Hi,

I am an outreach coordinator for the health videos website.

I wanted to jump start the discussion by offering up some videos for those of you looking for more information on health care reform. We have three topics pages about health care, one is specifically about policy, one is about the current reform efforts and finally, one features videos discussing the politics of it all.

http://www.icyou.com/topics/politics-policy/healthcare-policy

http://www.icyou.com/topics/politics-policy/healthcare-politics

http://www.icyou.com/topics/politics-policy/healthcare-reform

Check out these videos for answers to your questions, and check back daily for updates and new information!

Thanks,
Laura

Correct me if I am wrong.. but there is no public plan to chose from within the exchange?

If so, how on earth can an exchange be considered anything but another trigger, much less part of a public option?

There will be a public option just not one tied to medicare rates.

That’s great news on the house side; I believe getting a similar provision (or Wyden’s) into the Senate bill is by far the most important part of the remaining process. If everyone makes one call to your Senator/rep, this should be it.

I think a surprisingly rapid and massive rush towards using the public option is likely. Won’t the exchange Comissioner be a political appointee by the Democrats? And why wouldn’t most employers want to switch to the public plan? Sure, right now, there is a lot of ideological opposition and caution. But once it’s in effect, their only concern will be what’s cheapest.

Jon, do you see this morning’s weak tea actually functioning as a stepping stone to get us to real reform or do you see this as putting off reform for another few decades (kinda like Medicare could have evolved into a universal single payer system, but didn’t)?

What’s really sad is that nothing takes effect until 2013! In the meantime insurance companies continue to make record profits from people who can’t afford or have substandard coverage, and worse yet, how many more people DIE, let alone go bankrupt in the next three years. It’s shameful. I don’t know how some people can sleep at night…

Won’t the exchange Comissioner be a political appointee by the Democrats?

In 2015? Only if Republicans aren’t back in control by then. I’m not too keen on pinning our hopes on the beneficence of an appointed political operative.

In year one, 2013

Wow, thanks for that. Looks like I dropped the ball in keeping my calendar up to date — it says 2009. I must have done a Rip van Winkle there . . .

I don’t think any of the reform packages put forward will “work” what is important is getting the right foundations in place so when our whole broken health care system really falls apart.

Thanks for the reply. So do you think this bill contains the right foundations?

Either way, if I understand you correctly, Congress is determined to keep kicking the can down the road.

It’s hard to muster up any enthusiasm for such a pitiful effort.

the right foundation to me is a real public option. One run by the government and available right away. Strengthening CHIP and Medicaid is also the right direction.

This is still too long to wait. Why should we subsidize private profiteering for 6 more years, during which the profiteers will have figured out more ways to put off public insurance and the congressgrifters will have been trading further concessions for ongoing handouts.

This is not reform. This is fraud.

This provision is huge, a real sleeper. The principal difference between a “weak” and a “strong” public option is how rapidly it can attract a very large pool. A small pool = small negotiating leverage. In the long run, the rules for expanding exchange eligibility are probably just as important, even more important than, the Medicare rates vs negotiated rates issue.

The reason is that a much larger potential pool for the PO gives it more negotiating leverage — more market power. If that leverage reaches a critical mass, relative to the bargaining power of the providers, then the difference between “medicare rates +5%” and “negotiated rates” disappears. In fact, “negotiated rates” could become the same as Medicare rates.

Watch AHIP — the’ll go ballistic over this expansion, claiming it will dismantle the employer-based system — and it just might accellerate a trend that has already started.

Hi Sacrecrow, Do you know off the top of your head how many people work for firms with 100 or fewer employees?

Thanks Scarecrow. Perhaps the House is trying to keep this under the radar, hoping AHIP doesn’t notice…

Sorry, dunno — try searching Bureau of Labor Statistics

http://www.bls.gov/

Thank you, this is the issue that seems most important to me and is getting less coverage then it deserves. I almost wonder if that’s a good thing tho so we can work on it without the insanity

Haha, with two lobbyists for every member of congress nothing escapes the eyes of AHIP.

LOL, wishful thinking is one of my specialties ; )

On a more serious note though, I’ve been mulling over your comment earlier that the right foundation is a “real public option”. “Real” seems to be in the eye of the beholder… so lets say that Our Benevolent Commissioner decides to open the p.o. to everyone in 2015 would that make this a “real public option” to you?

I guess what I am struggling with is the question of whether the House bill (and I’m not even thinking ahead towards the conference committee with the Senate) is good enough to support. And is there still room to fix things like the patent issue Jane raised?

In other words what kind of hell should I be raising with my Congress critters — fix it or kill it?

My view is kill it! I think we can come back next year for another bite. The President and the blue dogs will be afraid of having nothing. And we will be in a much better bargaining position to get a better bill if we start out with Medicare for All and bargain down instead of pre-compromising.

I just saw Alan Grayson on Ed Schultz’s show giving his view that the House Bill ought to be supported. He says it will end pre-conditions, end the rescissions, and end the deaths, and it will also provide affordable insurance to many who have not had it before because of the subsidies. So he says it’s progress and should be supported.

My view, in opposition, is that if they want to pass a regulatory bill with subsidies for poor and lower middle class people, and without mandates or an exchange, or a PO, let them do that. I can support that. But having that in a bill with mandates, and having an inadequate PO that doesn’t take effect until 2013, doesn’t justify these bad aspects of a comprehensive bill.

So, my question is why don’t the progressives tell Pelosi that they’ll vote for a bill that contains the regulation part and the subsidies, but no mandates, and which takes effect 9 months after the bill is passed in 2010? That way, there’ll be no mandates for everyone without POs for everyone, and we can come back next year and see how the insurance companies feel about mandates, POs and exchanges then. Such a bill would still save lives and help with bankruptcies. But Democrats and progressives wouldn’t be in the position of forcing people to get private insurance they don’t want.

Would the blue dogs oppose this? I’d like to see them vote against a bill with subsidies, that outlawed preconditions, and regulations. What will they say? That it’s unfair to the poor insurance companies? Fat chance.

Hard to argue with your idea.

So much hot air and no one really knows what the hell is going to happen.

I think the most important part of the public option is to have it run by the HHS directly or indirectly. The CBO thinks 20% of people on the exchange will sign up for it. Every progressives should try to get every friend, family member, neighbor to sign up for it. If it can get 50 million member it does not matter it is not tied to Medicare rates it because the biggest market force in American.

As I see it, the PO is useful only to the extent that it is competitive with private insurers with respect to overall costs and services covered, and in so doing expands by drawing more enrollees irrespective of their risk than would private insurers.

Because the PO will inevitably contain higher risk enrollees, to provide comprehensive services at costs that are lower than private insurers it must depend on efficiency and lower reimbursement rates to accomplish this. That is if the PO is required by design to assume higher risk enrollees it must be allowed to charge less for services to stay competitive.

Jon wonder if you could expound on the following:

-Are people that receive subsidies to meet their premiums ineligible for the PO? If so they would by default be subsidized and go to private insurers.

-How would the exchange as described be able to independently bargain down costs from providers. And between the PO plan and private insurers which if either would benefit more from these bargained down costs?

And, as someone commented this morning, we haven’t even seen the riders yet. I’d like a dishwasher for me added to whatever they end up sending to the floor.

If the Congress really fixed the problem, there wouldn’t be six years’ worth of political contributions from Big Health, Big Pharma, and Big Insurance to look forward to, would there?

2013? What a crock.

But let’s look on the bright side! We don’t have to hear any more hysterical posts about “People are dying,” since that obviously wasn’t a concern.

Oh well, it gives people something to do.

CBO says the price of the House public option will be somewhat higher than other plans on the exchange. This means it’s going to be mainly a social conscience choice. I wonder how many people will have a few thousand extra a year to spend on making a social statement.

Calling all citizens of the State of CT:

This is your brain.

I think clearly what it’s about is primarily that fact that the industry that he’s serving by doing this—by preventing competition with the public option—is an industry from which he receives very substantial benefits. He’s drowning in campaign contributions from the insurance industry, the health care industry, the pharmaceutical industry—more than $2.5 million.

In early 2005 his wife was hired by a large P.R. firm, Hill & Knowlton, in the pharmaceutical division, which at the time was representing the health care giant Glaxo in major legislation before the Senate. And several months later Joe Lieberman was on the floor of the Senate offering legislation that would directly steer huge amounts of incentives to that company in order to develop vaccines.

So I think what you’re seeing here is the kind of legalized corruption, legalized bribery that runs the United States Senate; only in this case it’s particularly sleazy and transparent because Lieberman is ready to gut the major initiative of the Democratic Party.

Glenn Greenwald on Rachel Maddow 10/28/09

This is your brain on Lieberman’s claim to be a principled independent representing the interest of his CT constituents, rather than the unconscionable, narcissistic hack that he is.

Any questions?

letsgetitone writes:

So, my question is why don’t the progressives tell Pelosi that they’ll vote for a bill that contains the regulation part and the subsidies, but no mandates, and which takes effect 9 months after the bill is passed in 2010?

Progressives would.

The Blue Doggies will say this makes the deficit worse. They will be lying, but it’s become a very easy lie for them.

Sure we know what’s going to happen. The health insurance companies are going to get a huge bailout and a guaranteed market, which is what the mandate does.

Perhaps in the “mean time” if the the InsIndComplex goes really greedy it might piss off congress enough to amend the legislation and give them a hair cut. We can dream.

Yup. I promised you cake. It’s ready, and it’s devil’s food with fudge frosting.

Yes, and it’s just fine. There’s only three of us. Piece of…er, cake.

OMG, it’s after 10, I wouldn’t sleep a wink with all that white death!

I wonder which insurance company will get the contract to run the exchange?

Er, the “surprisingly rapid and massive rush” can’t start until 2013. And, parsing your words carefully, as single payer advocates must do with public option folks, I note that “surprisingly rapid and massive” is not at all the same as actually rapid and massive.

There especially won’t be a rush it the the “public option” costs more, see 30.

You want a to go box?

Exactly. I think some of us had hoped ( dont ask me why) that with a new “liberal” majority and a strong grass roots movement for health care that it would be done and the people will benefit. no way of course, but this fight has forced the door open and weakend the insurance industry. At least most people now see the insurance industry for what it is. they could be the next “big tobacco” ten years from now the country may have reason to be grateful for the can of worms we opened in 09′. Its definately going to take a never ending fight from now till then though. maybe we should start looking to see what kind of class action litigation might be brought against the health care monopolies.

If the legislation is amended between now and implementation, you can be sure that the financially precarious health insurers will get it amended to benefit themselves, not any of us.

that’d be good, us baby killers need our sleep

People whose “subsidy” for purchasing insurance will go directly to the insurance company’s bottom line, that’s who. The insurance company hired to run the public option, I mean.

(wink. again.)

Whichever one gave the most money to the OFA. Or perhaps Goldman Sachs could set up a new unit.

People getting tax credits to help afford health insurance will be eligible for the public option.

to my knowledge the exchange will not directly negotiate with providers.

Hey Teddy — Sounding the deficit alarm over health care reform is a calculated ruse to destroy any chance of real change in greater access & reduced costs at the expense of the insurance industry.

From the demise of any consideration of single payor … the fix was in & the jig was up.

Who asked where the money would come from when they passed $1 trillion tax cut for Bush’s base of “haves”?

Who willingly lied about where the money would come from when they authorized $2 trillion in war funding for Iraq & Afghanistan?

Who allowed Wall Street to blackmail the U.S. government into $5 trillion of burst bubble bailouts to refloat a systemically failed financial sector?

When it comes to putting corporate profits above, ahead & beyond people, America is the land of the free and the home of the brave.

(add to above)

Who allowed Wall Street to blackmail the U.S. government into $5 trillion of burst bubble bailouts to refloat a systemically failed financial sector?

When it comes to putting corporate profits above, ahead & beyond people, America is the land of the free and the home of the brave.

Kill it and usher out all the cocksuckers running for reelection in 2010, demanding that the new crop of legislators force the leadership to take up Healthcare reform again.

Teddy, “you can be sure that the financially precarious health insurers(sic) will get it amended to benefit themselves,”

Your sense of humor is delicious.

I’ve been mentally assembling a series of measures the insurers will use as rearguard action to prevent me from lowering my insurance costs.
– the big and obvious deal breaker is limiting negotiation. This is worse than Medicare Advantage (sic) passed under Bush
– require PO customers to be uninsured (thus preventing people with lousy low Medical Loss ratio insurance from changing plans)
– set income limit of P.O. customers to below a specific threshold.
– slow roll out
– I suspect the existing insurance cartels will penalize any doctors or clinics that try to offer lower rates to Public Option insurance.
– I suspect existing insurance cartel will identify
– existing cartel will have congress underfund PO audit and fraudster detection department just as Dubya didn’t fund Medicare fraudster detection and prosecution.

My rather severe problem with this has been indirectly mentioned above, i.e., Repugs will likely be in charge and appoint a Commisioner.

The P.O, and therefore reform itself, will have failed, gone bankrupt like MA and VT’s weak local plans, long before 2012. And the public’s justifiable rage at the skyrocketing, uncontrolled reform-compensation “pass-on” premium increases by Insurance, will be the death of Democratic credibility and power. I see nothing in these bills to stop those increases. There could be nothing but the most robust of P.O’s imaginable, that would do so.

It should have been HR676 as the Public Option in HR3200, Anthony Weiner knew it all along – but has strangely been co-opted with the rest.. Why doesn’t EVERYONE know that even a slightly weak bill is absolute death, a corporate welfare windfall for Insurance, and a cataclysm of cost for all, personally, through premium increases, and through government and already claimed ‘endangered’ entitlement fund costs as well ? (and btw, why doesn’t anyone call the legislature, on the persistent RAID of SS and Medicare?)

I am extremely afraid we have been defeated since Nancy (Pelosi,) and even Howard Dean (see his turncoat speech on Rachel tonight, 10/29,) appear to have been corrupted. Even Anthony Weiner is waffling! The House Public Option, like the one in the Senate, has a laughably ineffective risk pool size, where to survive it would desperately need a HUGE one immediately out of the gate, in EARLY 2010, to retain a Democratic congress and possibly create what we DON’T have now – a Democratic Senate. Of couyrse if we can;t namage to govern with all those majorities then we shouldn’t be allowed to try. Too bad we couldn’t find a candidate with even the stones to call out the first elephant in the room – The FED’s manufacured “credit Crisis” extortion of TARP and bailouts.

Baucus, Conrad, Nelson, Lincoln, and all the unacceptably corrupt ‘blue dogs’ need to be stripped of caucus membership (and DNC funding and support) immediately. They’re Republicans anyway, and who needs the spies in meetings?

And ‘The Lieberman’ (his name a newly coined epithet for the century) needs to be stripped of what he’s enjoying, in the spotlight of singlehandedly usurping a possible jewel of history, and throwing the American People under his Hartford Insurance Masters’ steamroller – POWER and the limelight.

If it’s power than moves him, then the threat of removing his committee seat should be an adequate threat. Why wasn’t it IMMEDIATELY used to preempt the media circus that almost got them Wye?

Apologies for the typos and lack of formatting –
The timeout on this site is far too short.

How can Grayson or Pelosi say insurance will be “affordable” when Pelosi took out Medicare +5 in the public option?

Mandates with this garbage? No thanks.

I agree, that’s a trigger.
It will never survive long enough to reach critical mass unless the initial risk pool limitation is never allowed to exist.

Imagine how affordable and complete Medicare would be if its risk pool weren’t limited to seniors, the most EXPENSIVE to insure.

Low cost but comprehensive Health Insurance relies on having the LARGEST and most diverse risk pool. You can’t build that gradually, with powerful competition buying legislation against it.

This is like what Howard Dean was recommending (before he now apparently got bought out like Nancy, and even Grayson)

- something like, without a strong public option immediately available to all, they should just strip out all the money (ie subsidies and mandates) and pass the reforms.

“Who allowed Wall Street to blackmail the U.S. government into $5 trillion of burst bubble bailouts to refloat a systemically failed financial sector? ”

PPDCUS -

What private cartel of 12 for-profit banks has the exclusive, unregulated, legally immune to independent audit, power, to set (or in this case, withhold) credit ?

hint: They also enjoy collecting UNTAXED interest from the USA in return for creating ALL its money supply.

IMO, considering the absolute, singleminded goal of business is to create profit in any way possible, if they could do such a thing – they did.

It’s too monstrous for people to believe, and so, laughably easy to get away with.

It has gone on liteally for centuries in the world, accruing such power, and perpetrating international atrocities of control over nations so monstrous, it again is very easy to call anyone illuminating it, a conpiracy theorist – the perfect cover.

Consider how plausible was the deniability of legislators returning home during the ‘sky is falling! We must act NOW!’ “crisis,” to document their stories of small businesses shrieking about the unavailability of credit.

proof positive – of what?

It was The FED – which it’s known, despite the obfuscation of its legal structure, is no more “Federal” than Federal Express.

What good would the regulations be, if no one could afford the “improved” insurance?

Insurance could – no, WOULD, just jack up premiums literally without limit, they would claim, “to pay for the reforms.” They’ve already told us that, which should have been absolute justification for the most robust, and universally available, P.O. imaginable.

What Switzerland and many other countries have done is simply legislate that Insurance Companies could no longer be for profit. In fact I believe no other country allows private profit in Health Insurance, and many don’t even allow it anywhere in Health CARE providers.

We all know that most of the cited drawbacks (like Canada and Britain’s waiting lines) would not need to happen in America, being a MUCH richer country, with far more Medical facilities and resources.

In other countries citizens go their entire lives NEVER SEEING A MEDICAL BILL. I can’t imagine how we ever allowed individuals to occur who believe it should be otherwise.

Hi rhytonen, First, let me “level-set” a bit. I’m one of the Medicare for All, single payer bloggers here.

You said:

“What good would the regulations be, if no one could afford the “improved” insurance?

Insurance could – no, WOULD, just jack up premiums literally without limit, they would claim, “to pay for the reforms.” They’ve already told us that, which should have been absolute justification for the most robust, and universally available, P.O. imaginable.”

Exactly. But first things first. You’d be able to get the regulatory bill passed this year, because Democrats just can’t vote against it. But, it’s a poison pill. When you put it into effect on January 1, 2010, there’s going to be an outcry and great anger at the insurance companies and also the Democrats. And that’s when you get them to pass either a Hacker-type PO operative on a very quick Day 1, with price controls until then, or Medicare for All, single payer within a year.

I have an easy remedy. Raise taxes on the rich some more. How about a wealth tax in addition to income taxes.

I’m not kidding. And, I’m not shy about it. If they’re so hot about the deficit, let them increase their own taxes to pay for it and quit shorting the middle class on health insurance that they all have.

I really have no patience with the deficit stuff in the first place. It’s all a big lie in the first place. Unless there’s inflation in the economy deficits don’t matter.

Hi lambertsrether, You mean we can’t even find 41 progressives in the CPC?

Thanks. Problem is the progressives are chicken when it comes to Nancy.

My questions were sardonic & rhetorical.