There's another alternative between public option and single payer

[many a good man]

I'm talking about the concept of putting all Americans into a single risk pool and dividing it among all insurance companies (including Medicare). Legislation would establish a basic formulary for services that all must abide by. A payroll tax would cover the cost required to insure all Americans.

There would be no more cherry-picking or denial of service to inflate profits. Government (the people) would negotiate with health care providers to control costs. Insurance companies would be free to offer gap or premium policies that go above and beyond the standard formulary.

This system would be more like the French health care system (#1 in the world) than the Canadian. What they both have in common is a single risk pool and universal coverage. These two concepts should be our main objective. I have not heard this option put on the table. I think it would have a better chance of passage than single payer even though it would still be revolutionary.

[annabanana]

1. I think the insurance companies would fight this as hard as they'll

fight single payer. Their business would shrink to an infinitesimal fraction of the bloated beast it is now.. For the guys at the top raking in the big bucks it would be a difference without a distinction.

[many a good man]

2. All reform requires a fight against insurance giants

A less effective compromise would keep private fees, allow public option, but keep the single risk pool and universal coverage. Medicare costs (payroll tax) would increase to cover those under 65 w/o coverage by basing costs on pctg of income.

[HelenWheels]

3. I'm afraid

the standard formulary would be pretty meager.

[shraby]

4. If insurance companies keep a finger in the pie,

before long they will be eating the whole pie again. They need some serious extremely long term curtailment. They're ruining everyone's health.

[subterranean]

5. That sounds very similar to the Netherlands system.

They also use a risk pool, and the system is financed 50% by employer payroll taxes, 45% by premiums (flat rate for everyone), and 5% by the government.

It seems that the single-payer systems of Canada and the UK are always mentioned as the models for universal health care, but there are other ways of accomplishing the same goal. But all of them involve significant government regulation.

[many a good man]

6. No one here seems to want to hear that

On DU its either SP or STFU.

I sometimes get the feeling for some it is more important to bash the evil corporations than to get a health system that can work!

I think the single risk pool idea and universal coverage are the two essential things that are needed in any national health care system. They are the common threads between Canadian single payer and the French or Dutch models. IMHO it's more important that we start saving lives.