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No Public Option = No Reform May 29, 2009

Posted by Kate Ryan in Economy, Health Care, National Politics, Public Health.
Tags: , , , , , , ,

health-care-300x300Progressive and Liberal Democrats have been biting their nails over health-care reform lately.  The reason for all the anxiety?  Word being whispered out of all the “think-tank” meetings that the health care reform plans to be introduced in Congress will not include a public option.

Earlier this month, Senator Max Baucus (D-NE) announced that any public option would be a “deal breaker” to health care reform (though yesterday he indicated his opposition is softening).  Advertisements are running on television showing people from countries with single-payer health care – or socialized medicine to some – that have apparently received substandard care.  Private insurance companies rushed to the table with a package of $21 billion in cost savings (that they later backpedaled on) to attempt to convince Congress that a public option was unnecessary.  

Let us be perfectly frank here.  If any health care reform proposal does not include a public insurance option – then there will be no real reform.  Americans will continue to be captive to the for-profit insurance industry – the same industry that denies coverage, increases consumer costs by double-digits every year, and has administrative costs that eat up almost 30% of paid premium dollars.  This is the same industry that has recorded record profits every year while more and more Americans are dropped from coverage or go without coverage because of costs. 

The anti-public option side favors either a “Massachusetts-style” reform plan or, of course, tax credits to individuals that will enable them to pay for “market-based” insurance. 

The Massachusetts model requires all persons to either buy a health insurance policy or show proof of an employer-provided plan.  Those persons not able to afford insurance can apply to the state for income-based assistance.  This is paid for by a surcharge on employers that do not provide insurance plans and some taxes.  The problem is, the Massachusetts plan does not regulate what insurers can charge. The state does not limit health insurance overhead and profit, and does not limit how much people have to pay out-of-pocket when they get sick.  In a study of Massachusetts residents released yesterday the number of adults “who reported that they did not get care that they thought they needed” has increased due to the proliferation of high-deductible health insurance policies that require patients to pay up to thousands of dollars out-of-pocket before accessing care.

Of course, the Republican tax credit plan also does not regulate insurers nor does it do anything to control costs.  It merely provides those Americans that must buy insurance on the private market a refundable tax credit of up to $7,500 to defray the cost of insurance (the average family health plan costs about $12,000 per year).   The plan assumes that people can afford to shell out a grand a month for insurance and wait a year to get reimbursed by the government.  Try that on the average American salary of about $800 a week before taxes.  It also assumes that if Americans were able to “shop around” for insurance that this would provide enough competition and incentive for companies to control costs. 

That sounds good until you really start looking at insurance costs.  As public employees, my husband and I have the “advantage” of choosing among many different providers during health care “open seasons”.  As a federal employee, my brochure shows the rates all around the country.  Guess what?  They’re almost all the same.  The cost differences between the insurers are so small as to be indistinct.

The only way to control costs and ensure real competition among the for-profit carriers is to include a public option.  The easiest and most cost-effective way to do this is to open Medicare to everyone.

Many of our parents and grandparents use Medicare.  As far as I know, they do not wait for treatment or have treatment refused, unlike many people covered by private plans.  They choose their own doctors from those in the community, unlike choosing them from an approved list in private plans.  They are covered for durable medical equipment, outpatient nursing care, and long-term care – things that are unheard of in private insurance plans. 

Of course, when one brings up opening Medicare to all, the hysterical right immediately counters with, “But Medicare is going broke!”  The latest estimate is that Medicare will run out of money in 2017.

Current working people pay 1.45% on all income (Medicare – unlike Social Security – is not income capped) into Medicare.  In addition, current Medicare recipients pay about $500 per month in premiums (there is help available for people who cannot afford the cost).   Also,  the prescription benefit program costs an additional premium whose formula is so complex it begs for reform.    The question is valid – how can Medicare cover the uninsured without driving the program further into the hole or increasing premiums to recipients?

First, raise the working Medicare tax.  Increase it from its current 1.45% to 3.5%.  For a person making that average American salary, this is an increase of about $17 per week.  Keep premiums where they are, but increase the yearly deductible for ALL medical services (including prescription drugs) to $500 for an individual and $1,000 per family.  Eliminate the medical-expense deductions on income taxes (not many middle or lower income Americans qualify for this).  Reform Medicare to cut its costs; digitize medical records, negotiate prescription drug prices, allow reimportation of prescription drugs, increase reimbursement rates to physicians for patient health improvements, and reimburse health and welfare/early intervention programs.  Finally, enrolling younger and healthier Americans into Medicare will create a larger pool of money in the program that can be invested against future program needs.

Progressive talkers like Ed Shultz and Thom Hartman are keeping the public option viable.  Americans are ready for public health insurance.  A recent poll found that 65% support opening Medicare to everyone and 60% are willing to pay more to achieve that goal.



1. mixblogteam - May 30, 2009

News! Very good. Good luck with your blog …

2. indri - May 29, 2009

Thank you Friends … To find it, I am very happy to be able to visit your blog, a lot of good information
interesting, I hope we can share information…

3. No Public Option = No Reform | Health Insurance - May 29, 2009

[…] View original here: No Public Option = No Reform […]

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