Michael Moore on the Public Option

[babylonsister]

http://politicalwire.com/archives/2009/08/11/michael_moore_on_the_public_option.html

Michael Moore on the Public Option


Filmmaker Michael Moore, who directed Sicko, discusses health care reform in the current issue of Rolling Stone:

"If a true public option is enacted -- and Obama knows this -- it will eventually bring about a single payer system, because the profit-making insurance companies won't be able to compete with a government run plan and make the profits they want to make."

Moore adds: "I probably shouldn't be saying this, but I'm counting on the fact that Republicans won't be reading this Rolling Stone."

Rolling Stone article here:

http://www.rollingstone.com/politics/story/29551986/barack_obama_so_far

[TexasObserver]

1. Recommend

[closeupready]

2. Bingo, Michael! That is EXACTLY why.

They want to protect their gravy train.

[Cha]

3. I read something else Moore said

in Rolling STone, last night, .."He Fakes Right And Goes Left", says Moore. "I'll be shocked if he keeps 50 troops in Iraq-he just says those things to keep the opposition at bay."!

[FatDave]

4. Absofuckinglutely.

Let the record show: Michael Moore, director of Sicko and single-payer proponent, supports the public option. And we're very close to being able to pass it. I hope this will bring some of the "single-payer or nothing" folks on board so we can fight unified.

'Cause you know, if we can't get together, the republicans will always beat us, because they are always unified, without exception. Granted, their simplistic ideals make it easier, but it doesn't make our solidarity any less important.

[ipaint]

13. Moore supports "a true public option"

That isn't the fake one in the bills that have been offered so far.

[FatDave]

15. Firstly, the bill isn't even written yet.

Secondly, Obama has said over and over that lack of a strong public option is a deal breaker. Let's all work for a strong public option in the final bill, OK? We can accomplish that, especially if we can drop all the infighting.

[ipaint]

16. A strong public option is medicare for all who choose it.

If we can't get single payer because the ins. companies won't allow it how do you see medicare for all as realistic.

[FatDave]

18. "A" strong public option, not "the only" strong public option.

I don't see medicare for all as realistic. I see it as a great solution, but very unlikely to pass in the Senate. But there's no reason we can't have a good public option that isn't based on medicare.

If you want a strong public option, fight with us for it. But if you're going to sit in the corner and pout because you can't have single-payer today, then you're not really contributing.

[ipaint]

19. Really

Your way or the highway.

Well since your way has been tried and failed twice so far. I'll take the highway. Having lived as an adult through the last two health care reform failures pout free, I don't think I'll be starting now either.



"Single-payer legislation was the first out of the chute during the 1970-1973 cycle. In January 1970, Sen. Ted Kennedy introduced what we would today call a single-payer bill. But Kennedy and other leading Democrats quickly abandoned single-payer in favor of a theory about cost containment called the “health maintenance strategy.” This strategy revolved around a new-fangled type of insurance company proposed by a Minnesota physician named Paul Ellwood that Ellwood called the “health maintenance organization.”

Ellwood would become rich and famous selling his HMO idea. He single-handedly convinced President Richard Nixon to endorse legislation to subsidize the formation of HMOs all over the country. While Ellwood worked the Republicans, the AFL-CIO worked the Democrats. Within a year, Kennedy and many other Democrats had been persuaded to abandon the single-payer approach in favor of legislation that would subsidize HMOs. The 1970-1973 cycle ended with the enactment of the HMO Act of 1973. Thus was the world’s first HMO industry born. As we all know now, the HMO experiment failed.

Two decades later, when the 1992-1994 cycle opened, single-payer legislation was not only in place in Congress it had also been introduced in many states (the first state single-payer bill to be introduced was introduced in Ohio’s legislature in 1990). The first modern-day single-payer bill was introduced in the US House by Rep. Marty Russo (D-IL) in 1991 and in the Senate by Senator Paul Wellstone in 1992. But as was the case during the previous cycle, the Democratic leadership was seduced by an alternative to single-payer. Once again, Paul Ellwood played an important role in luring Democrats away from single-payer.

Late in 1992, candidate Bill Clinton was persuaded by representatives of a group Ellwood helped form, the Jackson Hole Group, to support something called “managed competition.” The Jackson Hole Group was a coalition of insurance company executives and conservatives who met regularly at Ellwood’s mansion in Jackson Hole, WY. The theory of “managed competition” held that if the insurance “market” were tweaked (with report cards on insurance companies, for example), competition between insurers would intensify, Ellwood’s beloved HMOs would gradually seize more market share, and this would drive industry-wide premiums down. Clinton’s endorsement of “managed competition within a budget” catapulted what might have remained an obscure idea into the political lime light. When Clinton was elected, single-payer legislation once again languished while the Clintons, with help from groups like Families USA, AFSCME, and Citizen Action (now called USAction), flogged their managed competition bill. The 1994 cycle ended with the death of Clinton’s bill in September 1994, and the unraveling of similar managed competition legislation enacted in Minnesota and Washington."

Cont. with todays proposed reform-

http://pnhp.org/blog/2009/08/08/reply-to-critics-of -“bait-and-switch-how-the-‘public-option’-was-sold”/

Today we have the "public option" invented by a person named Jacob Hacker, another market based public/private attempt that will more than likely fail. Instead of the Jackson Hole Group we have the Herndon Alliance and their offshoot HCAN pushing it.

[FatDave]

20. I'm not the one saying "my way or the highway" here.

I'm saying that single-payer is not going to pass this year. We can barely pass this not-quite-as-good reform. And believe me, I understand that it's not as good.

But...

Most agree that it will be a great first step towards single payer, as the federal government will be able to undercut the private companies and provide better service. So my point is, why not get behind the thing that's likely to make it through the senate and will likely lead to single-payer anyway?

Sure, maybe it won't work that way. But it's likelier than getting this congress to pass single-payer.

[ipaint]

24. Because it's not going to lead to single payer.

We are mandating a steady supply of millions of paying customers to an industry that profits on denying care. That doesn't lead to anything. The government is not in the drivers seat and is negotiating from a position of weakness. Our government currently can't regulate any industry, expecting them to regulate the health insurance industry isn't realistic.

This could very easily turn people away from government insurance for good when it fails. Besides that the next repub administration will dismantle it. Unless a plan is put in place that people value as much as they do medicare and social security all we are going to end up with is a lousy mandate to purchase from the bloodsucking insurance companies and dozens of new consumer organizations trying to fight an uphill battle to educate the public and try to stop new and sneakier ways of denying care.

I'm amazed at the willingness of people, given the history of the insurance industry, to give them more power in the form of mandated customers. Here we have a nasty murderous industry that will be significantly weakened in the next 10-15 years when millions of baby boomers turn to medicare and we opt to get them millions more customers to keep them in business. Go figure.

[FatDave]

31. Your pessimism is striking.

I'm suggesting that this is the best bill we can hope to pass, and that many people, including the president and Michale Moore, believe it will be a path to single payer. You say "no it won't" with certainty. You already know for a fact that what we'll end up with is a private insurance mandate. I say wait and see how the final bill shapes up. If it's bad, I won't support it. We still have no idea at this point, but you've already shut down all consideration.

Good day, sir.

[bvar22]

42. His pessimism is reality based.

The same people who brought you Welfare for Wall Street are writing your Health Care Reforms.

[FatDave]

43. I know, don't pay any attention to the conservative Michael Moore wing of the party.

[bvar22]

44. What part of "a true public option" goes over your head?

"A True Public Option"

The Bill I'm most familiar with (HR 3200), and the ONE scored by the Congressional Budget Office does NOT contain a "true Public Option".

It does contain something they call a Public Option, but it is NOT available to the "Public", and it is not much of an option.

[ipaint]

46. It's ma'am.

[flyarm]

45. incorrect...here read it..or one of the several that are written..read it !!

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:

H.R.3200
America's Affordable Health Choices Act of 2009 (Introduced in House)

[Uzybone]

5. I think they already know this. Thus they fight viscously

the protesters are not smart, but the ones controlling them know that a public option will lead to single payer.

[babylonsister]

7. I think you're right. I'm just sad the people are so malleable. nt

[defendandprotect]

6. k i c k

[Oregone]

8. Cept with a firewalled option only covering 11-12 million people in a decade...

It wont work out so hot. How could it have a market influence if only a fraction of people qualified to enroll in it? This is just all fiction and wishful thinking

You would have this same effect if you opened up Medicare for anyone to enroll in it. I guess thatd be too simple

[babylonsister]

9. Do you know what's in the final plan? I don't. Moore doesn't. nt

[ipaint]

10. Realistically who is going to sneak in the genuine strong public option.

It's not in any of the plans now. Who is in charge of including it?

[babylonsister]

11. Hold on. You don't know how this will shake out either.

Patience.

And ftr, the House progressives don't plan on signing off on anything w/o a public option.

[ipaint]

12. No, a strong public option.

The Congressional Progressive Caucus calls for a robust public option that must:

Enact concurrently with other significant expansions of coverage and must not be conditioned on private industry actions.

Consist of one entity, operated by the federal government, which sets policies and bears the risk for paying medical claims to keep administrative costs low and provide a higher standard of care.

Be available to all individuals and employers across the nation without limitation Allow patients to have access to their choice of doctors and other providers that meet defined participation standards, similar to the traditional Medicare model, promote the medical home model, and eliminate lifetime caps on benefits.

Have the ability to structure the provider rates to promote quality care, primary care, prevention, chronic care management, and good public health.

Utilize the existing infrastructure of successful public programs like Medicare in order to maintain transparency and consumer protections for administering processes including payment systems, claims and appeals.

Establish or negotiate rates with pharmaceutical companies, durable medical equipment providers, and other providers to achieve the lowest prices for consumers.

Receive a level of subsidy and support that is no less than that received by private plans.

Ensure premiums must be priced at the lowest levels possible, not tied to the rates of private insurance plans.

In conclusion, the public plan, like all other qualified plans, must redress historical disparities in underrepresented communities. It must provide a standard package of comprehensive benefits including dental, vision, mental health and prescription drug coverage with no pre-existing condition exclusions.
It must limit cost-sharing so that there are no barriers to care, and incorporate up-to-date best practice models to improve quality and lower costs. All plans, including the public plan, must include coverage for evidence-based preventive health services at minimal or no co-pay. All plans, including the public plan, should be at least as transparent as traditional Medicare.

Unfortunately they left out 4 requirements of the original design of a public option in order to guarantee success:

• the public program must be pre-populated with tens of millions of
people;
• subsidies must go only to Americans who enroll in the public program;
• the program must be authorized to use Medicare’s payment rates; and
• the insurance industry must be required to offer the same benefits
the public program is required to offer.


So far not one proposal includes those demands.

What does the CPC do-
The cpc was supposed to publish an evaluation of hr 3200. Didn't happen.
Instead they send this to obama

"As the health care proposal continues to move forward in the House and Senate, we ask that you continue your commitment to the inclusion of a strong public option and do not weaken the language that has already passed through two committees. Let us be clear: A strong public option is already a compromise for the CPC. Many of us strongly supported a single-payer approach. We will not support a weakened public option.… "

Huh??? The language in that bill is extremely weak. So are they accepting it or not?

and this to pelosi-

"We want to assure you that for our continued support, the public option …. must be on a level playing field …. And, it must be connected to the Medicare infrastructure, including the provider and payment system. Allowing providers to opt out of the public option has already created a loss of $91 billion in savings. We cannot tolerate further weakening of the public option."

So now the initial weakening is ok just no more?


My prediction, they'll sign off on just about anything as long as someone refers to it as the public option to cover their butts.



There is no strong public option being supported by anyone in a position of power that is capable of controlling costs much less leading to a single payer system. So who exactly is going to sneak it in at the last minute.

[FatDave]

17. The things left out.

You seem to have a lot of details on the house bill that I haven't seen. Can you please share your source so I can be as well-versed as you?

Even still, the points you list as left out don't seem that major to me. In fact they mostly seem like things that would likely happen anyway, even if not explicitly defined. I'll comment point by point:

• the public program must be pre-populated with tens of millions of people;

How is this even possible, given that it is an option? If it must be pre-populated, you must force people into it, and it is no longer an option. Also, I don't think finding a few million to sign on immediately will be a problem. I'll be one of them.

• subsidies must go only to Americans who enroll in the public program;

If we assume the public option will be cheaper than private insurance (and that is, after all, the whole point), then why subsidize any more than the cost of the public option premium? This would be strong incentive for the poor (who would be the people receiving the subsidies) to go with the public rather than private, which will cost them extra money out of pocket.

• the program must be authorized to use Medicare’s payment rates;

If these prices have already been negotiated by the federal government, whose goal it is to keep costs down and who presumably wants the program to be successful, then why would the public plan offer to pay any more?

• the insurance industry must be required to offer the same benefits the public program is required to offer.

I don't see what difference it makes. If implemented, the public plan will be the same as the privates but cheaper. Without this provision, it'll be cheaper and better. Either is a win.

But again, I could be way off base. I'm just a regular guy trying to apply common sense, and you obviously know a lot more about it than me, so please feel free to correct any faulty assumptions I've made.

[ipaint]

22. Here are some links

http://markcrispinmiller.com/2009/07/the-public-option-really-isnt/

http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-“public-option”-was-sold/

The person who thought up the public option:
http://www.rwjf.org/pr/product.jsp?id=39853


For the record I don't think a strong or weak public option will solve anything. But when folks refer to a public option, strong or weak, most have no clue what that means.

The problem is out of control private for profit medical industry. Nothing short of medicare for all or a form of single payer with possibly non profit private insurance companies playing a small role will solve it. The government has to be in the dominant role. Currently it is not and this reform does not put it in that position.

This attempt at reform will end up like the other two attempts. As long as private insurance is allowed to control access to healthcare the problem with price and availability will get worse.

At some point the left will have to push for single payer. Half measures won't get us there. Concessions that cement the private insurers in their place of power won't get us there. Single payer may not pass now but it is essential to debate, discuss, educate and endorse it publicly now because down the road people will need to seriously consider it when it becomes obvious this current exercise in repeating the past isn't reform.

[babylonsister]

23. Chill. Most on DU know. Why don't you think whatever passes is

not better than nothing?

And single payer is in the cards imo. Baby steps. Nothing gets accomplished immediately, ever!

[ipaint]

26. Immediately?

This is my third go around as an adult. 35 years of writing letters, phone calls, protests.
You want to make the same mistake as the last two times there is not much I can do. But I learned from reading and discussing through the years and stifling that discussion with banal baby steps, it takes time memes is boring.

Hopefully when the time comes for real reform the left will assume it's responsibility to educate the public on the benefits of doing what every other industrilized country does, institute a form of national insurance/health care that minimizes or eliminates for profit vultures.

[babylonsister]

27. Well woo hoo. You are not the only one who's

been doing this.

Why are you sounding so defeated?

Why did you just get here? Where've you been?

[ipaint]

28. Oh, is this the only place where all the action is.

You go back to rainbows and sunshine and hope for a better day.

I'll stick with my approach. It may be depressing but it's real.

[babylonsister]

29. Enjoy. And you are don't know a thing about me prior to

October 4th, when you got here? In 2004? Only 374 posts? Ahhh, sweet. And busted. Red flag there.

:rofl:

[Oregone]

36. Would you be calling someone out on their post count?

When all else fails

[ipaint]

40. Yup, I'm busted.

:crazy:

[Oregone]

34. "And single payer is in the cards imo. Baby steps."

With all due respect, this is silly childhood fantasies.

Answer me this...why would creating a new firewalled, self-sustaining, premium-based insurance entity be closer to acoomplishing single-payer than simply incrementally expanding Medicare (which has a model apt for a single-payer system)? Why should anyone believe that the "public option" would be expanded at a later time if Medicare hasn't for decades? Are you sure this isn't just a silly talking point designed to try and recruit Medicare for All proponents onto the Nixonian-Romney based health reform?

[Oregone]

33. Well now, if we are just making shit up about the final bill, I guess it could be anything

But, ya know, it just might be closer to the CBO scored drafts than to some fantasy conception that exists in the hopefuls' minds alone.

[Sebastian Doyle]

14. So Michael Moore agrees with Howard Dean and myself?

Now let's hope that's exactly what Obama IS thinking, and he vetoes any bill that is less than that.

[Swamp Rat]

21. k&r

:hi::hug:

[Tierra_y_Libertad]

25. Trickle down healthcare? Why not single-payer now, Mike?

[harun]

32. I am sure if it was up to him, that is what he would prefer.

[Howard509]

30. Why doesn't Obama listen to Michael Moore?

It's not like Moore is any less of an expert than anyone working for his administration. Single payer now!

[Echo In Light]

35. Money, not altruism, fuels the oligarchy

[Blue_Tires]

37. k+r

[Union Yes]

38. Moore is one of my many heroes.

[moondust]

39. "...the profits they want to make."

Sure they'll make profits. They just won't be the obscene profits they're used to.

[DefenseLawyer]

41. The thing they end up calling the "public option"

won't be competing with anything, it was be complicated, underfunded and stigmatized by the media as "welfare" insurance. It will probably cover 10 million at best, and all people that private insurers didn't want anyway. The politician will still get to say that the "reformed" the system and did pass a "public option". From there it will wither on the vine. Then for the next 20 years we will be shouted down by the mantra that we tried public insurance and it just couldn't compete with the superior free market.

[ipaint]

47. Make Sure Your Rep. Supports H.R. 676

http://www.michaelmoore.com/sicko/what-can-i-do/boxscore/index.php?action=print

http://www.michaelmoore.com/sicko/what-can-i-do/petitions/pnum649.php