Insurance has, in reality, degenerated into a racket that now supports itself by peddling the illusory "advantage" (to their customers) of admission to a lower risk demographic pool, while higher risk groups are left to either fend for themselves, or dumped on the taxpayer.




We now even witness the perverse reality that our health insurance industry has MALIGNANTLY MUTATED into the exact OPPOSITE of its original raison d'etat: . . . . . . . Specifically, insurance was originally created to SPREAD RISK. But, in its present degenerate mutation, the major source of its profits (when not denying legitimate claims) is the illusory "benefit" of SEGREGATING the industry's relatively healthier customers from those unhealthy enough to be denied coverage.

And we see daily that this "benefit" is indeed a mirage: Whatever crumbs of savings the insurance companies may pass along to customers (resulting from the exclusion of high risk groups) is counterbalanced by higher taxes to support programs for those denied insurance.

“Administrative” fees extracted by our insurance cabal are several times higher than any other nation. These unconsiounable fees (so destructive to our industrial competitiveness, the very viability of our auto industry, and our national, state and family treasuries) are possible only because incentives are currently constructed to encourage CHERRY PICKING by the insurance industry, rather than rewarding those that design systems that efficiently improve the health of all Americans.







So how does this relate to our Senate Finance Committee (still basking in the warm glow of its kind welcome of the doctors and nurses advocating single payer)?







Believe it or not, the Baucus-Schumer collaborators are labeling as “reform” a scheme which (you guessed it) will allow the insurance industry to continue to CHERRY PICK!!!!

Sen. Schumer, despite his claim to support a “public option”, has designed a plan which is fatally CRIPPLED by the demands of the insurance lobby:

In the Schumer plan, Big Insurance will get the profitable patients, the “public option” the sick ones. The public plan, saddled with the expensive patients will be unable to offer competitive premiums without massive tax subsidies. Because this burden will continue to be dumped on taxpayers (after they have already paid the insurance companies for the illusion of cheaper, low risk group insurance policies), the insurance industry will be abetted in their business of extracting excessive administrative fees to the healthier population while leaving it to others to clean up their mess.



Our funds that now go to excessive “administrative” fees to the insurance industry (to maintain this broken system) are needed to help finance universal coverage. But in the Schumer scheme, Big Insurance’s taxpayer protected racket will continue.

When Sen. Shumer met with representatives of Physicians for a National Health Plan, and was presented with 5 issues central to constructing a viable public plan, Schumer promised to "consider" 2 of the 5 points, but REFUSED TO CONSIDER THE CRITICAL ISSUE OF OPEN ENROLLMENT INTO PRIVATE PLANS. (the essential need #5 that private plans “accept all comers”, in effect requiring community ratings).

But without OPEN ENROLLMENT in both the public and private plans, the competition-averse industry lobbyists will have succeeded once again in creating an un-level playing field, and the public plan will become, as insurance lobbyists desire, the dumping ground for sick, expensive patients, the taxpayer will be stuck with the bill.











OPEN ENROLLMENT in both private and public plans is ESSENTIAL!



Without open enrollment, incentives will continue to be aligned such that profits will accrue, NOT to those who create value (by creating healthier citizens), but to those insurance companies who continue to SEGREGATE the healthy from the sick, overcharging the former while dumping the latter on the taxpayer.

Without open enrollment, Big Insurance will continue to abscond with their fees for this non-value-producing “service”.

This business of segregating profitable from unprofitable patients (while dumping the unprofitable on the public at large) IS NOT VALUE-PRODUCING…….This no more creates value than does a polluter who may make millions, even while creating billions in environmental damage, the costs to be born by the public at large……Such non-value-producing schemes are RACKETS AT BEST.

Our Democratic Senators have no business creating pseudo-“reforms” that coddle such non-value-producing business practices.

Rather, Democrats need to create competitive, level playing fields…..with correctly aligned incentives reward business behavior that actually benefits our citizens.


To create such a constructive competitive environment, it is essential that any hybrid (public/private) reform INCLUDE OPEN ENROLLMENT for both the public and private plans.

Without such OPEN ENROLLMENT, the un-level playing field will destroy competition, cripple the public plan, continue to devastate patients and taxpayers, and continue competitively disadvataging America’s productive industrial base.




If we are to achieve healthcare reform, we must stand with Howard Dean and demand that it include a viable public option. (We must reject the Wyden mandated insurance, no-public-option plan.)

And we must require that the reform stipulate OPEN ENROLLMENT for both the public and private plans.




:kick:





We must convince Sen. Schumer re-design his crippled plan, and to require open enrollment with community ratings in the private plans. (We must reject the crippled Shumer “public option” as it stands.)





To contact Sen. Schumer: http://schumer.senate.gov/new_website/contact.cfm


To contact Sen. Baucus: http://baucus.senate.gov/contact/offices.cfm


Sen. Wyden has indicated he “might be open to” a public option, (if his no-public-option plan stalls.)


To encourage Sen. Wyden to support a public option: http://wyden.senate.gov/contact/


To thank Sen. Kennedy, and to encourage him to continue to stand firm: http://kennedy.senate.gov/senator/contact.cfm


To thank Howard Dean, and to urge him to work for open enrollment in both public and private plans: [e-mail]


To contact Physicians for a National Health Program: http://www.pnhp.org/about/contact_us.php


To contact the California Nurses Association: http://www.calnurses.org/contact-us/


A complete list of Congressmen is at: http://www.usa.gov/Contact/Elected.shtml








:kick:

[Occam Bandage]

1. I'm fine with the public option getting "the sick ones."

That would make private health insurance cheaper for those who want it, and would ensure that nobody is without coverage, as the sick (who would be rejected by the for-profit insurance companies) are able to sign on to the public option. That wouldn't even increase the tax burden, since the sick would be able to go to relatively inexpensive general practitioners, instead of going to extraordinarily expensive emergency rooms (and not paying) as they do now.

[Oregone]

3. Hang on a minute

If a self-sustaining public option was paying for care for "the sick ones", how the hell do you suppose they would afford it? Well, with some pretty steep premiums, which makes the care for the sick ones "unaffordable". The savings from administration and profit are not going to mitigate the losses from actually paying out on high-risk individuals.

Further, you are making an assumption that private insurance for the healthy will become cheap (probably with the premise that the public option will become a pool for high risk health consumers)? The only thing we *know* is that in this scenario, they could potentially make more profits from less potential payouts on their more healthy consumer base. Their altruistic ability to forgo on potential profits in hope of helping to make their service cheaper is a great assumption.

[Faryn Balyncd]

4. You're missing the point, Occam. . . . . . . . .

. . . Rather, Big Insurance's dirtiest secret is that in 2009 they NO LONGER CREATE VALUE. Big Insurance has, in reality, degenerated into a racket that now supports itself by peddling the illusory "advantage" (to their customers) of admission to a lower risk demographic pool, while higher risk groups are left to either fend for themselves, or dumped on the taxpayer.

We now even witness the perverse reality that our health insurance industry has MALIGNANTLY MUTATED into the exact OPPOSITE of its original raison d'etat: . . . . . . . Specifically, insurance was originally created to SPREAD RISK. But, in its present degenerate mutation, the major source of its profits (when not denying legitimate claims) is the illusory "benefit" of SEGREGATING the industry's relatively healthier customers from those unhealthy enough to be denied coverage.

And we see daily that this "benefit" is indeed a mirage: Whatever crumbs of savings the insurance companies may pass along to customers (resulting from the exclusion of high risk groups) is counterbalanced by higher taxes to support programs for those denied insurance.

“Administrative” fees extracted by our insurance cabal are several times higher than any other nation. These unconsiounable fees (so destructive to our industrial competitiveness, the very viability of our auto industry, and our national, state and family treasuries) are possible only because incentives are currently constructed to encourage CHERRY PICKING by the insurance industry, rather than rewarding those that design systems that efficiently improve the health of all Americans..........



. . . Our funds that now go to excessive “administrative” fees to the insurance industry (to maintain this broken system) are needed to help finance universal coverage. But in the Schumer scheme, Big Insurance’s taxpayer protected racket will continue.

In short, we're just not rich enough to continue to coddle the unproductive insurance mafia.

[On the Road]

5. That Position Would Make Perfect Sense, Occam,

except for the fact that health care rates are disengaged from costs and removed from competition today. Optimum Choice had 40% gross margins a couple of years ago, which is not what you would expect from a competitive industry.

Competition is not effective at controlling rates in the current model because (1) the employers, not the users, choose which companies to deal with and (2) insurance providers can set the risk pools.

I am not an anti-corporate crusader, but the current model is not effective. I completely support what Dean is doing. Schumer's alternative does not address some of the fundamental issues.

[Mojambo]

2. Excellent post! Recommended. n/t

[Orangepeel]

6. Or let everyone enroll in Medicare and let private industry do what it wants

If there are mandates or government subsidies for private insurance, then private insurance needs to have to take everyone. But letting everyone enroll in Medicare if they want and letting private insurance companies do what they want, would be just like single payer for everyone who wants it.