Comments on: The Max Tax: Baucus Plan Fails to Control Growth of Insurance Premiums

By: Jon Walker

Jon Walker — Thu, 24 Sep 2009 19:20:06 +0000

looking at all the systems in the world. I think the French system offers the best overall package. There are cheaper, there are fairer, and there are some high quality for select individuals.

They use a system of basic care being single payer government run with the option to buy additional coverage.

The CBO says the House PO would be 10% cheaper. I think that is more than enough to develop large market share and compete.

By: bmull

bmull — Thu, 24 Sep 2009 19:17:37 +0000

The two simplest things we could have done to bring down costs: Single Payer and Medicare Drug Price Negotiation. That was the low hanging fruit.

That said, if we could get any kind of Public Option passed, I suspect that we could find some ways to save taxpayers money. For instance, we could open a new HMO called Saiser Sermanente in every state that has just one or two dominant insureres.

There are also delivery system ideas which aren’t getting much discussion such as increasing incentives for new medical graduates to practice in underserved areas, and increasing incentives for doctors to join high-efficiency medical groups.

By: selise

selise — Thu, 24 Sep 2009 19:12:01 +0000

is it fair to say that as far as you know there is no significant policy analysis to back up the competition claims above?

Even a plan like the one in the House with a strong public option would be far from my own choice.

but do you think the house bill po will compete to bring down costs — that was the question.

If it was up to me I would throw everything at the wall to bring down price

then why do you chose a multipayer system? where is your analysis to show this is the most effective way to bring down price?

p.s. fair warning: i will save my objections to your use of the qualifier “strong” for another day. i’ve already peppered you with enough questions for one day. thanks again for taking my questions seriously and for responding.

By: Jon Walker

Jon Walker — Thu, 24 Sep 2009 18:34:37 +0000

I believe the devil is in the details. Even a plan like the one in the House with a strong public option would be far from my own choice.

I think you could have a system that works. If you had very tight consumer protections, a very strong ombudsman with the power to enforce them and levy huge fines for violations, no cost control regulations but a robust national public option.

If it was up to me I would throw everything at the wall to bring down price. A basic minimum plan everyone was in by default. Supplemental or separate insurance in a highly regulated exchange (with private and public options). Only non-profit insurance companies, Fix minimum medical loss ratio at 91%. An ombudsman with the power to directly take funds from any plan to pay a claim, etc…

By: selise

selise — Thu, 24 Sep 2009 18:28:38 +0000

i know that’s what hacker is now saying — but is there any analysis to back it up? seems very strange to me based on his earlier work and as i wrote above, makes no sense at all to me. maybe i’m just stupid or missing something though and would really like to be educated on the subject if that is the case.

By: selise

selise — Thu, 24 Sep 2009 18:25:26 +0000

thanks very much for the reply. what do you think? in your opinion, is it correct?

By: i4u2bi

i4u2bi — Thu, 24 Sep 2009 18:18:43 +0000

I’m beginning to rethink this axis of evil thing…US – Russia – China maybe? No universal health care here, no none here either.

By: Jon Walker

Jon Walker — Thu, 24 Sep 2009 18:16:57 +0000

Jacob Hacker, creator of public option idea, “The current proposals really hinge on the public plan to provide a source of long-term cost control and to limit the federal government’s liability for health care.”

http://money.cnn.com/2009/09/0.....2009090412

By: Jon Walker

Jon Walker — Thu, 24 Sep 2009 18:13:46 +0000

I did not say it was correct, I did say that was the argument made for it.

By: wigwam

wigwam — Thu, 24 Sep 2009 18:03:01 +0000

Jon, did you notice that Levey and Oliphant did not mention the words “public option” until 20 inches into this 30-inch article and then gave it only one sentence before moving on to the Baucus bill’s co-ops?

[…]

The House bill also features a new government insurance program — or “public option” — that advocates believe could offer consumers a lower-priced alternative to private plans and, in turn, pressure insurers to rein in premiums.

The Baucus proposal, which addresses widespread industry and business opposition to a new government plan, would instead set up a series of nonprofit health insurance cooperatives.

These may not offer much relief to consumers, however. The nonpartisan Congressional Budget Office has concluded that the co-ops outlined by Baucus “seem unlikely to establish a significant market presence in many areas of the country.”

That means that premium relief for consumers would depend on a series of indirect steps Baucus and other Democrats are pushing to nudge down medical costs and change the way insurers market their policies.

[…]

That’s it. That’s all they say about the public option.