House Health Plan to Include Government-Run Option

[steven johnson]

House Democrats are trying to skirt the filibuster veto that the Senate Republicans have on healthcare legislation by including fast-track language in their version of the budget resolution that would allow it to be adopted by a majority vote. Some Senate Democrats have joined Republicans in rejecting use of the reconciliation tactic for this legislation.

March 26 (Bloomberg) -- House Speaker Nancy Pelosi said the House this year will consider health-care legislation including an option for a government-run program that would compete with private insurers.

“This is a big agenda, and I believe it should have a public option in it for it to be really substantial,” Pelosi told reporters at her weekly news conference in the U.S. Capitol.

Pelosi said she intends for the House to be “aggressive” in its approach to a health-care overhaul, which is a centerpiece of President Barack Obama’s agenda this year. She defended a drive by House Democrats to put health-care legislation on a fast track under a budget proposal announced this week.

A draft of the tax-and-spending blueprint in the House calls for using “reconciliation” procedures to approve health- care legislation, a maneuver that would allow a health-care overhaul to move through the Senate with a requirement for a simple majority of 51 votes. Under normal Senate debate rules, 60 votes are needed to keep opponents from blocking legislation.


http://www.bloomberg.com/apps/news?pid=20601103&sid=aRcaIAYrfaV8&refer=us

[pinto]

1. Interesting approach. COBRA was passed this way in '85 or '86, iirc.

fwiw - Byrd would likely bail on reconciliation in the Senate - he's on record opposing its use except in limited circumstances.

[redqueen]

2. Excellent.

We have the House pushing it... we have Dr Dean pushing it... and a coalition of organizations behind it as well.

I hope everyone who wants this has signed up to help. It won't be easy, not by a longshot.

If you don't remember the media blitz the insurerers used to counter any possibility of real progress during Clinton's administration, well you're about to be reminded.

Get on board: http://www.standwithdrdean.com/

[Winterblues]

3. I would love to see Government run clinics in every major town.

You could choose to either go to a free clinic or go to a private doctor and either pay yourself or have some insurance pay for it. I believe in Choice...

[Juche]

4. It effing better

The public plan will be about 20% cheaper than a private plan since administration, profits and shareholder profits will not be an issue.

http://takingnote.tcf.org/2009/02/last-week-the-commonwealth-fund-published-a-proposal-for-a-high-performance-health-care-system-that-is-ambitious-and-a.html

This is, in part, because a public sector plan like Medicare spends less on administration—just 5 percent of the dollars Medicare receives are needed to cover paperwork and salaries. By contrast, Schoen points out, insurance industry overhead (which includes advertising, lobbying, high executive salaries and profits for shareholders) devours 15 percent of the premiums that for-profit insurers take in.

But, the report reveals, this is not the only reason why a public-sector plan would be less expensive. It also would save money by using “Medicare provider payment rates.” Today, Medicare pays physicians less than most private insurers. While the Commonwealth Fund’s High-Performance public sector plan would raise payments for primary care physicians, family doctors and pediatricians, it would lower reimbursements for many specialists, particularly those practicing in regions of the country where research suggests that excess capacity (of doctors and hospital beds) leads to overtreatment.

The report is both clear and candid on this point: “The modeling estimates that premiums for the public plan would be at least 20 percent below a comparable benefit package for those insured through fee-for-service insurance plans in private individual and group markets. This advantage comes from a lower share of the premium for administrative overhead and the effect of lower provider payments."

Not only that but after we spend the 1.1 billion researching what works in healthcare and apply it to the public plan so we use the most cost effective interventions, it may end up being 30-40% cheaper than a private plan.

[redqueen]

5. "premiums for the public plan would be at least 20 percent below a comparable ..."

I like that estimate!

:kick:

[Phoebe Loosinhouse]

6. Not if it's only 20% below what exists currently. nt.

[redqueen]

7. What? So if it's not more than 20% less than current private premiums...

it's not good enough, in your opinion?

Really?

[shraby]

8. To really be effective and cover the people it's

supposedly designed to cover, the premium should be no more than 20% of the cost of an insurance company plan...not a 20% reduction in the cost.

[Juche]

10. Thats not going to happen

You can't get decent healthcare for 1/5 of what we currently spend. You can get decent healthcare for 1/2 what we currently spend (Japan, Taiwan and the UK all do), but not 1/5.

[redqueen]

11. Well it's good enough for me. (nt)

[Phoebe Loosinhouse]

12. Well, go find a family paying right 1K right now for family coverage

and there are lots of them and ask them if paying $800 a month will be life altering. It won't be. And it will STILL be a far higher per capita costs than what the rest of the world pays. So no, it wouldn't be good enough.

[Juche]

17. Businesses will be forced to pay part of the premiums

Under Obama's plan businesses will be forced to pay part of the premiums if they can afford it, and the gov will help people who cannot afford the healthcare.

You are right, for a family making 40k a year spending $800 a month on premiums instead of $1000 a month is not much of an improvement. But with employer contributions and gov. funding maybe the cost to the family can be cut down to $300-400 a month.

Besides, Obamas plan can open the door to single payer someday. Because the public plan is cheaper an estimate reported that by 2020 about 100 million people will be in the public plan (vs 100 million in the private plans). COmbined with all the people on SCHIP, medicaid, medicare, VA, etc and about 2/3 of te public will be on gov. healthcare by then. Instituting single payer in the 2020s will be far easier if we start with Obama's plan now.

[Juche]

9. It could be even lower than that eventually

Peter Orszag says about $700 billion a year on medical care goes to care that doesn't improve people's health and a good cause of that is a lack of transparency in researching the most effective treatments. In the stimulus bill $1.1 billion was devoted to researching the most effective medical treatments, which will go a long way to addressing that excess spending.

The research, when it is finished, will be voluntary for doctors but maybe it'll be integrated into the public plan and cut premiums even further, maybe a 30-40% cut is possible after the research is integrated. For a family of 4 saving 35% on healthcare is a massive improvement.

[Phoebe Loosinhouse]

13. I want government PROVIDED healthcare not government ADMINISTRATED healthcare

Big difference. I want to pay what a Canadian pays. How much is that? I want to pay what a Frenchman pays. How much is that? Guess what - it's nothing.

[redqueen]

14. Um, no. Their taxes pay for it.

There is a cost in there somewhere, I promise you. It is not free.

[Phoebe Loosinhouse]

15. I get that. Any my taxes can pay for mine. nt.

[redqueen]

16. But not unless it only costs 1/5 what a private plan would?

Good luck with that. Let me know when someone floats a bill you can support.

Until then, I'll go ahead and support current efforts.

[redqueen]

18. Kick for a public plan.

:kick:

[redqueen]

19. Ooh it's up to three recs!

:bounce:

[Aloha Spirit]

20. If medicare/medicaid were open to everybody, I assume its costs would go down per person

as healthier people would participate, they would hopefully be able to bargain for cheaper drugs, they would be able to respond to research more quickly probably, other reasons too that I'm not thinking of.

Would companies who provide private insurance benefit financially from directing their employees to the public health insurance?

That seems volatile.