Why we need a public option!

[Revere]

Every other industrialized nation in the world has national health insurance, and they pay HALF per capita what we pay for healthcare. The French have the best system, it is a combination of public and private insurance.

Why should government tell you how much health care you should buy, and how much you should accept to provide health care services?

Because it's the best way to provide healthcare for everyone.

It should be just like the fire department and the police.

Do 310,000,000 people always get the fire and police protection they think they should?

 

[Chris]

Why should government tell you how much health care you should buy, and how much you should accept to provide health care services?

Because it's the best way to provide healthcare for everyone.

It should be just like the fire department and the police.

Do 310,000,000 people always get the fire and police protection they think they should?

It's called 911.

Maybe you've heard of it?

 

[antagon]

i could appreciate the want. where's the need?

"Lost Labor Time" Costs U.S. $260 Billion Each Year.

Estimated 18 Million Adults With Chronic Illness or Disability Are Not Working.

i dont draw a connection between these matters and a need for a public option. i've explained how. can you link these issues with a public option based solution? ie: 'with a public option, paradoxically, people would be less likely to get sick or injured, causing lost labor time.' i dont think that is supportable because of the paradox.

help me out.

 

[Bern80]

Your argument is a loose as a 99 year old man with bowel problems.

1.Show proof that, "Government can't guarantee 310,000,000 people all the health care they want."

How about basic supply and demand for starters?

Private medicine is currently unable to supply facilities to meet the demands of society. Government has shown it can meet supply for a demand through several American diseases in the past, many I listed earlier.

How exactly is government going to magically supply more doctors?

 

[Bern80]

The word should be "available."

availability and affordability are not the same thing.

Affordibility and supply are not the same thing.

Thank you for saying exactly what I just said. The point is you said you want health care to be available, well one of the best ways to make any service less available is to reduce its price, which is why I said in response to your other post that supply and demand show that making health care free is going to make health care less availabel to people, not more. Please come back when you've completed beginner level economics.

 

[Bern80]

Every other industrialized nation in the world has national health insurance, and they pay HALF per capita what we pay for healthcare. The French have the best system, it is a combination of public and private insurance.

Why should government tell you how much health care you should buy, and how much you should accept to provide health care services?

Because it's the best way to provide healthcare for everyone.

It should be just like the fire department and the police.

It's should be just like fire and police protection? Government doesn't make you go out and purchase fire insurance or police protection.

 

[Bern80]

Every other leading nation manages to do it.

What does that mean, 'they do it'? Does that mean you actually think it's working? You libs seem to see one and only one component of this argument. The cost. You seem to think if the cost of health care gets low enough, or even free, that every thing will just be rainbows and butterflies for everyone. WAKE THE FUCK UP. You have to account for some basic economic principles as well. Lowering somethings cost puts it in greater demand which in health care terms means longer waits, kind of like I don't know, A LOT OF COUNTRIES WITH LOW COST HEALTH CARE. The other factor is maybe you the consumer aren't paying much for health care directly, but someone has to pay the doctors nurses and administrators and what is happening in France? THE CAN'T PAY FOR IT. They pay exhorbitant taxes already, and the amount they would have to be raised to actually cover their health care costs would lead to a revolt. Consequently this beacon of health care you lovers of france point to is running massive debts. From living in THIS country we all should be able to figure out what happens when you do that for too long.

In a lot of ways Europe is likely where we will be in a few years. Countries like France and the U.K. are finally starting to see the real problems with government getting to big. It is simply unsustainable. The U.K. alone was just forced to cut almost half a million government jobs.

 

[Mr. Shaman]

How quicky the right forgets the huge price increases the Insurance cos have treated us to over the last couple of decades while their profits were off the charts.

They will game us to death until we have a public option that will threaten their ability to act like a monopoly.

Is a 3-4% profit margin "off the charts?"

No.....but, the 20% IS!!!!!!!​

BILL MOYERS: Why is public insurance, a public option, so fiercely opposed by the industry?

WENDELL POTTER: The industry doesn't want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don't want any more competition period. They certainly don't want it from a government plan that might be operating more efficiently than they are, that they operate. The Medicare program that we have here is a government-run program that has administrative expenses that are like three percent or so.

BILL MOYERS: Compared to the industry's--

WENDELL POTTER: They spend about 20 cents of every premium dollar on overhead, which is administrative expense or profit. So they don't want to compete against a more efficient competitor.

 

[Greenbeard]

How exactly is government going to magically supply more doctors?

The government already produces much of the supply of doctors; most graduate medical education (i.e. residencies) in the United States is paid for by the government, primarily because it's expensive to train residents. There are more residency slots every year than there are graduating medical students, which is why we bring in lots of international med school graduates (~a quarter of new residents every year) to fill some of the gap.

Doctors don't just fall out of the sky. A nation's physician workforce is affected by everything from its explicit workforce strategies to payment policies (FFS has been good to the specialists; hence we have lots and lots of specialists). So yes, if we want to significantly increase the number of doctors, it's going to require policy.

 

[Full-Auto]

No IDIOT, its an insurance group that charges premiums and deductables and makes no profit which makes the product cheaper.

You have bought into the right wing hack lies about what it is.

LOL I see you have zero ability to think how this would affect tomorrow. My God. A non profit doesnt take away the things that will happen. Try common sense instead of dem rethoric.

Dear idiot.,
Non profits opperate in this country just fine and have for decades.


YOU PEOPLE ARE BRAINWASHED!

Yes idiot they do. You have still failed to adress the points raised.

If you are a coward just say so wuss.

 

[Bern80]

The government already produces much of the supply of doctors; most graduate medical education (i.e. residencies) in the United States is paid for by the government, primarily because it's expensive to train residents. There are more residency slots every year than there are graduating medical students, which is why we bring in lots of international med school graduates (~a quarter of new residents every year) to fill some of the gap.

The government isn't supplying more doctors in this case. They are paying for them.

Doctors don't just fall out of the sky. A nation's physician workforce is affected by everything from its explicit workforce strategies to payment policies (FFS has been good to the specialists; hence we have lots and lots of specialists). So yes, if we want to significantly increase the number of doctors, it's going to require policy.

Maybe, but not on the part of government. It would seem to me that universities need to increase the quantity of qualified applicants they admit into med school.

 

[Wry Catcher]

Why should government tell you how much health care you should buy, and how much you should accept to provide health care services?

Because it's the best way to provide healthcare for everyone.

It should be just like the fire department and the police.

It's should be just like fire and police protection? Government doesn't make you go out and purchase fire insurance or police protection.

You're really reaching now, why not 'grow up' and quite tossing mud on the wall and hope some sticks. Those who don't buy health insurance and get ill or injured get treated and the tax payer pays.
Those who are homeless still get police protection, and if their meager belongings are set on fire, firefighters will respond and give aid, and the tax payer pays.

Not everyone who can't afford health insurance is a bum, though it seems the 'tea party mentality' likes to assume such is true. There are those who earn a living, though not a living wage, who go to two or more jobs, pay taxes, support their famiilies and have no benefits or 'disposable' income - for food, clothing, energy and shelter take it all. There is no extra, no dental care, no regular check-ups, no child care when both parents work. There is only the hope that their kids will have it better.
And now the TP and the Callous Conservatives wish to take hope away.
Yes, there are 'bums' and cheats but there are 'bums' and cheats in all income levels and in all the strata of our society; the difference being some bums are addicted to drugs/alcohol or suffer from mental disorders and some in suits and ties are addicted to avarice & take pleasure in great wealth without regard for others.

 

[AmericanFirst]

How quicky the right forgets the huge price increases the Insurance cos have treated us to over the last couple of decades while their profits were off the charts.

They will game us to death until we have a public option that will threaten their ability to act like a monopoly.

The public option is just gov't control. That is what the health care bill is all about!!

 

[Soggy in NOLA]

Because it's the best way to provide healthcare for everyone.

It should be just like the fire department and the police.

It's should be just like fire and police protection? Government doesn't make you go out and purchase fire insurance or police protection.

You're really reaching now, why not 'grow up' and quite tossing mud on the wall and hope some sticks. Those who don't buy health insurance and get ill or injured get treated and the tax payer pays.
Those who are homeless still get police protection, and if their meager belongings are set on fire, firefighters will respond and give aid, and the tax payer pays.

Not everyone who can't afford health insurance is a bum, though it seems the 'tea party mentality' likes to assume such is true. There are those who earn a living, though not a living wage, who go to two or more jobs, pay taxes, support their famiilies and have no benefits or 'disposable' income - for food, clothing, energy and shelter take it all. There is no extra, no dental care, no regular check-ups, no child care when both parents work. There is only the hope that their kids will have it better.
And now the TP and the Callous Conservatives wish to take hope away.
Yes, there are 'bums' and cheats but there are 'bums' and cheats in all income levels and in all the strata of our society; the difference being some bums are addicted to drugs/alcohol or suffer from mental disorders and some in suits and ties are addicted to avarice & take pleasure in great wealth without regard for others.

Actually, it is the progressive left that demonizes those who don't buy health insurance, eat what they say they shouldn't eat, smoke, don't do this or do that. Bunch of busybody fucktards.

 

[editec]

How about basic supply and demand for starters?

Private medicine is currently unable to supply facilities to meet the demands of society. Government has shown it can meet supply for a demand through several American diseases in the past, many I listed earlier.

How exactly is government going to magically supply more doctors?

In the short run?

They cannot.

In the long run?

By funding educational opportunities in the health care field.

The average Doctor or Nurse comes out of school so deeply in debt they have NO CHOICE but to demand salaries that are wildly out of line with what their patients are making.

Medical Student Debt

In a recent study by the Association of American Medical Colleges (3) the cost of private medical schools has risen 165% and the cost of public medical schools has gone up 312% over the last 20 years. A similar study by the AMA (4) found that medical school costs have increased substantially more than the Consumer Price Index (inflation). The average medical student graduates with nearly $100,000 in student loan debt (Medical School Loans).

source

 

[Bern80]

You're really reaching now, why not 'grow up' and quite tossing mud on the wall and hope some sticks. Those who don't buy health insurance and get ill or injured get treated and the tax payer pays.
Those who are homeless still get police protection, and if their meager belongings are set on fire, firefighters will respond and give aid, and the tax payer pays.

So instead of making everyone buy health insurance to cover your precieved problem of taxpayers paying for other people (which there going to be anyway if government run it, DOH!), why don't we legislate that you are on the hook for your health care costs. Why would anyone assume they shouldn't have to pay for services rendered?

Not everyone who can't afford health insurance is a bum, though it seems the 'tea party mentality' likes to assume such is true. There are those who earn a living, though not a living wage, who go to two or more jobs, pay taxes, support their famiilies and have no benefits or 'disposable' income - for food, clothing, energy and shelter take it all. There is no extra, no dental care, no regular check-ups, no child care when both parents work. There is only the hope that their kids will have it better.
And now the TP and the Callous Conservatives wish to take hope away.
Yes, there are 'bums' and cheats but there are 'bums' and cheats in all income levels and in all the strata of our society; the difference being some bums are addicted to drugs/alcohol or suffer from mental disorders and some in suits and ties are addicted to avarice & take pleasure in great wealth without regard for others.

If I need to stop mud sligning then you need to get fucking real. You really believe that conservatives don't want people to receive the health care they need? Come on, attempt a little intellectual integrity please. This isn't about who should get health care or who shoudn't, it's about how it should be provided. History shows government doesn't do very much, bery well so I think a lot of us are perfectly justified in worrying about government sticking its nose in. In the grander scheme it is an erosion of freedom. Everytime you would rather have government provide something for you then you providing it yourself you are giving away your freedom. You are saying I would rather someone else makes the decisions for me. I guess some people don't mind that.

 

[Immanuel]

Are you quoting the bill itself with that "NO BAILOUTS" information or something else?

Yes, that's from the bill passed by the House last November, H.R. 3962 (the final, post-mark-up, iteration of the original, H.R. 3200).

The "administrative expenses" that you mention are not something that the government has to worry about, they simply pass those expenses off on the tax payer or should I say our great grandchildren at the moment. And if the tax dollars collected in a given year for this legislation are insufficient to cover the expenses, the government simply passes the short fall off on to future generations just as they are doing with Social Security, not to mention every other social endeavor the government attempts. It is called the deficit and right now, this country is drowning in red ink.

Again, the public option wouldn't be funded like Medicare or Social Security. Medicare is partially funded by premiums. A public option would be entirely funded by premiums; that's a requirement of the law. Tax revenues play no part in its operation, beyond the refundable tax credit offered to anyone with income below 400% FPL buying coverage in an exchange. Or as the legislation itself read:

(a) Establishment of Premiums-

(1) IN GENERAL- The Secretary shall establish geographically adjusted premium rates for the public health insurance option--

(A) in a manner that complies with the premium rules established by the Commissioner under section 213 for Exchange-participating health benefits plans; and
(B) at a level sufficient to fully finance the costs of--

(i) health benefits provided by the public health insurance option; and
(ii) administrative costs related to operating the public health insurance option.​

(2) CONTINGENCY MARGIN- In establishing premium rates under paragraph (1), the Secretary shall include an appropriate amount for a contingency margin (which shall be not less than 90 days of estimated claims). Before setting such appropriate amount for years starting with Y3, the Secretary shall solicit a recommendation on such amount from the American Academy of Actuaries.​

​

Eliminating price competition is only one part of the problem. Another problem is that when the government has driven the other insurers out of the market, then the government will dictate to the providers (as they already do with Medicare) what the providers will receive for their services. There will be no "negotiating" as there is in today's market between the health care provider and the insurers. The government will inform the providers what the government will pay and that will be all that there is to it. That will in effect drive the quality of health care down the toilet and force good doctors into other professions or retirement.

That's the key feature of the robust public option (i.e. the original version found in H.R. 3200): it starts with the Medicare provider network, though providers may opt-out, and it pegs reimbursements to Medicare rates + 5% for the first few years. The negotiated rates public option, which would be much less effective, was what eventually passed the House. And of course ultimately no public option became law.

As I've argued before, the idea behind the public option was never that the public option would became the only insurer or that all insurance would eventually reimburse at rates set like Medicare rates (not least because the proposed public option was limited to the exchanges, which is not where the large majority of people will be buying their coverage). Instead, it would've put pressure on private insurers and providers alike to start controlling costs. The reason, of course, is that since the robust public option would have reimbursed at lower rates than private insurers, its premiums would be lower.

Insurers would face pressure to negotiate lower reimbursement rates to keep their own premiums down and providers would have an incentive to grant lower rates, lest more customers flock toward the public option (an outcome that would lower reimbursements to those providers more than would granting private insurers lower--but still higher than public option--rates). As I said above, the intent wasn't for it to take over the market but rather to reshape the landscape in which the insurer-provider negotiation takes place. In one sense, it would have given private insurers cover (and leverage--something payers lack in many areas) to start bringing down rates. The public option would be most effective if it actually had relatively few customers but succeeded in narrowing the gap between its administratively set rates and the average negotiated private payer rate. That's the most important point that was never stressed enough: the point of the public option was to change the way private payers and providers interact with each other, not scoop up everyone's customers.

Now, as I mentioned, all-payer rate setting can close the gap between the private (negotiated) and public (administratively set) payments and overcome the cost-driving influences of provider consolidation in numerous markets in a much less cutesy way. But that would require lots of effort on the part of states (only Maryland currently has an all-payer rate setting system in place), whereas a public option would be a problem for the feds alone. But at very least, using all-payer rate setting instead of a public option would presumably assuage your fears that there's some plot afoot to destroy private insurance, even though it's arguably more heavy-handed.

All that I will say about this, is that you have a hell of a lot of confidence in bureaucrats.

This for instance:

the point of the public option was to change the way private payers and providers interact with each other, not scoop up everyone's customers.

Let me remind you that the stated goal of the villains in Washington is Single-payer Health care, meaning they want it all. They have sold us a bill of goods that they claim will do one thing which, in fact, does something quite the opposite.

Again, the "administrative costs" are much lower than those that would be encountered by a private insurer. Since the government need not worry about taxes or even the "bottom line" that private insurers (even not-for-profit insurers if there were such a thing) must worry about the inevitable result of this plan will be to drive private insurers into bankruptcy AND I MIGHT ADD their employees (the clerks, salesmen, adjusters etc.) onto the unemployment lines. Remember that the government plan does not have to worry about paying taxes or even meeting other expenses. The government can operate with a loss almost indefinitely. No other insurer can do this.

Eventually, the stated goal of Single-payer Health Care will be achieved. I think candidate Obama's estimate was fifteen to twenty years and I am fairly confident that he is not all that far off.

Immie

 

[Immanuel]

Every other leading nation manages to do it.

Really?

So what? I choose to live in the United States of America because it is not like every other nation.

Immie

 

[California Girl]

Which nations that are "leading" ours have better health care than we do?

The French.

Exactly what are they "leading" us in?

Health care. The French are consistently ranked first in the world on health care. Of course, there is a down side.... it is very expensive for their taxpayers. On the other hand, it's probably a system that we could instigate in the US. Personally, having seen both systems, I would have respected Obama had he said that he wanted to put together a team to investigate how a similar system might work here rather than the complete cluster fuck that he ended up doing.

 

[Immanuel]

Every other industrialized nation in the world has national health insurance, and they pay HALF per capita what we pay for healthcare. The French have the best system, it is a combination of public and private insurance.

Why should government tell you how much health care you should buy, and how much you should accept to provide health care services?

Because it's the best way to provide healthcare for everyone.

It should be just like the fire department and the police.

The health care bill we are discussing is nothing at all like the fire department or the police. If it were similar then the state (more likely the county) governments would employ Doctors and Nurses to work in their facilities. If we needed medical attention, we would go to the hospital receive their services and go on our way without ever having to pay a dime out of pocket because they would have taxed us for it.

Immie