About that public option
Aug. 21st, 2009 08:49 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
pecuniumWe all want one right?
Maybe not. I want one if it actually makes real healthcare available. If it's some version of, "catastrophic coverage", or has some unworkable, "trigger mechanism"
The trigger is, at present, dead, but it's not completly out of the question, and it's not good. The last time anyone tried to make some aspect of healthcare "affordable" they stuck one in.
Mr. Emanuel said one of several ways to meet Mr. Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect. (WSJ, 7 July, 2009)
We all know how useful that's been. The advertising companies have made a lot of money, because the insurance companies are pushing the private coverage people need to survive, "the donut hole"
That would be bad enough. But there is more to consider. A public option which provides barely adequate coverage is better than nothing, but it might be worse than nothing too. People are amazingly willing to put up with an inadequacy. They may do it from ignorance (the insurance lobby has done a great job of that on this subject, look at all the people who think France, Britain, Canada, etc. is full of people dying because they are not allowed to get care from the national healthplan). They may do it from fear, "What I have isn't the best, but it could be worse."
A poor public plan is likely to make more substantive change much harder.
I want single payer. If I can't get that, I want a pubic option which is well-funded, has a slew of customer protections, competes head to head with private insurance (hey, if the "free market" is so damned good that it can sure all ills, let's put it to the test. So far, on this subject Adam Smith seems to have been right People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices., but that's for another day).
What I don't want is the public option to be used as cover for another handout of my money to the money-grubbers who are presently running the "death panels" which are killing people (not just grandma, but people my age (42) and children), or consigning them to lives of misery and poverty, shortened by illness and ruined by despair.
That is something which could happen. Max Bachus, Chuck Grassley, Olympia Snowe; and their fellow travellers, are more than capable of putting a different sort of poison pill in the bill (in committee, or in conference). They could stripthe protections people need (no retroactive recission, no-prexisiting condition, keeping the anti-trust exemptions the insurers have, etc.). We would be told these "compromises" were made to get a neutered ghost of a real public plan created. That without them no public option would ever be passed.
Ten years down the road, when the indsutry is still doing well, when the poor are still struggling to get real healthcare (but they have something), when the costs are still grossly higher than any other nation on earth, and someone tries to change it... inertia will kill it aborning. People would be willing to cling to an inadequate plan, for fear the new would be worse.
If you doubt me, just look at the town-hall meetings, where people who don't have the sort of coverage single payer, or a well crafted public plan, would provide; who are paying more than they would have to, to get lesser coverage, are fighting, tooth and nail, to keep the status quo.
A huge majority want's single payer. A larger percentage want's a public option (though much of that is overlap, people like me who will support a public option because we have been told single payer is off the table)>
We need real reform. We need real coverage. We need to make sure the rhetoric (public plan, healtcare for everyone), lives up to the ideal.
Maybe not. I want one if it actually makes real healthcare available. If it's some version of, "catastrophic coverage", or has some unworkable, "trigger mechanism"
The trigger is, at present, dead, but it's not completly out of the question, and it's not good. The last time anyone tried to make some aspect of healthcare "affordable" they stuck one in.
Mr. Emanuel said one of several ways to meet Mr. Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect. (WSJ, 7 July, 2009)
We all know how useful that's been. The advertising companies have made a lot of money, because the insurance companies are pushing the private coverage people need to survive, "the donut hole"
That would be bad enough. But there is more to consider. A public option which provides barely adequate coverage is better than nothing, but it might be worse than nothing too. People are amazingly willing to put up with an inadequacy. They may do it from ignorance (the insurance lobby has done a great job of that on this subject, look at all the people who think France, Britain, Canada, etc. is full of people dying because they are not allowed to get care from the national healthplan). They may do it from fear, "What I have isn't the best, but it could be worse."
A poor public plan is likely to make more substantive change much harder.
I want single payer. If I can't get that, I want a pubic option which is well-funded, has a slew of customer protections, competes head to head with private insurance (hey, if the "free market" is so damned good that it can sure all ills, let's put it to the test. So far, on this subject Adam Smith seems to have been right People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices., but that's for another day).
What I don't want is the public option to be used as cover for another handout of my money to the money-grubbers who are presently running the "death panels" which are killing people (not just grandma, but people my age (42) and children), or consigning them to lives of misery and poverty, shortened by illness and ruined by despair.
That is something which could happen. Max Bachus, Chuck Grassley, Olympia Snowe; and their fellow travellers, are more than capable of putting a different sort of poison pill in the bill (in committee, or in conference). They could stripthe protections people need (no retroactive recission, no-prexisiting condition, keeping the anti-trust exemptions the insurers have, etc.). We would be told these "compromises" were made to get a neutered ghost of a real public plan created. That without them no public option would ever be passed.
Ten years down the road, when the indsutry is still doing well, when the poor are still struggling to get real healthcare (but they have something), when the costs are still grossly higher than any other nation on earth, and someone tries to change it... inertia will kill it aborning. People would be willing to cling to an inadequate plan, for fear the new would be worse.
If you doubt me, just look at the town-hall meetings, where people who don't have the sort of coverage single payer, or a well crafted public plan, would provide; who are paying more than they would have to, to get lesser coverage, are fighting, tooth and nail, to keep the status quo.
A huge majority want's single payer. A larger percentage want's a public option (though much of that is overlap, people like me who will support a public option because we have been told single payer is off the table)>
We need real reform. We need real coverage. We need to make sure the rhetoric (public plan, healtcare for everyone), lives up to the ideal.
