Does anybody care anymore what "public option" ends up in the health reform bill?

[clear eye]

The article by Kip Sullivan called "HR 3200’s “public option” will not resemble Medicare" summarizes major aspects of both the public option section of the House bill and that Section of the Senate HELP committee bill.

PLEASE READ TO LEARN WHAT IS PLANNED:

Medicare is administered by public employees; the “options” in both bills will be administered by private-sector corporations, some or all of which will be insurance companies. The “option” in neither bill resembles Medicare...

...~Both bills authorize the Secretary of DHHS to sell health insurance to the non-elderly. HR 3200 calls the program that will do this the “public health insurance option” while the HELP bill calls it “community health insurance options.” In both bills, “option” insurance can be purchased only within an “exchange” (a one-stop shopping center for health insurance). The exchange will clearly be multiple exchanges at the state level under the HELP bill. The exchange will probably be a single national program under HR 3200...

...~ Both bills authorize subsidies for the relatively small number of Americans who will be eligible to shop within the exchange. These subsidies will be given to eligible individuals regardless of whether they use the subsidy to buy insurance from the “option” or from an insurance company.

~ Both bills authorize the Secretary to contract with corporations to conduct unspecified activities that will somehow lead to the creation of an “option” program throughout the country.

The bills require the corporations administering the "public" option to meet the same criteria as the insurance companies allowed to administer the Medicare Advantage plans. It strikes me that even the lucky few who get into the exchanges will have a crapshoot in what sorts of coverage will be available. Especially disturbing is that there is no language referring to the price of premiums. Mightn't the private insurers simply use the subsidies as an opportunity to overcharge? The premiums are only expected to be lower because providers are supposed to take the Medicare payment rates. But even that is not mandated.

The implication is that competition? will restrain the price of premiums. We already know how well that works. And of course this setup will do nothing to lower the costs in the system associated w/ doing business w/ multiple private corporations, all w/ different rules and forms.

Other parts of Sullivan's article clarify why, despite what proponents claim, the option(s) won't resemble Medicare at all. And why there's a good possibility that insurers won't be able to make enough profit to keep them providing the option plans, and the whole thing will just peter out.

The Senate bill still contains the individual mandate, and since even the contemplated "public" option is to be privatized, it will be a mandate for each and every one of us not elegible for Medicaid to purchase private insurance. It strikes me that we might be better off going for passage of health insurance reform this time around, eliminating denial of physician-recommended care and loss of coverage for pre-existing conditions, etc., and live to fight another day for a workable way to get care for the uncovered. I'd hate to find myself outside of the tiny pool of people allowed into the exchanges and forced to buy a policy overpriced because of the captive market. Since the $2B loans and the costs for the few people elegible for the subsidies are slated to come from Medicare cuts and unspecified sources, rather than an increase in tax for the top bracket, should we even be supporting this?