The Senate HELP Committee “public option” will be multiple “options,” - run by insur

[slipslidingaway]

http://pnhp.org/blog/

By Kip Sullivan, JD

"....Finding the HELP Committee bill

To determine what the HELP Committee “public option” proposal is, one must first find a final version of the legislation that came out of the committee. Ordinarily, that is not a difficult process. But for some reason, the HELP Committee bill still has no bill number and, three weeks after it was voted out of the HELP committee, still is not available for the public to read. That might sound like a sloppy way to run a Senate committee, but I have confirmed with two sources that there is no final bill available. An aide in the Washington office of Senator Al Franken (D-MN), with whom I spoke on August 7, referred me to the draft bill posted at the HELP Committee’s Website. At this Website, the draft bill appears in two pieces, one labeled “the Affordable Health Choices Act” and the other labeled “the additional Chairman’s mark on coverage.” It is in the “Chairman’s mark” segment of the bill, beginning at page 77, that we find “Section 3106: Community health insurance option.”

http://help.senate.gov/BAI09F54_xml.pdf


Summary of Section 3106 in semi-plain English

Section 3106 is difficult to read. It fails to offer clear definitions of critical terms, it uses different terms to describe the same thing, and it contains unnecessarily abstract language. Because it is poorly written, it requires at least two readings to understand it. I will tell you first what I derive from it in the plainest language possible, and then discuss some of its provisions so you can judge for yourself whether I got it right.

Section 3106 requires the Secretary of the Department of Health and Human Services (DHHS, the federal agency within which Medicare and Medicaid are housed) to create multiple health insurance companies that, together, will make “public” health insurance available for sale to the non-elderly in every state in the country. The Secretary will not be using federal employees to make this happen. The Secretary is required, rather, to contract with nonprofit insurance companies to create health insurance policies that will qualify as “community health insurance options.” (Some of the bill’s language seems to be confusing by design. What meaning is conveyed by adding “community” and “options” to “health insurance”?)

The corporations that contract with the Secretary to create these “community” health insurance companies will be required to meet the same standards insurance companies currently must meet in order to serve as “Medicare Administrative Contractors” (MACs) to administer Medicare’s traditional program. These corporations must, in other words, be insurance companies...


Decoding Section 3106: Is it one “option” or multiple “options”?

Section 3106 proposes multiple “options,” not a single Medicare-like program, but this is not apparent at first. The first three sentences contradict each other. The very first sentence says there will be multiple “options” serving “communities” (not the whole country):...


....Here are two examples of provisions giving the states authority to define key features of “options”: (1) The only sentence in a section entitled “States may offer additional benefits” reads, “A state may require that a community health insurance option offered in such State offer benefits in addition to the essential health benefits required under ”; and (2) under a section headed “Solvency,” we find, “A community health insurance option shall … be subject to the solvency standard of each State in which such community health insurance option is offered.”

A patchwork of 50 different reserve requirements and 50 different benefit levels seems a far cry from “public option” proponents’ vision of a single, Medicare-like plan covering the whole country..."

[Wednesdays]

1. I need new glasses, for sure

I read your headline as "The Senate HELP Committee public option will be multiple orgasms..." and thought, hey, I could really support that! :spray: :blush:

[slipslidingaway]

4. We know where your mind is this afternoon :)) better for your health

anyway!

:hi:

[slipslidingaway]

2. Another snip...

"...If my interpretation of Section 3106 is correct – if the Senate HELP Committee’s “option” program is going to be balkanized and run by the nonprofit wing of the insurance industry – then reasonable people have to conclude that the deck is really stacked against the Committee’s “option” program...

But if public employees are not going to be directly responsible for creating the “community options” – if the nonprofit wing of the insurance industry is going to be doing that – then the entire “community option” project of the Senate HELP Committee amounts to a cruel joke on the public. Should the public trust corporations like Blue Cross and Kaiser Permanente to make a good faith effort to build competing insurance companies?

...Section 3106 is a mess, but its meaning becomes clear after several readings. Section 3106 does not create the “Medicare-like” program promised by Jacob Hacker, HCAN, Howard Dean, and other “option” advocates. Instead it proposes a program that authorizes DHHS to create numerous health insurance companies tied to geographic areas, and to contract with members of the existing insurance industry to create and possibly run those companies.

Leaders of the “public option” movement have an obligation to advertise the HELP Committee bill truthfully. It is not accurate to say the HELP Committee bill creates a “robust” or “strong” public option. It is not even accurate to say the HELP Committee bill creates one “option.” The truth is the “option” is balkanized and very weak. In fact, HCAN, Andy Stern, Howard Dean and other “option” advocates who have praised the HELP Committee bill should do more than cease to praise it. They should tell Congress they oppose it."

[nashville_brook]

13. lets be clear -- this is NOT A PUBLIC OPTION -- this is a giveaway to insurance co's

[slipslidingaway]

14. I'm with you, but many on the left continue to push this reform bill...

:(

[nashville_brook]

23. i don't think people realize how it's shaping up -- that's why the OP here is so important.

[slipslidingaway]

30. I think so too, sorry just saw this reply now :) nt

[newspeak]

27. Oh my goddess!!!

years ago, I lived in California, and Kaiser Permanente had a couple of lawsuits against them for not doing critical tests (save money?) and not treating certain patients. I remember, patients died. This was years ago and since I don't live there now, I don't know what's going on with them now.

[ipaint]

3. Mine keeps falling off the page, maybe yours will do better!

:hi:

Apparently "death panels" and many other shiny objects are successfully distracting the masses. Actual health care policy discussions and critiques are few and very far between.

For what it is worth Howard Dean thinks the HELP committee bill "is a great bill".

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6302054&mesg_id=6302054

[slipslidingaway]

7. Just gave the thread a knr - sorry I missed it earlier...

two threads might get noticed over the distractions.

:shrug:

[ipaint]

9. No problem

If folks are going to settle for less than less it's important it is defined clearly.

I'm at a loss as to the advantages of privatizing the "medicare for all" strong public option.
The concept worked so well in iraq, maybe? :crazy:

[slipslidingaway]

12. I'm at a loss as well, no doubt the bill will allow some people to

obtain coverage, but it still leaves many people out and will not bring real competition to the private companies as advertised.

I see my rec got your thread unreccomended.

:(

[ipaint]

16. Yes

Apparently the evil, up to no good single payer advocates are telling the truth again.

Couldn't be the paid off politicians and an industry that destroyed access to affordable health care in this country 40 years ago to today pulling another fast one.

Nope it's the folks advocating for the right to health care every other industrialized nation has.
Those single payer people are lying.

Can people really rationalize a privatized "medicare for all" public option to the point it is morphed into reform.

You betcha.

[slipslidingaway]

21. Why would SP advocates want profit removed from the equation...

that would be crazy.

From the above Kip Sullivan article...

"...Here are two examples of provisions giving the states authority to define key features of “options”: (1) The only sentence in a section entitled “States may offer additional benefits” reads, “A state may require that a community health insurance option offered in such State offer benefits in addition to the essential health benefits required under ”; and (2) under a section headed “Solvency,” we find, “A community health insurance option shall … be subject to the solvency standard of each State in which such community health insurance option is offered.”

A patchwork of 50 different reserve requirements and 50 different benefit levels seems a far cry from “public option” proponents’ vision of a single, Medicare-like plan covering the whole country....


...If my interpretation of Section 3106 is correct – if the Senate HELP Committee’s “option” program is going to be balkanized and run by the nonprofit wing of the insurance industry – then reasonable people have to conclude that the deck is really stacked against the Committee’s “option” program. Even if Section 3106 authorized public employees, not Blue Cross Blue Shield employees, to create the dozens or hundreds of “community health insurance options” called for by Section 3106, the program would fail to pose any challenge to the insurance industry and might even die in the cradle. The health insurance industry has been very difficult to break into since at least the 1980s, and has become more so in the wake of the merger madness that swept through the industry in the early 1990s. But if public employees are not going to be directly responsible for creating the “community options” – if the nonprofit wing of the insurance industry is going to be doing that – then the entire “community option” project of the Senate HELP Committee amounts to a cruel joke on the public. Should the public trust corporations like Blue Cross and Kaiser Permanente to make a good faith effort to build competing insurance companies?..."

[Laelth]

5. Thanks for wading through the draft and explaining it.

Needless to say, it's a piece of shit, and I hope nothing like it ever becomes law.

Thanks, again, for your service to the community.

:dem:

-Laelth

[redqueen]

6. That was posted at a blog. The thanks should go to Kip Sullivan. (nt)

[slipslidingaway]

8. As noted above, credit goes to Kip Sullivan ...

this bill could set back real reform.

:(

[Laelth]

10. Well, then, thanks for bringing this synopsis to my attention.

And thanks to Kip Sullivan for his service to the American people.

:)

:dem:

-Laelth

[slipslidingaway]

11. Just changed the OP to make it more apparent and also included

the link to the second portion of the bill he mentions below. Most of the times I just use quotes, but including the authors name is reduces confusion.

:) you're welcome and thank you for the knr.


"...At this Website, the draft bill appears in two pieces, one labeled “the Affordable Health Choices Act” and the other labeled “the additional Chairman’s mark on coverage.” It is in the “Chairman’s mark” segment of the bill, beginning at page 77, that we find “Section 3106: Community health insurance option.”"

[bvar22]

15. K&R

A thousand little Community Based "Public Options" run by Insurance Corporations will NOT be effective at "Keeping the Insurance Corps honest" or "opening the door to Single Payer". Nor will they be able to negotiate better prices from Big Pharm and Health Care Providers.

There will be no reduction in administrative costs, and no savings inherent with a LARGE risk pool.

Designed to fail.


Man, you really have to watch these FUCKERS......and I'm talking about The Democrats.

[kenny blankenship]

17. You've got to let the insurance companies be in charge of keeping the insurance companies honest

That's the UNIQUELY AMERICAN solution. Where do you get off questioning that? What are you, anti-American as well as anti-business???

[SammyWinstonJack]

20. +1 nt

[slipslidingaway]

22. Thanks and a great last line n/t

[Festivito]

18. Many, so they can point to one that gets to fail as they all fail.

They'll even be able to direct certain people to certain programs, then say how much better they handle a particular malady against a single payer company.

Then they can let another single payer go economically under and claim it's a problem with the entire single payer system.

Designed to fail.

[ipaint]

19. The companies know medicare is going to be overburdened 10 years down the road as the baby

boomers come of age. With no effective long term cost controls in the ins. reform this nationwide network of private "public option" ins. companies would be positioned to fold in medicare recipients. That would be a quite a coup for them.

Mission Accomplished.

[newspeak]

28. yeah, then Wall Street might get their pipe dream

and they'll reform social security and privatize that too. See * will have his privatization of SS and he didn't even have to be in office.

[slipslidingaway]

24. "...direct certain people to certain programs..." great for the insurance

companies as there will be a mandate to purchase insurance.

And I agree that we'll hear about the ones that are failing.

:(

[slipslidingaway]

25. Sunday kick and repost - A pseudo-public option ... guess we'll find out

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5878900&mesg_id=5878900

http://pnhp.org/blog/2009/06/17/sebelius-flat-out-never-single-payer/


"...The proposal to provide a government-run Medicare-like program as an option for purchase within an insurance exchange of private health plans is vehemently opposed by the insurance industry, the U.S. Chamber of Commerce, the AMA, all Republicans, a large bloc of conservative Democrats, and many others. No amount of negotiation can resuscitate a Medicare-like option. It’s dead.

To avoid losing the support of the progressives and many of the moderates in Congress, efforts are being made to create a new private program that has distinguishing features, primarily cosmetic, that will allow them to mislabel it as a public option. The fear of opponents is that this pseudo-public option could later be transformed into a government-run program. Thus it is imperative that the design of the option would lock it up as a private sector model with no possibility of transformation. Without that assurance, the pseudo-public option will have to be eliminated during markup in order to salvage other reform policies. The opponents will never ever sign on to single-payer-in-waiting.

Those in the progressive community who abandoned single payer to support a public Medicare-like option, believing that this was the politically feasible strategy for success, simply haven’t been paying attention if they still really believe that a government-run public option can survive. They can keep on wishing, but they would be wise to back up their position by signing Sen. Bernie Sanders’ Petition to Congress:..."

[nightrain]

26. knr! This needs wider circulation.

[slipslidingaway]

29. Thanks, there is a new post in GD-P that is being unrecommended...

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8590725&mesg_id=8590725