maybe that was the plan?

Private health insurance in American is extremely inefficient and more costly that public insurance. Basic logic dictates that a single public program directly collectively bargaining with providers for thousands of individuals is going to get a much better deal than one low-income individual with no market power and limited knowledge buying a product from a middleman.

Pretty much anything that is done that requires a profit is going to be more costly to the taxpayer than if it is done by an entity that does not demand a profit.

This is true no matter how many times and ways certain folks and organizations try to claim otherwise

I reckon that was the plan–keep the engorged corporate profits coming in, and lie, lie, lie about the benefits of the plan to people.

Looks like state by state we will have “universal” health care – despite Obama.

As far as the eye can see state after state must cut back medical care programs for the underclass? No money to help them! No other options available? Yea Social Security with it’s two trillion surplus is bankrupting the nation! Yea I understand.

60 votes in Senate with only 50 needed in the budget reconciliation bill – and this was the plan?

I think Obama would prefer to be remembered as a con-artist rather than a dunce.

This state by state result – if it occurs – requires new law so the 2017 opt out is reduced to 2014 and the state can avoid “exchanges”.

A lot of people predicted that BHP was going to prove to be the most effective part of the whole scheme. Unfortunately it only works in states that already have high enough HMO penetration. And there is the problem that providers are still in the drivers seat when it comes to costs, because switching to a different contractor is going to be difficult or impossible.

Slightly O/T: The just announced Wyden-Grassley proposal is a potential game changer. It will allow the public to see all payments made to individual Medicare providers. It would greatly improve oversight and dispel a lot of myths about who’s really getting our health care dollars. This is a true cost-control measure unlike the fake ones in Obamacare. Progressives should be strongly behind this. Expect it to be viciously opposed by the AMA and other provider grouops.

A public health plan?!? If only someone had thought of this earlier!

Private health insurance in American is extremely inefficient and more costly that public insurance. Basic logic dictates that a single public program directly collectively bargaining with providers for thousands of individuals is going to get a much better deal than one low-income individual with no market power and limited knowledge buying a product from a middleman.

But but but . . .the US Congress made a finding that it could regulate activity that is commercial and economic in nature, under the commerce clause, and force everyone to purchase private medical insurance, and that will REDUCE costs. It’s right there in the PPACA:

By significantly increasing health insurance coverage, the [mandatory purchase] requirement, together with the other provisions of this Act, will minimize this adverse selection and broaden the health insurance risk pool to include healthy individuals, which will lower health insurance premiums.

Perhaps the congressional “finding” was wrong? Wellpoint should have the answer.

It’s not the insurer profits that are driving this difference. Even if the profits of the insurers were zero, the private exchange would still be more costly to consumers, because each consumer bargains on his own and she has zero power to affect prices, and because of market concentration among insurers, there’s no competition to drive prices down. Hence, there’s no way for the private “competitive” exchange to achieve efficient pricing. Jon’s point about market power of a single buyer — the public plan — relative to the providers is the key point.

LOL – my friends at Wellpoint (OK – just one friend who still has not retired) insist that they(he) do(es) not do claim underwriting (reject more claims if profits need to go up) despite the court cases and my family members in Claims reporting their experience over the years. And I don’t push it. But Wellpoint with its Blue Cross Blue Shield franchise is indeed a good example of what is wrong with the industry.

I have to admit that I did not understand the “WHY” of de-mutualization into for-profit status back when I was assisting the process – I thought it was because of a need for access to capital to expand because my CEO told me that was the reason – and back then I believed my CEO! :-)

I would argue the real key point is the anti-trust exemption.

When “competitors” can legally collude to set prices and availability, there isn’t much of anything that’s going to be effective at controlling these costs except perhaps a strong, public option.

I still can’t for the life of me understand how progressives, or Democracts, for that matter, supported this POS, or any POS, without ending the anti-trust exemption.

Correct – the exchanges are the same as going to a brokers office – and the real effect is moving folks from group health being put out for bids, and an individual being told these are the prices you must pay.

Another Obama con-job sold by a MIT prof with no experience in the industry – just a very special spreadsheet that he has used to influence the Mass and national debate, getting a seat on the Mass board that runs things. My former school does not always hire based on ability to think – more on ability to seem to have a “reputation”. I screamed to all that would listen that it was a con – but we live in a world of “relationship” and not debate on merit. Now the new Mass cost containment “emergency?” committee, after suggesting new ways to pay MDs that was shot down (a market place solution like exchanges), is still looking at cost containment in Mass and is a bit late on telling us what their solution is post the failure of exchanges to control cost.

So Obama’s health care reform might fail. At least he’s done lots of other good things to remember him by.

[sarcastically]

And the irony cherry on this maddening sundae is that it was done to keep AHIP from bolting back to the GOP in 2010. Ha-ha!

Jon’s point about market power of a single buyer — the public plan — relative to the providers is the key point.

the public plan, if by that you mean a “public option,” is not not about a single buyer (that would be single payer). a single payer, and even without the market power you describe, would still save something like 30% of total health care costs (due to administration efficiency for both the providers and the insurer).

i know you know all this, but i’m still pissed off that anyone, especially progressives, is still trying to sell this effed up reform approach instead of something that has been shown to work.