Possible compromise emerges in health care debate

[babylonsister]

Possible compromise emerges in health care debate

By ERICA WERNER
Associated Press Writer


WASHINGTON (AP) -- A potential compromise emerged Wednesday on one of the most vexing issues of the health care overhaul debate - whether to create a new government-sponsored health plan to compete with private insurers.

The compromise offered by Sen. Kent Conrad, D-N.D., would create health care cooperatives owned by groups of residents and small businesses, similar to how electric or other cooperatives operate. They'd be nonprofit, and without the government involvement that troubles Republicans and business groups about the public plan options.

The chairman of the Senate Finance Committee, Sen. Max Baucus of Montana, said Wednesday the idea could be key to a bipartisan health bill. Baucus raised it in a meeting with President Barack Obama, saying later that Obama showed interest. Baucus' Republican counterpart, Sen. Chuck Grassley of Iowa, also said the concept had potential.

"It's a way to bridge the gap," Baucus told reporters.

That's significant because the dispute over the public plan has been a major obstacle to bipartisan consensus on Obama's goal of reshaping the nation's health care system to bring down costs and extend coverage to 50 million uninsured Americans.

more...

http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHA...

[annabanana]

1. Small "health care cooperatives" would NOT have the leverage

to negotiate for significant savings from the providers. They would not lower the cost of health care. (That's why Conrad is OK with it - it poses NO risk to insurance company profits.)

This is no kind of a "compromise".

[clear eye]

6. And they would be shaky economically--

potentially not able to afford true catastrophic coverage or care for chronically ill children of members w/o pricing themselves out of existence. They're fine for primary care, but how would they get large enough immediately to do anything else? The threat of medical bankruptcy would continue.

Of course if the solution to affordability is to be federal subsidization of whatever amount is necessary to create sliding scale premiums that would be the same as private insurers and they enrolled the sickest Americans whom the private insurers rejected, their astronomical costs would be a horrific taxpayer burden and poison public opinion against all gov't paid healthcare. We'd be left w/ continuing spiraling costs and a worse political climate in which to come up w/ a real solution.

[annabanana]

10. Exactly. This is just another neutering attempt to keep any genuine

public option from seeing the light of day.

[Ms. Toad]

11. All it takes to realize this is to look at the price difference

between single premiums for uninsurable people, premiums for small businesses (up to 50), and premiums for large businesses. Yes, there's profit built in, but the insurance companies didn't pull the rating differences out of thin air.

[sandnsea]

13. Your avatar

Can I use it? My mother was a transplant recipient.

[Ms. Toad]

15. Sure - I borrowed it from

OrganDonor.gov and played with it a bit in PaintShop Pro to make it work with the small number of pixels available.

Hope you mom's ok.

I'm sporting it because my daughter was recently diagnosed with an bile duct disorder for which a liver transplant is the only known "cure." I'm trying to beef up the supply before she has to make a demand.

I think you can just right click and save the image then upload it as a personal avatar.

[sandnsea]

18. Thank You!

Sorry to hear about your daughter. Maybe they will make some kind of progress with stem cell treatment and she won't need a transplant. My mom got an extra ten years, so my kids got to know their grandma at least. It is difficult to live with all the transplant medications too, but better than the alternative as the saying goes. It was hard enough going through all this with my mother, I don't know how you manage when it's your child.

[Ms. Toad]

22. It's tough.

It's not fun thinking of my daughter at age 18 as perhaps having her life half over (median prognosis at the time of diagnosis to either death or transplant was 10-12 years; in the two months since then it has increased to 18 years. The increase is because they are diagnosing earlier - not because they have any better clue how to treat it - in fact the only accepted quality of life treatment was found a couple of weeks ago to lead more quickly to transplant, death, or other life-threatening complications (it was previously thought to be neutral as to life expectancy, but made you more able to function relatively normally in the mean time)

She's in a drug trial right now - the 11 people who were in the first trial with the same stage of disease went into remission and stayed there as long as they continued the medication. She's #9 in the second trial. I don't think it is a good long term solution (it costs about $55,000 a year - and it isn't a drug that should be used lightly because of the risk of creating drug resistant bacteria).

I'm hoping it works well enough to prevent further damage to her liver until either they find a real cure (who knows when) or learn to grow-your-own liver (about 10 years out) so that she can do without the anti-rejection drugs.

Glad your kids got to know their grandma, but sorry they (and you) didn't have a longer time with her!

[kirby]

2. Total BS! n/t

[KansDem]

3. To Hell with the "gap!!!"

They'd be nonprofit, and without the government involvement that troubles Republicans and business groups about the public plan options.

...and to Hell with "troubled" Republicans!

edited for taste...

[liberalpragmatist]

4. Matt Yglesias had a good point about this - it's not a bad idea on its own, BUT...

... it doesn't address the issues that a public plan would address.

I’ll say that I think this is a pretty good idea, but it stands on its own merits completely apart from the merits of a public plan. In other words, there’s no reason we shouldn’t have co-ops and private plans and a real public plan. Medicine has always been a mix of state, non-profit, and for-profit actors and I think it’s worth broadening the mix of insurance options available to ordinary people.

That said, as an alternative to a public plan this simply doesn’t meet what I see as the main objective of a public plan. But beyond this, I think the larger issue is that you sort of can’t “compromise” around the core political issues here. Insurance companies object to the idea of a public plan because they don’t want to lose business. Anything you dream up that would cause insurance companies to lose business, they’ll object to. After all, what else are they going to do? But anything you dream up that doesn’t cause insurance companies to lose any business isn’t going to accomplish anything meaningful. Insofar as what’s really going on in the halls of congress is that members are trying to balance progressive pressure for a public plan with industry opposition to it, you’re going to keep banging your head against the reality that you can’t split the difference between “incumbents face a new strong competitor” and “incumbents don’t face a new strong competitor.” And incumbents really don’t want to face a new strong competitor—incumbents hate competitors!

[dweller]

8. sounds like incumbants

need strong competitors...

dp

[Cleita]

5. I knew they would find a way to screw it up.n/t

[scarletwoman]

7. What fucking good does it do if these "co-ops" still have to purchase from insurance companies?

How stupid do they think we are?

[Telly Savalas]

9. The co-ops wouldn't purchase from insurance companies.

They'd essentially be non-profit insurance companies themselves. I'm not saying this is a good plan. I'm just saying how it's supposed to work.

[scarletwoman]

17. Thank you. I jumped the gun -- I must admit I didn't read the linked article before I posted.

I will tone down my outrage to mere skepticism -- even after reading the article, I don't quite get how it would work.

Still, I ought to have at least read the piece before responding.


sw

[Telly Savalas]

19. The article doesn't provide much in the way of details of how the plan would work.

The basic idea is that small businesses and individuals could band together to form these co-ops, which would essentially be non-profit health insurance companies owned by the small businesses and individuals who participate in it. The federal government would provide money to help get these started.

It's not clear that this would make much of a difference. If the co-ops are required to let anyone join while insurance companies can keep their tight underwriting, then the insurance companies can select the good risks and the co-ops get stuck with expensive sick people which result in their rates being really high and hence not being much of a help. If the co-ops aren't required to take everybody then it may reduce expenses for healthy people and groups, but it will still leave out in the cold the folks who need help the most.

As an armchair policy analyst, I'd say such a plan could potentially represent a slight improvement of the way things are now, but it would leave the majority of the problems with our health care system unaddressed.

[scarletwoman]

20. I don't see how such co-ops could possibly compete.

It would be one thing to have a huge entity like the federal government creating its own insurance pool, with the risk spread out among millions of people. It would be a fair fight -- insurance companies are largely national, after all.

But how would little guy co-ops survive with their smaller risk pools? I'm big on decentralization, but I'm having trouble seeing how that work in the realm of health insurance.

sw

[sandnsea]

12. I get electric from a co-op

No.

I don't even have the state PUD to fall back on. They're completely unregulated.

[Mojorabbit]

14. Oh Hell no

This is totally unacceptable.

[WeDidIt]

16. No untriggered public plan? No go. n/t

[dflprincess]

21. Is anyone really surprised by this?

By the time all the compromises and amendments have been added to Kennedy's bill we'll be lucky if doesn't require us to send a minimum monthly payment to the insurance companies to cover their lobbying costs (actual insurance coverage will be extra).

Introducing a bill that starts the bargaining at the point where you might have settled makes no sense at all. Maybe this is Kennedy's way of killing this sort of phoney "reform" so single payer could actually be considered. Once upon a time that's what Ted supported.