Schumer guarantees public health care option

[kpete]

Source: Politico

July 05, 2009
Categories: Health care
Schumer guarantees public health care option

Senate Finance Committee chairman Chuck Schumer (D-N.Y.), one of the major health care players on Capitol Hill, guaranteed that there will be a government-managed health care insurance option in any legislation that emerges from the Senate.

“Make no mistake about it, there will be a public option in the final bill – some form of it,” said Schumer on CBS’ Face the Nation.

“We want it to be a fair level playing field, but you need something to keep the big boys honest. And the only thing that really is out there is a public option. We don’t trust the private insurance companies left to their own devices, and neither do the American people.”

Schumer also said that it’s possible that the Senate will reach agreement on health care legislation before August 8 -- the next Congressional recess.

Read more: http://www.politico.com/blogs/politicolive/0709/Schumer...

[ccharles000]

1. good

[nightrain]

45. actually, not so good--critique of the public option--

source--http://www.pnhp.org/blog/2009/06/25/paul-starr-and-stef... /


Perils of the Public Plan
A badly designed public plan could turn out to be the opposite of what progressives intend.
By Paul Starr
The American Prospect
June 24, 2009 (web)

In the current battle over health reform, progressives may have set themselves up for trouble by pinning all their hopes on the creation of a government-run insurance plan.

All the proposals receiving serious consideration in Congress allow employers to continue to insure their workers and dependents directly. They also call for new “insurance exchanges” as an alternative means for individuals and employee groups to purchase coverage. If there is a new government-run plan, it would be one of the options in those exchanges.

The great danger is that the public plan could end up with a high-cost population in a system that fails to compensate adequately for those risks. Private insurers make money today in large part by avoiding people with high medical costs, and in a reformed system they’d love a public plan where they could dump the sick.

Entry into the public plan for the eligible employed would be a two-stage process. First, employers would choose between paying into the exchange and buying insurance directly to cover their workers. Unless the exchange is such a good deal that nearly all employers take it, firms with a young, healthy work force would tend to buy insurance on their own, while those with higher-cost employees would go into the exchange’s pool. As a result, the pool would suffer “adverse selection” — it would get stuck with a higher-risk population.

Second, within the exchange, the government-run plan would compete against private insurers, yet it would likely abstain from the marketing strategies used by private plans to avoid high-risk enrollees. This double jeopardy of adverse selection could then more than nullify the advantage the public plan derives from its lower overhead (as a result of less money going for salaries, profits, and marketing).

Here’s the delicate political problem: Unconstrained, the public plan could drive private insurers out of business… Over-constrained, the public plan could go into a death spiral itself as it becomes a dumping ground for high-risk enrollees, its rates rise, and it loses its appeal to the public at large. Creating a fair system of public-private competition — giving the public plan just enough power to offset its likely higher risks — wouldn’t be easy even if it were up to neutral experts, which it isn’t.

There are a lot of ways to defeat reform, not just by blocking it entirely, but by setting it up for failure. Those who think a public plan is a good idea no matter how badly designed are not thinking ahead.

(Paul Starr received the Pultizer Prize for “The Social Transformation of American Medicine.”)

http://www.prospect.org/cs/articles?article=perils_of_t...

And…

Will a Public Plan Bring Better Care?
The New York Times
June 24, 2009

To the Editor:

Re “A Public Health Plan” (editorial, June 21):

A public plan option that competes with private insurers won’t fix health care. Competition in health insurance involves a race to the bottom, not the top. Insurers compete by not paying for care: by seeking out the healthy and avoiding the sick; by denying payment and shifting costs onto patients. These bad behaviors confer a decisive competitive advantage; a public plan would either emulate them — becoming a clone of private insurance — or go under.

Moreover, the savings on overhead from a public plan option are far smaller than you suggest. While it might cut insurers’ profits (which is why they hate it), that’s only 3 percent of the roughly $400 billion squandered on health bureaucracy annually.

Far more goes for armies of insurance administrators who fight over payment, and to their counterparts at hospitals and doctors’ offices — all of whom would be retained with a public plan option. In contrast, a single-payer reform would radically simplify the payment system and redirect the vast savings to care.

Steffie Woolhandler
Cambridge, Mass., June 21, 2009

The writer, an associate professor of medicine at Harvard, is a primary care doctor.

The heated debate over the proposal to offer a public plan option is certainly warranted, but the much of the debate misses the point. While most people are arguing over the design of the public option, they are neglecting the fundamental flaws of our multi-payer system.

Adding a public option to this system, no matter the design of the option, can only result in a perpetuation of the waste, inequities and unaffordable costs that should be the primary drivers of reform.

Some say that private plan regulation will resolve these problems, but you need only look at the perversities of the regulated Medicare Advantage plans to understand that this is a fiction.

Decisions have already been made to include hardship waivers that would leave tens of millions without insurance, and to require only the lowest tier of coverage - the very definition of underinsurance.

The intensive labor and political capital that is being frittered away on the public option is a tragic diversion of human resources that should be directed toward resolving the fundamental flaws in our financing system. Once we get the financing right, we can use that power to ensure that all of us receive higher quality health care.

[troubledamerican]

59. Money quote

"There are a lot of ways to defeat reform, not just by blocking it entirely, but by setting it up for failure"

[Zhade]

72. Thank you for linking this fantastic analysis so quickly, so it will be seen.

The primary problem with a public option is that it's still INSURANCE care, not HEALTH care.

If I've said it once, I've said it a thousand times:

[brentspeak]

2. "Some form of it"

How watered-down and ineffectual will it be?

[midnight]

9. Those words are concerning to me as well.

[Honeycombe8]

19. Well, it's a start. I think we know it won't be what we want, but once it's there,

it'll be easier to amend it in the future, rather than try to get one at all in the future. It won't be easy to amend it, but easier than not having one at all and getting one installed. We can see right now how hard it's gonna be to get it included, and the cards are stacked in OUR favor. In the future, well, it won't happen, I think.

So I won't be happy with a partial public option, but I'll go along with it and consider it a victory.

We're the only industrialized nation without public health care. Unbelievable.

[bobbolink]

20. I beg to differ. Once we "settle" (yet again!) any further change will take much more effort.

We need to stop "settling" like an abused spouse, and go all out for what we NEED!

[Honeycombe8]

28. The point is...NO plan will satisfy the left, since they are in disagreement as to

what a good public option is. First, some of the far left think a public option is a bad idea to begin with, and there should a public plan, period. Not an "option." So that group won't be happy with anything less. They'll consider it a "settlement," as you put it.

Then others consider this or that as a necessary part of a public option, while others consider other items as necessary parts of a public option.

EVERYTHING regarding the plan will be considered a "settlement" by someone on the left.

So will the plan that is ultimately passed, even if it has a public option. No matter what it is, it will be considered a "settlement," a "compromise," a "selling out." There's no way to make everyone happy.

So I will take a decent public option, whatever that is, and consider it a success, to be refined in the future. Others, OTOH, are gonna whine and complain no matter what. Which gets us nowhere.

[Cleita]

30. There is only one really good and workable public option and that is to open up Medicare

to all. Anything else is unworkable because it will be any variation of a plan to give either money or tax credits to the poor to buy more private insurance, no doubt with high deductibles and co-pays so that they still remain uninsured in fact if not on paper and of course it will cost the tax payer more.

[Honeycombe8]

49. I think you've misunderstood "public option." What you describe is the

subsidy part of the plan, where the govt subsidies ins. premiums.

When people speak of a "public option," the term is meant generally health care through the govt, similar (just similar, not identical) to Medicare.

If we end up with only subsidies, then that is a plan withOUT a public option.

[Cleita]

51. You've got it. n/t

[nightrain]

91. is this "public option" he way you want it??

see post #57

[nightrain]

39. some options are better than others. We should be asking

why single payer is not getting a CBO rating. Why would the Congresspeople NOT seriously consider an option? (Have they been bought off?)

I don't consider the way to a decent bill as one where we start with only some options on the table. Talk about a level playing field!?! We healthcare practitioners have a good sense of what is workable from both the recipient side (ourselves) and the practitioner side. We've been promoting and researching single payer since the 1970s.

No real need to further complicate the already complicated and bloated way we finance and provide care by adding more regulation/layers/search for practitioners on the PO (public option) panel, etc....

Have you read the comparisons of single payer and PO?

Here are some comparisons and critiques--

http://www.pnhp.org/blog/2009/06/15/hold-o ... /

http://oxdown.firedoglake.com/diary/6089 , and

http://www.centerforpolicyanalysis.org/id3 ... for parts of the HELP

[Honeycombe8]

50. Thx for the links. It all just boggles the mind. nt

[dionysus]

40. that, kind poster, is the situation in a nutshell.

[Jakes Progress]

42. Who's this "left" you are talking about.

Does this mean you consider yourself right wing?

You are the one who misses the point. Once the "plan" is in place, it won't get better. It will be nibbled and chewed by the interest groups until it doesn't even achieve whatever small good it meant to.

Show me an example of a mediocre government program that got better.

NCLB. Bad and getting worse every year. Senior Drug Plan. Cruel and tricky. Still making obscene profits for the drug companies.

Both of these, education and drug prices, were things that needed to be addressed. In the name of getting some form of legislation passed, the left compromised and let the corporations have their way. Of course the congressmen who capitulated got to congratulate themselves on passing "something". Their kids still get private schools and they still don't have to pay for their drugs. They pat themselves on the back and give us the shaft.

You have no idea what the left is?

[Honeycombe8]

52. No, I distinguished "the left," because I assume "the right" is against ANY reform

at all, much less one that might raise taxes or infringe on ins. co. and pharma profits.

So I referred to the "left," just to distinguish it from the Republicans. I didn't want to limit it to Democrats, since many Independents are on the "left" regarding this issue.

That's all I meant. I most DEFINITELY am on the left on this issue and DEFINITELY think we need bold health care reform. I wasn't sure whether a public option was necessary at first, t hinking subsidies might do the trick. But I am sold on that, now. "I see the light" and am fully in the corner for single payer, if we could get it. (I just haven't seen anything in Washington to indicate that they're going to go full-out with single payer. But public option is a possibility, and I'll be pissed if we don't get at least that.)

As for Part D, Medicare, to pass "something," I don't believe they didn't know what they were getting into. I think they knew only too well. They didn't compromise. They sold out. Very few Dems voted for it, and the main ones who did (even co-sponsored it) were paid well by big pharma. Kennedy and others railed against the plan and fully informed everyone about it. I watched his speech on CSpan. It was awesome.

I grant you that govt plans rarely get better when amended. But what I do know is...I haven't heard one inkling from any Senator or Congressman that there was a chance in hell of getting single payer or even a STRONG public option. I'm not against single payer or a strong public option. That's what I WANT. But it doesn't look like we're gonna get it. So in view of that, I've decided that it's better to take a public option that we CAN get, than to wish for the last 8 Republican years, where health care got a lot worse for millions of people. Just reality.

[Jakes Progress]

61. No plan is better than a bad one.

A bad one will cost us the election in 2012.

Medicare D became known as bush's drug plan. I work with many seniors who voted for bush and usually voted republican. Because of what this plan did to them, they voted Democratic this time.

The same will happen with whatever health care legislation comes out. It will be Obama's Health Care plan. Regardless of who did what, it will be his. Right now the direction that bill is heading looks a lot like what happened with Medicare D, lots of "options" offered by insurance companies with now real oversight. If this goes through, it will haunt us in 2012. The republicans will gut this health care plan and then run against Obama based on how bad the plan they devised is. That's how politics works.

Better would be for him to lay out his idea of what he will sign. If he tells the public that he will veto a bill that cheats the people with double dealing and back room amendments, they will believe him. He can blame it on the Republicans and then when the public knows whose fault it is, he can send his own legislation - a good plan - for them to pass. It might take another year, but if we settle for the crap they are working on, we are sunk.

You mentioned Ted Kennedy. He was a co-author of the NCLB legislation. It was seriously compromised, but he settled because it was a "foot in the door". Well the door has slammed shut and we are left with this mean-spirited and nasty program. Good intentions won't help. A good bill or none.

[Honeycombe8]

69. Then I guess we disagree. A plan that helps more people is better than not helping them.

If that's the goal.

Plans can be amended. Now is the time. We have a Dem. President, the will of the people, and a majority in Congress. That trifecta won't remain. That's why Obama is adamant that now is the time. There may not, and probably will not, be a better time.

Also...no one will agree on exactly what is a "good plan." There will be as many opinions on that as there are people. What is passed will, in fact, be considered good by many people, even if you don't think it is, or I don't think it is. It's subjective.

[Jakes Progress]

86. Please read the whole post.

If you help 50 people but ruin the lives of a thousand, that is not better than nothing. A bad plan will not be "amended". Show me examples of programs from the last thirty years (the political and corporate climate in which we work now) that was made better by "amending".

Passing a bad plan will keep a good plan from being enacted. Once the pharma and insurance companies have their profits written into law, it will stay that way. Without a true public option, the plan will be nothing more than another form of corporate welfare where the corporations rake in tax money without responsibility. Check what the banking bills from the last decade did for us, and notice that even though they led to the collapse of our economic system, those rules are still in effect. A bad law is forever. And it will be tied to Obama's name.

You are right that there is disagreement over what is a good plan. The corporations have their idea of a good plan and it is what we are heading towards. It may be your idea of a good plan, but it is not mine.

[Honeycombe8]

70. What you call a bad plan, others will call a good plan. No plan will cost the Dems the election in

2012. There is no such as a purely bad plan, since it's guaranteed that whatever is passed, SOMEONE will think it's good. And someone will think it's bad, no matter WHAT is passed. You see? It's not just YOUR opinion or mine that matters.

A public option is good, in and of itself. A strong public option is better. Changing from what we have now to a purely governmetn single payer? Millions of people would think that's bad. There is no "good" or "bad" plan, as such.

If the Dems pass a significant plan that gets health care to millions more people, that is a good thing, in and of itself, and will help get the Dems re-elected. It's certain that many will be unhappy with it, and many will be happy with it.

[Honeycombe8]

53. As for amendments not improving a govt plan, I'm not a historian.

I don't know if it could be made better in the future with amendments. Seems to me it could be. But maybe it couldn't.

I DO know that Social Security and Medicare BOTH were expanded over the years. Unfortunately, that's why they're bankrupt. So...I don't know. Common sense tells me that it's possible, though.

[Jakes Progress]

63. No history of that happening.

And neither SS nor Medicare is bankrupt. That is neocon propaganda, repeated by their MSM hired thugs. Simply repealing the bush tax cuts to wealthy would provide solvency in plenty. Not to mention stopping the trillions going for bush's illegal wars.

If you really want to make Medicare solvent, expand it to all citizens. If all pay the costs would be only a fraction of what we now pay for insurance and the uninsured.

[Honeycombe8]

68. I don't think it's propaganda that SS and Medicare are almost bankrupt.

This has been discussed for a decade, now. I've seen it discussed in committee hearings on Cspan, etc. It's a pervasive opinion by every single person I've heard of or seen who has looked at the issue.

And if you know how SS works, it makes sense. Each generation's SS is paid for by the current working generation. It was set up that way. That was done because it was assumed that each generation got larger, so there would always be a larger pool of workers to pay for the benefits. But when the baby boomer generation hit, things changed. Lots of babies were born, and afterwards, the population increase dropped off. So there are lots of baby boomers retiring now and for the next decade, whose benefits will need to be paid for by the smaller workforce. Add to it the loss of jobs in a bad economy, and it doesn't take an Einstein to see the problem.

Add to it the fact that Social Security was enlarged over the years to add disabled people (who hadn't paid into the system), widows and other dependents. Lots of people were added for benefits, but they hadn't paid into the system.

So here we are in deep trouble in the SS program. I totally believe it. And Medicare? The cost of Part D is now at well over $1 Trillion Dollars, added to the already overburdened cost of Medicare.

The lowering of taxes the last 8 years added to the problem.

Remember, too, that there is a cap on SS taxes. The very wealthy don't pay SS taxes on income over a certain amount. So not even all income is taxed.

As for expanding Medicare, I would be happy with that. But realistically, that's just not gonna happen. Most people don't want that, according to the polls I've seen. We can see how hard it is just to get a public option added to the reform act, even though most people want that. And to change an entire system from one to another without taking it in stages is just unrealistic.

[Zhade]

73. You're wrong, and spreading untruths.

NT!

[Honeycombe8]

80. I can see you haven't studied the situation. As a middle aged baby boomer, I have.

It's the truth.

This problem with SS has been faced before, decades ago. Maybe that was before your time. But I remember. And now, because of all that I laid out for you, the problem has come back. Mainly because the SS fund, which is supposed to be kept separate from other federal funds, was raided by the Bush administration and spent on other stuff (borrowed, they called it).

So the SS fund is almost out of money and will not have the incoming funds to pay for the huge pool of baby boomers retiring. That's a fact. Read up on it.

As for a single payer system, imagine yourself in charge of a huge system set up in a certain way, and receiving orders to totally change the system to something else entirely. Millions of employees. Multiple millions of people who rely on the system daily, with bills coming in daily. Millions of people (employees, doctors, patients), who are set up to use certain forms, certain procedures, and you have to totally change all that. Imagine the cost of that, and imagine how long it would take you just to devise a plan to change it all, much less implement it. All without missing a beat to pay for someone health care every single day. It's unrealistic. And that's the truth.

You will not see a single payer system unless it is done in stages. Social Security is in deep trouble, as is Medicare. Those are truths. They are fixable. But they will be fixed by decreasing benefits and increasing taxes. That's the truth, also. So don't blame the current administration or be surprised when those things happen. It will be necessary.

[Cleita]

83. Social Security and Medicare are not in as deep trouble as all the conservative

think tanks would like you to believe. It's all propaganda pure and simple. Lifting the cap on the P/R tax would fix all the funding problems for decades to come. However, don't believe me but go read some stuff by Paul Krugman, Ravi Batri or any number of economists who haven't drunk the kool-aid and see what they have to say.

[Jakes Progress]

89. He'd rather spout neocon meme.

If all the news you get comes from MSM, you would believe that SS and Medicare are on the brink of bankruptcy. You can't make some people get away from what the tube tells them.

[Jakes Progress]

88. I know the neocons have been discussing it for a decade.

Most of us know to check our wallets when they start trying to convince us that government is the problem.

I know how SS works, but then I don't get my information from MSM.

[bobbolink]

94. I'm sick to death of this splintering and name-calling. you think you're

so above the rest of us, and yet you are doing the same damage that we've endured for the last 30 years.

Give your OWN whining a rest.

[TankLV]

102. Actually - NO WE'RE NOT - it's called SINGLE PAYER GOVERNMENT PROVIDED HEALTHCARE FOR ALL!!!

you know - WITHOUT any "insurance" as part of it...

just like CANADA'S or MEDICARE FOR ALL!!!

it's really quite simple - and we're ALL in agreement: GET RID OF THE "INSURANCE" ALTOGETHER!!!

[WestSeattle2]

37. I agree. Every macroeconomic program in our history

has been improved and amended a multitude of times, this will be no different. We're working with 435 House members and 100 Senate members, many, many of whom are from very conservative states and districts. Millions of Americans, including many Democrats, have a real problem with government competing with private business, that's just a reality. They do not draw a distinction between business types, and to them health care is a business just like building airplanes is. Clearly, many of us think otherwise, but we cannot dismiss reality.

To think that the private insurance industry will be eliminated and the government will take over everything at this point in time, is not a realistic expectation. Compare Social Security from what it was at its inception to what it is today, and people will see how this health care program will unfold. This will be an evolving, decades long process. Even if someone were able to wave a magic wand and make a pure single-payer plan the law of the land right now, today, it would take years to implement. We're talking about a program that will effect 300 million people, change that large does not happen overnight. Hell, it will take at least three to five years just to map out a strategy for the transition. Congress is in the business of making laws, which as we're witnessing takes months and years by itself; the actual transition and the details of that transition, including the inevitable reams and reams of policies and procedures, are in the hands of thousands of others. And this doesn't even address the issue of stock and bond holders of the private insurance companies. Millions of working people have those stocks in 401k's and mutual funds, and they're not going to go quietly into the night. Screaming, yelling, and calling them every name in the book will not change that reality.

I'm 49 and have no illusion that much will change before I'm 55, and I certainly don't expect to see a pure single-payer system in my lifetime. I think kids who are in their teens today may, but they will probably be the first generation to experience a true single-payer system, assuming it evolves that far.

[Honeycombe8]

54. I think you're right. But...I hope you're wrong about how long it takes. nt

[WestSeattle2]

56. I too, hope I'm wrong about the length of time, but my

estimate is based on historical perspective. Of course it's always possible that our government will turn over a new leaf, become a lean, mean fighting machine which will implement this monstrosity of a program in a short period of time. It's also possible that North Korea will drop all hostilities, embrace a free and democratic form of government, and apologize to its neighbors for being a royal pain in the ass. If I had to bet on which of those possibilities would occur first, my bet would be on North Korea.

[Cleita]

84. Look at you two holding hands all through this thread.n/t

[radhika]

29. Don't like that phrase one bit

'Level playing field' simply requires that the public plan be as contrived, exclusionary, costly and ineffectual as private plans. I don't see it as a step in the right unless it forces the public plans to reduce admin costs to 5%, take all applicants, and reduce executive compensation to the level of a public health administator.

[dysfunctional press]

92. translation: we're fucked yet AGAIN.

i'm really getting fed up with EVERYTHING in this fucked up world.

[lindisfarne]

3. Is Schumer a long-term NYer? Amazing that they can produce such a competent senator given the mess

in the state legislature.

[Oregone]

11. He is barely competent

[Eric J in MN]

4. Schumer wants a public option with no subsidies.

The problem of people going bankrupt from out-of-pocket costs from serious illnesses will continue if the public option is designed such that it offers similar payouts.

Without subsidies, those bankuptcies will continue.


http://www.washingtonpost.com/wp-dyn/articles/A9447-200...

[madfloridian]

8. Great article by Warren from 2005

So true.

[backscatter712]

26. Maybe better would be subsidies that can go either to public or private health care.

In other words, if the individual choose the public option, the subsidy will go towards that, but if he chooses a private insurer, it goes there - that keeps things fair.

Granted, what Schumer's talking about will be watered down.

But I will take a watered down public option, because a watered-down public option can be fixed down the road - it's a lot easier to change an existing public option to make it better than it is to get it implemented from scratch. Since implementing it from scratch is what we're trying to do, and we have to deal with bribed conservadems and corrupt rethugs in order to make it happen, we may have to make a compromise or two, just so long as a public option gets implemented.

I'd recommend that Schumer and the rest of the Finance committee come up with something similar to the Kennedy Dodd bill, which itself is watered down a bit - it doesn't let you join the public option if you have insurance through your employer, though that may be enough that the insurance companies are left a little room to stay in business, which may bring the conservadems on board. At the same time, the CBO estimate of $600B, combined with the estimate of increasing health care coverage so that 97% of the population has health care, means it's something I can live with.

[earcandle]

5. We don't want a public insurance option. we want public health care

[Davis_X_Machina]

14. No we don't.

...we should, but we don't.

You couldn't get an NHS-style plan adopted in this country even if there were a national referendum-and-initiative system, never mind Congress.

[Cleita]

32. We aren't looking for that but getting Medicare to be opened up for those

who can't get private health insurance or who don't want it but want a public plan they can buy into.

[WestSeattle2]

44. Medicare won't be able to support any more than

it currently does. It's not adequately funded, and thousands of doctors every year refuse new Medicare patients. Heck, if I recall, even Howard Dean's wife who is a doctor in Vermont, no longer takes Medicare patients because the cost of care far exceeds the Medicare reimbursement rates. It's a real problem and the only fix is either a reduction in services, or a substantial increase in payroll taxes.

http://www.ssa.gov/OACT/TRSUM/index.html

http://seattle.bizjournals.com/seattle/stories/2008/05/...

[Cleita]

46. Oh, please read something from Rep. John Conyer's website.

Of course right now it's not adequately funded thanks to generations of Republicans who have been shooting holes in it. Congressman Conyers lays out exactly how it can be paid for, improved on, and cover everyone and every thing including dental for less that we spend per capita for health care now and still manage to insure the 40 million Americans that are uninsured and even more underinsured today.

http://www.johnconyers.com

[WestSeattle2]

58. If it were as easy as Mr. Conyers suggests,

Medicare would not be a financial train wreck. And how have pugs shot holes in Medicare? The problem with Medicare is the same as the problem with Social Security. As is, they're unsustainable Ponzi schemes. It's simple mathematics = The volume of recipients and services far exceeds current resources. So, either benefits are reduced or payroll taxes dramatically increased. Pugs shoot holes in many things, but the rules of mathematics are beyond their reach.

[Cleita]

65. It is as easy because it's being done successfully in many other industrialized

countries today.

[WestSeattle2]

71. And their tax rates are astronomical. Many people

will support single-payer until they find out how much it will really cost, and where the money will actually come from. When the true cost is known, and people realize where the money is really going to come from, support for single-payer will diminish greatly. Remember, there are tens of millions of voters who believe they have adequate insurance and see no need for radical reform. And if there is reform, they certainly will not tolerate it costing them one red cent. You can bet senators and congress members are hearing from them and the lobbying groups who represent their interests.

Nothing of this magnitude is easy or simple. Any leader who implies otherwise is being disingenuous. It took countries that have single-payer systems decades to evolve into what they are today and they are, for the most part, far less populated than the United States.

[Zhade]

74. I pay only 8% less in taxes than Swedish citizens do -- I'd GLADLY pay 50 % for what they have!

If it's so hard to accomplish, how did other countries get it?

[aquart]

76. What a very good question.

Did they somehow fail to demonize the left?

[WestSeattle2]

85. Swedish income tax

rates top out at 59.09%, US income tax rates top out at 35%. When you say you pay less than 8% Swedish citizens do, what are you basing that on?

[Cleita]

81. Their tax rates are more than ours but they aren't astronomical. We here

at DU have been debunking these insurance company propaganda points for years now and yet they keep cropping up. Go read something besides the Fox news website. The only voters who feel they have adequate insurance are government workers, who are on a government single payer system incidentally. Nothing of this magnitude is simple because the corporate whores in our Congress make it complicated.

[WestSeattle2]

87. British citizens pay a 23.8% payroll tax just to pay

for their national health care. That's over and above their income tax and the Value Added Tax.

Please, get your facts right.


http://en.wikipedia.org/wiki/Tax_rates_around_the_world

[Cleita]

90. They don't have to pay insurance premiums and they don't have to go

bankrupt if a member of their family gets an expensive terminal disease. Most Brits consider the trade off acceptable. Of course it seems you don't read the posts where our Brits and our Canadians tell us about their systems. Believe me they aren't complaining and they'd cut off an arm before they would let our system become their system.

[WestSeattle2]

93. That's all well and good, but we need to be honest about

the true cost of single-payer. I would prefer single-payer too, but I'm also very aware of the long-term consequences of voters believing they were misled by Democrats as to the true cost.

[Cleita]

95. Yes, we do need to be honest about and repeating talking points from

astroturf spread by insurance company publicists isn't honest.

[WestSeattle2]

98. The world tax rate table speaks volumes about the

true cost of single-payer systems. I don't believe insurance company publicists, Fox News, the RNC, or anyone else has input on other countries tax rates. The numbers are there in black and white, side by side comparisons for anyone who is truly interested in facts:

http://en.wikipedia.org/wiki/Tax_rates_around_the_world


Again, I prefer single-payer systems but feel that everyone should go into this fully enlightened as to the true cost. The last thing I want is for Democrats to be accused of "Bait and Switch", misleading voters, or ginning up numbers to make single-payer palatable.

[Cleita]

101. Liberals don't get upset about taxes for the greater good like schools and

health care. Why are you so concerned about it?

[WestSeattle2]

103. The voting public includes more than just

progressives, and Democrats, in many areas of the country, need moderate voters in order to win.

[Cleita]

104. We are the majority and it's time government reflected that.

Corporate rule has to stop.

[fascisthunter]

105. most moderates I know would call you out on that assumption

most are already on board, and the Democratic Party has a REAL MANDATE.

[nightrain]

60. It would be FAR easier to fix the issues with Medicare than

to add another layer of complexity and confusion to this whole mess. For instance, slightly raise the levels of reimbursement via Medicare to some/all practitioners, and add more and expand the licensed service practitioners. As a practitioner I would be glad to take Medicare if it were reasonably reimbursed, doesn't have to be exhorbitant, just reasonable.

Medicare's overhead is about 3-5%. Health insurance extortionists have an overhead rate of about 30%! That difference could/should be going to services, not the millions CEOs are compensated.

[ProudDad]

77. It's not adequately funded

because the PUKES and blue-dog Dems didn't want it adequately funded!

And it's also harder to maintain because, HEY, the least healthy folks are all included!!!

Single-Payer or Medicare for all would be a larger, healthier risk pool and would therefore be much easier and cheaper to keep solvent...a HELL of a lot cheaper than the "for profit sick care" system we've got now for those under 65...

Inadequate funding has also been a CONSCIOUS decision by the powers that be to starve the most successful health care program USAmerica ever passed in order to keep their god damn profits and discredit any attempts to convey that benefit to the rest of the people...

Please don't buy into the RW bullshit...

As for SS -- nothing that raising the cap wouldn't fix...

[Cleita]

82. And yet in spite of everything the conservatives have done to Medicare, it

still functions more efficiently and cost effective than any of the private insurances. I know. I'm almost seventy and it's the best health insurance that I ever had.

[ProudDad]

100. Y yo tambien

I woke up about 2 months ago on my 65th birthday and magically had health care again for the first time in years!

I still haven't got used to the idea. I recently had to agonize for an hour over whether to go to the ER at 1am to deal with an acute pain in my eye (minor torn cornea)...kept thinking "how can I afford to go?"

We get so conditioned by the for-profit sick care system to wait until the agony is beyond bearing before seeking help. What a crime!

[robinlynne]

16. exactly.

[jberryhill]

22. IMHO, this is a move in that direction

Depending on how this plays out, if the "public option" system becomes the dominant mechanism of insurance over time, then it provides the foundation for moving to a comprehensive system.

[Davis_X_Machina]

27. If wikipedia's rather garbled...

...description of the German system is accurate, they've got a insurance-based (i.e. non-NHS style) system with about 75% of the population covered by what in our terminology would be a number of public options.

[kestrel91316]

31. Exactly. For-profit medical "insurance needs to be done away with.

YEAH, I WENT THERE.

The thing is, we already HAVE "public health care" of a sort, and we have it pretty much everywhere. It's rudimentary, and generally only deals with infectious diseases, but every county in the country (or most) has a department of public health. We need to build on that.

[xchrom]

6. he has one thing spot on --

“We want it to be a fair level playing field, but you need something to keep the big boys honest. And the only thing that really is out there is a public option. We don’t trust the private insurance companies left to their own devices, and neither do the American people.”

[pattmarty]

7. Do not take Schumers word for it, keep on pushing. Schumer is..............

.................one of the "corporate" Dems, unlike Bernie Sanders (but, he's not a Dem, either).

[wildflower]

10. I agree...keep contacting your legislators!

Though I am cautiously optimistic by this news. I hope it's true.

[Stuart G]

17. So do I.. K and R...Let's hope Schumer keeps his word...nt.

[NewJeffCT]

41. Agreed - keep writing & calling Schumer

and your other senator (Kristen whose last name is escaping me right now...) and your rep in Congress.

[DarthDem]

67. Kirsten Gillibrand

I'm inclined to take this news from Schumer as good. Single-payer will take time, but it will happen. A public option is the first step.

[ProudDad]

78. Bernie is a SOCIALIST!!! Hoooray for Bernie!!! (n/t)

[quidam56]

12. We are the change we voted for !

Politician$ and Profit Machine$ drive this Nation. Change will only come from the bottom up, we are the change we voted for. Because of pure greed, there's no value in people and their quality of life. Take cancer. In four years the cost of chemo has gone up 400%. How many cancer treatments have cured in comparison to killed ? I read where the largest health care corporation in America is buying the largest funeral corporation in America. At the end of the day, the status quo is all about the love of money. When 72% of Americans' want single payer, public option and the Politician$ say they don't have the votes, clearly the Profit Machine$ are in control of those votes. When your home becomes a mountaintop removal mine site, clearly the Politician$ and the Profit Machine$ are the one's who made those rules, laws and decisions. Just because we voted for change doesn't mean it's going to happen. We may not have $ 1.4 million to lobby congress daily like the health care industry but we do have a voice http://www.wisecountyissues.com/?p=62

[creeksneakers2]

13. Some form?

Probably some form the insurance companies don't mind.

[bvar22]

15. Schumer is a weasel....

...and his statement is full of weasel words.

One that scares me is,
"We want it to be a fair level playing field,"
Schumer is protecting the For Profits with this statement.
He doesn't want the Public Plan to have ANY advantage over the For Profits.

The Public Plan should NOT be FORCED onto a "level playing field" with the For Profits.
The American People NEED the Public Plan to have EVERY single advantage that Public Ownership and Government Administration can give it.

Schumer is NO friend of Americans who Work for a Living.
Beware of anything Schumer supports.
He works for the other team.

[nightrain]

18. title could be--"Schumer guarantees bankruptcies and millions still unable to afford healthcare"

[debbierlus]

21. LEVEL PLAYING FIELD?

My journal has the full post, but this statement is a triple red flag...

This is about maintaining corporate PROFIT while sacrificing real health care for every American citizen. Why the hell is maintaining the insurance companies profits even part of the debate, let alone the CENTRAL issue?

This is nothing to be excited about - this whole charade has been about allowing the health insurance companies to continue to leech off our health care dollars while providing NOTHING. They need to extricated off our system like the LEECHES they are.

This is disgusting.

[Joanne98]

23. But what kind of public option. We don't want the Snow version.

[cyclezealot]

24. One promise delivered.

Should the Democrats deliver it.. That would be worth their election alone.. We've had some doubts about how Obama has handled Wall Street. Give us a public health option and we'll be pleased as punch.

[Zhade]

75. Look upthread before you start celebrating.

NT!

[Phoebe Loosinhouse]

25. ANYONE who continuously speaks of "level playing fields"

is someone who is attempting to gut a true public option.

"Unfair" "Level playing field" "Unfair advantage" "uncompetitive" are all words and phrases used by pols who are trying very hard to serve their corporate insurance masters at the expense of the public.

A true public option would be funded and/or subsidized by the government, it would be available and accessible to any who chose to enroll, and it would have some sort of mandated acceptance by providers. It would also negotiate the best prices and rates and drug costs for on behalf of its millions of members and for the benefit of the taxpayers. (This is what a lot of the legislators whine about being "unfair" - remember that these are the same morons who negotiated the Medicare part D plan that FORBADE negotiation - they would like to pull the same trick here).

Schumer has consistently tried to underfund a public option as his most major strategy for making it go away. A PUBLIC, non-profit health care plan will OBVIOUSLY lose money, particularly in the beginning and will REQUIRE government underwriting just like the VA and Medicare. Schumer has stated previously that his public option needs to pay for itself out of premiums.

Out of all this entire debate, the person I have come to trust the LEAST is Schumer.

[Cleita]

33. Well, said and that's exactly what that code speak is about. n/t

[Better Believe It]

36. "some form" of a public option means no viable, strong public option.

And if that happens the Democrats will be toast in 2010 and 2012.

Not only is the Democratic Party incapable of getting single payer Medicare for All passed with super majorities in the House and Senate and control of the White House, they can't even get a strong public option passed!

But, we may have have a bi-partisan healthcare agreement!

A great follow-up to the Republican written stimulus bill which failed to stimulate much in the way of jobs!

[Ms. Toad]

34. The key word is "But"

“We want it to be a fair level playing field, but..."

If it is not a level playing field, it is not worth celebrating.

By level playing field, it must require (at a minimum):

All parties offering health insurance - public or private - must take ALL applicants
All parties offering health insurance - public or private - must cover ALL pre-existing conditions
All parties offering health insurance - public or private - must be prohibited from basing the premium on health status.

If these pre-requisites are not included, any public option is doomed to fail because it will be the insurance of last resort for anyone who is more costly (or presumed to be more costly) because insurance companies will cherry pick out all those they can make a profit on.

“We want it to be a fair level playing field, but . . . " is not good enough. I will even go so far as to say a level playing field is more critical than just having "some form of" public option. It must be level, without "but."

[burning rain]

35. I'd connect this to Schumer's chairmanship of the DSCC.

He wants to win Senatte races and knows he needs to "turn out the base."

[zalinda]

38. He's my rep

and I emailed him that I would not vote for him if there was not a public option. Whether or not that did any good, I don't know, but it felt good to voice my opinion to him (actually his minions, I doubt he reads them).

zalinda

[NewJeffCT]

43. Every call, fax, letter and email helps

Even if your rep is a dyed-in-the-wool Republican, at least they won't honestly be able to say, "well, nobody contacted my office about the public option, so they can't be interested here!"

[IndianaGreen]

47. Schumer makes lots of promises

but what is his track record really when it comes to fighting for the working class against the powerful interests that finance his senatorial campaigns?

[harry_pothead]

48. Great news assuming that "some form of it" still means a real public option

[nightrain]

57. It doesn't have a real public option. It is extremely limited-- to

those who currently do not have healthcare coverage or those whose insurance policies are "unaffordable". There is no "public" there. See #45 and #39 for more details. The HELP proposal seems to actually perpetuate all the problems we currently have and add to it, and protects the health insurance extortion corporations.

[ooglymoogly]

55. key words..."some form of it" All you need do for a public option

is insert the words "Public Option" and only this because the public is demanding a public option; And I am afraid that is exactly where we are headed. A system whereby the taxpayer pays the insurance industry for a hefty fee, to pay for health care of the most tragic and dire medical cases that the insurance industry does not want on its roles. We are witnessing just another DLC kabuki dance to fatten the fat cats.

[and-justice-for-all]

62. Without fines and triggers? nt

[earcandle]

64. what is wrong with HR676? Isn't that single payer? Universal Health care? Doesn't Dennis already

have it worked out?  

[riverdeep]

66. I don't trust Schumer since his support of Mukasey.

This tepid support of 'some sort of public option' tells me he's already given up.

[blm]

96. given up? Schumer's public option support was ALWAYS a front - Schumer's capacity for deceit and

misdirection and self-glorification is bottomless.

[ProudDad]

79. I don't want no stinkin' "level playing field"

I want the profit motive taken the FUCK OUT OF HEALTH CARE!!!

Very simple.

No more god damn insurance companies!!! Drive down big pharma's blood money prices...

[MisterP]

99. but if we can't trust the Holy Market, what can we have? GOAL-oriented action? *snort* it's against

everything the Friedmans say, so it couldn't possible work!

[Mass]

97. "Some sort of it"- Enough said, coming from Schumer.

[fascisthunter]

106. KEEP PUSHING!

[ProudDad]

107. Best explanation of the benefits of Single Payer I've Read!!!

http://www.tikkun.org/article.php/jul_09_roland

The Bottom Line for Progressives

The case for a single-payer health program is abundantly clear to anyone who is paying attention to the issue. President Obama himself has on several occasions said, "If I were designing a system from scratch, I would probably go ahead with a single-payer system." In private conversations that I have had with congressional representatives who are not on record as supporting single-payer reform, with leaders of the health care industry, and even with executives in the health insurance business, I have heard Obama's sentiment echoed time and again.

Nevertheless, as the lack of co-sponsors for Senator Sanders's S 703 so clearly illustrates, we aren't going to get a single-payer plan passed any time soon. So what do we do?

First, we need to make sure that all reform options, including a single-payer option (see how the confusion between "single-payer" and "public option" has arisen?) get a fair hearing. Single-payer advocates and academics in health care finance and research must be included in all hearings from now on. And there must be a complete, honest, side-by-side comparison of all major proposals, including HR 676, the most prominent single-payer bill, by the Congressional Budget Office. The side-by-side comparison must include projected costs now and into the future, not only to the federal government, but also to state governments, employers, and individuals and households of different income levels.

As the conservative economist Milton Friedman wrote:

It is worth discussing radical changes, not in the expectation that they will be adopted promptly but for two other reasons. One is to construct an ideal goal, so that incremental changes can be judged by whether they move the institutional structure toward or away from that ideal. The other reason is very different. It is so that if a crisis requiring or facilitating radical change does arise, alternatives will be available that have been carefully developed and fully explored.

Next, failing to get single-payer reform enacted, we need to ensure that any legislation includes a strong, robust public option, one which is designed in such a way that it can fairly compete, not as just another insurance company, but as a public option, with the private insurance industry.

Finally, we need to make it clear that we do not view even the watered-down "minimums" of the House Progressive Caucus as representative of what we believe is truly needed in health care finance reform. We need to make sure that when a health reform bill is passed, Americans know what they are getting and what they are not getting. We need to ensure that the likely failure of the Obama/Baucus/Kennedy plan five or ten years from now, a failure occasioned by continued dependence on a deeply inadequate private heath insurance system, can't be misrepresented as a failure of the progressive transformation of the health care system.