The public option always was something of a sideshow. It would be available only to those buying their health insurance through the new system of "Exchanges"--that is, health care superstores where individuals and small businesses would combine to establish the same sort of purchasing clout that major companies (like, say, Time Warner) have in dealing insurance companies.It is to laugh, my fellow prisoners.
The aforementioned clout would force insurance companies to clean up their act and lower their prices. In effect, the Exchanges would accomplish much of what the public option is intended to do.
The presence of a health care exchange by itself without a public option really does nothing to force insurance companies to compete for market share (or, as Paul Waldman tells us here)…
Perhaps a reform bill without a public option could regulate the insurance companies enough to keep them from engaging in their most despicable business practices. We could outlaw the practice of rescission (in which they cash your premiums, then kick you off your plan once you get a serious illness). We could make them accept anyone, regardless of pre-existing conditions. We could set up an insurance exchange, a kind of managed market where people could easily compare different plans and have a variety of choices. As part of the deal for getting access to this pool of customers, we could force the insurers to accept "community rating" -- charging everyone within a population the same price, no matter their age, gender, or medical history. Those regulations would certainly go a long way toward curbing the worst abuses.If you doubt any of this, just ask yourself why the insurance industry, their front groups, and their political puppets (along with their sympathetic corporate media cousins, of which Klein is apparently a member) are fighting health care reform like they have never fought anything else before in my lifetime.
Call me cynical, but I can't help but assume that even if we do all that, the insurance companies will still come up with a dozen creative new ways to cut people off, avoid paying claims, and generally pad their profits at the expense of their enrollees' health and security. There's a reason why they'll fight against the public option with every ounce of strength -- and every dollar -- they can muster (insurance companies spent $74 million on lobbyists in 2008 alone). It's because the presence of a plan that offers security is a dire threat to their business model. It's possible that the health-care system could be improved without a public option. But as long as most people have no choice but to get coverage through a private insurance company, security is the one thing we won't have.
Last week, as the debate over health care reform continued to dominate the news cycle, an effort to place a billboard in U.S. Rep. Roy Blunt’s home district was, well, blunted.The post tells us that the billboard was rejected by Lamar Advertising Company last Thursday. However, the company changed its mind the following day and decided to put up the billboard after all; kudos to them (though Lamar is still a profit-making enterprise, I know).
The billboard was to have featured a picture of Blunt with the words: “Roy Blunt has taken $556,682 in contributions from the insurance industry. Is that why he won’t take our side on health care reform?”
Concerning Blunt, it should be noted that, according to this story, he is stepping down from his U.S. House set so he can campaign for the U.S. Senate seat of fellow Repug “Kit” Bond, who is also bowing out (and as noted here, Blunt served as temporary House Majority Leader until John Boehner was tapped for the role after a certain dancing ex-representative stepped down due to a criminal indictment).
And in the unhappy event that Blunt ends up in “the world’s greatest deliberative body,” I’m sure that that half a million or so from his insurance biz buds will only increase exponentially over time.
Update 8/20/09: And speaking of Blunt, please don't be so quick to pronounce him a senator yet, Keith (oh, sorry I forgot to apologize, Karl; I was too busy offering tea and sympathy to the 9/11 hijackers, you creep...and by the way, Sen. Cornyn, my Email address is email@example.com).
H.R. 1 (more commonly known as the Recovery and Reinvestment Act, even more commonly known as the Stimulus Bill and aptly dubbed the Porkulus Bill) contains a whopping $1.1 billion to fund the Federal Coordinating Council for Comparative Effectiveness Research. The Council is the brain child of former Health and Human Services Secretary Nominee Tom Daschle. Before the Porkulus Bill passed, Betsy McCaughey (pictured), former Lieutenant governor of New York, wrote in detail about the Council's purpose.There’s your first sign of trouble, people (and by the way, I wonder how much the “porkulus” has been ridiculed by individuals who were hired or had their jobs saved as a result of the ARRA – you can read about them here)…
Back to the wingnuts…
Daschle's stated purpose (and therefore President Obama's purpose) for creating the Council is to empower an unelected bureaucracy to make the hard decisions about health care rationing that elected politicians are politically unable to make. The end result is to slow costly medical advancement and consumption. Daschle argues that Americans ought to be more like Europeans who passively accept "hopeless diagnoses."I’m not going to try and decipher McCaughey’s idiocy here (and it is truly that, people; all of this is a replay of her tactics in scuttling the Clinton health care reform effort of the early ‘90s, as noted here, where Ezra Klein "spoke truth to stupid" regarding McCaughey’s claim that “(a) National Coordinator of Health Information Technology… will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective."
But returning to the present, we learn the following (from here - a bit of a rehash, I know)…
The U.S. Department of Health and Human Services today announced the members of the Federal Coordinating Council for Comparative Effectiveness Research. Authorized by the American Recovery and Reinvestment Act (ARRA), the new Council will help coordinate research and guide investments in comparative effectiveness research funded by the Recovery Act.So who dreamed up this idea of “comparative effectiveness” anyway? Was it President Obama, who wants to “snuff out Granny,” as the Courier Times laughably asked last week?
“Comparative effectiveness research can improve care for all Americans and is an important element of President Obama’s health reform plan,” said HHS Spokeswoman Jenny Backus. “President Obama is committed to openness and transparency and the Coordinating Council will host open meetings and a listening session as it begins its important work.”
Here is the answer (though they've fallen into disrepute as this has all played out, IMHO)...
Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Budget Committee Chair Kent Conrad (D-N.D.) on Friday introduced a bill (S 3408) to create a public-private comparative effectiveness institute, which health care policy experts say is essential to controlling health care costs and covering the uninsured, CQ HealthBeat reports.And how much money, more or less, could we save?
The institute would function as a not-for-profit private entity, not a federal agency, governed by a public-private Board of Governors, according to Baucus.
“Congressional Budget Office Director Peter Orszag estimated that the U.S. could save up to $700 billion annually in health spending by identifying treatments that do not produce the best medical outcomes.”And as govtrack notes here, the bill was introduced in July '08, but basically died from that point. So I guess it just makes waay too much sense to reintroduce it into health care reform legislation, doesn’t it?
So, summing up, as far as McCaughey and her pals are concerned, controlling costs + covering the uninsured + saving $700 billion + identifying best treatments = KILLING UNPRODUCTIVE OLD PEOPLE!
I know this battle over trying to enact common sense health care reform hasn’t lasted as long as the entire ’08 presidential campaign, but I already feel like it has.
Update 8/21/09: As the late, great Harry Kalas might put it, McCaughey is "OUTTA HERE!" (here).