Where's the public option?

[rug]

Here are the details that every American needs to know about this plan:

First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.

What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

That’s what Americans who have health insurance can expect from this plan – more security and stability.

Now, if you’re one of the tens of millions of Americans who don’t currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.

For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can’t get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it’s a good idea now, and we should embrace it.

Now, even if we provide these affordable options, there may be those – particularly the young and healthy – who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers. The problem is, such irresponsible behavior costs all the rest of us money. If there are affordable options and people still don’t sign up for health insurance, it means we pay for those people’s expensive emergency room visits. If some businesses don’t provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors. And unless everybody does their part, many of the insurance reforms we seek – especially requiring insurance companies to cover pre-existing conditions – just can’t be achieved.

That’s why under my plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part.

While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to purchase affordable coverage, and a requirement that people who can afford insurance get insurance.

----------

1. If you have insurance thus plan will not affect you.

2. A shopping mall populated by private insurers.

3. You must buy health insurance.

What am I missing?

[Connie_Corleone]

1. You need to get the rest of the speech.

[rug]

4. I just read it. Can you tell me what I missed?

This excerpt appears to be the plan.

There is a lot of stirring language, but this seems to be the heart of the plan.

[Connie_Corleone]

6. Read it again. It's in there.

[rug]

8. Read it twice. Still looking.

[Uzybone]

2. you are missing most of the speech

[Teaser]

3. reading the whole speech wasn't worth your time eh?

what, are you curing cancer or something?

[rug]

5. I did. Waste your time and show me what's missing.

[laconicsax]

7. The part where tax dollars go into exective pay.

4. Tax dollars will go towards covering the administrative costs and executive pay that some can't afford.

[rug]

9. Seriously? That is the public option?

[polpilot]

11. 'MM* Public Option'

*Mickey Mouse

[laconicsax]

16. That's part of how it works.

The whole plan is about universal insurance coverage. Private insurers provide coverage and people who can't afford it are given tax credits to offset the cost. It isn't a direct pipeline from tax money to the insurance co's, but it might as well be.

[ChimpersMcSmirkers]

10. Try this

http://www.nytimes.com/2009/09/10/us/politics/10obama.text.html?_r=1&pagewanted=all

...
My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.

So let me set the record straight. My guiding principle is, and always has been, that consumers do better when there is choice and competition. Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies. In Alabama, almost 90% is controlled by just one company. Without competition, the price of insurance goes up and the quality goes down. And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.

Insurance executives don't do this because they are bad people. They do it because it's profitable. As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it. All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers. It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated – by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

[rug]

14. Thanks, that seems to be the only pertinent paragraph.

"Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up."

It appears to be quite limited.

If it's to exist only in the insurance excahange, and available only to those without insurance, only those too destitute to purchase private insurance would be eligible.It's hard to see how that would provide competition.

[polichick]

12. Here's the line that I'm not crazy about...

"Let me be clear – it would only be an option for those who don’t have insurance."

[SWr]

13. hmmm

The PO is only available to those who DONT have insurance ... so how is that a public option? Does nothing for me or my SKY HIGH premiums.

[andym]

18. Won't everyone be free to decline their insurance and get the PO?

Once you no longer have insurance you would qualify.

[jeanpalmer]

15. You're missing nothing

except that that the status quo will continue for 4 years, during which healthcare costs are projected to rise by 5.5% each year. That's 5.5% added on to the exorbitant costs of the current healthcare system. Four years from now, his exchange will kick in and we'll supposedly get competition. This is like the credit card bill that allowed banks to raise rates for 16 months; and the results will be similar.

This is exatly what they've been telegraphing to us for the past month. It's Baucus' bill. It costs the same as his -- $900 billion. Mandatory insurance, with an insurance exchange. By floating the idea, and then denying it, and floating it again, and denying it again, over and over, they have brainwashed the cultists into acceptance, as near as I can tell. They wore down all resistance.

Obama shows little understanding of the healthcare crisis. The problem is we pay $6700 per person annually for healthcare while other countries pay a lot less. There are reasons why that is so. Finding out why and zeroing in on the causes will start the process of real healthcare reform. Obama shows no interest in finding out why. Instead, he wants to start with a bloated system at $6700/year and tinker with it, mostly 4 years from now. What a disappointment.

[Name removed]

17. Deleted message

Message removed by moderator. Click here to review the message board rules.

[FrenchieCat]

21. Name calling just like that other party! How smart you are!

[laconicsax]

25. Ah, the old stand-by.

[OwnedByFerrets]

19. If you have shitty insurance you're fucked.

[beaglelover]

20. The public option is part of that mall. n/t

[Honeycombe8]

22. Your listed points are incorrect.

Your point #1 says "If you have insurance thus plan will not affect you." That's wrong, according to what he says. He says that the plan will make your coverage more secure and stable. (you can't be dropped when you get sick...like my mother was)

Your other points seem accurate enough. But you left out the portion of the speech where he talks about the public option.

[fadedrose]

23. Insurance companies will operate under NEW rules

NO-profit, or low profit will no doubt force many of them out of the health insurance business. Policies with NO caps will drive some of them out of business, and preexisting conditions will get the rest of them.

Don't forget - their profits are higher now than ever, and they're payng $2 mil bonuses to their top people - you think that's not going to change???

The public option will turn out to be the default option, as the rats leave their sinking ships..

That's how I read between the lines...

[GOTV]

24. Here's the part of the speech that I think applies

My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.

So let me set the record straight. My guiding principle is, and always has been, that consumers do better when there is choice and competition. Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies. In Alabama, almost 90% is controlled by just one company. Without competition, the price of insurance goes up and the quality goes down. And it makes it easier for insurance companies to treat their customers badly - by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.

Insurance executives don't do this because they are bad people. They do it because it's profitable. As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it. All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear - it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers. It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated - by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end - and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.