The Sellout May be Complete

The key issue is reasonably straightforward ... (4.00 / 2)

... though the politics and implementation details might be anything but.

Big health insurance corporations will be putting plans into multiple health care exchanges. Under the "strong public option", the NHS would be putting the same public plan into each of those exchanges as well.

That is the head to head competition that would give a public plan the ability to benefit from its intrinsic competitive advantages - the advantages that private health insurance companies fear, and at the same time are claiming do not exist.

In the most likely version of a "co-op" system, each health exchange would have its own not-for-profit plan, with its own administration with substantial duplication of the administration of neighboring co-ops, and little market leverage to persuade health care providers to go out of their way to work with the co-op.

So small, divided, not for profit co-ops get to compete against large coporations putting the same plan into multiple exchanges ... ensuring that the competitive advantages of a not-for-profit system do not have a level playing field.

Of course, one could sabotage the idea of crippling the not-for-profit option with co-ops by having co-ops that are allowed to pool administrative resources to offer a common plan in multiple exchanges. And indeed, one could go one further and say that since they are not "public" plans, there's no call for government restricting their power to negotiate lower prices with health service providers and drug companies.

But that's only if the "substantial competition" is a real line in the sand. Certainly it seems that if Rahm gets his way, it'll be empty rhetoric.

The Words of the Prophets
  Are Written on the Subway Walls
    And Tenement Halls

---

by: BruceMcF @ Sun Aug 16, 2009 at 18:02:25 PM UTC

Bruce... (0.00 / 0)

I am curious to know, because I will admit this is not exactly my area of great expertise and I have come to respect your intelligence since reading your diaries, what do you think about the co-op plans introduced in the Senate by Conrad?? Do you think it is a viable alternative to a robust public option??

I admit also that part of my reaction to this is knee-jerk. I simply do not trust anything that any Republican in govt right now is open to. They have shown how bad they treat the economy and anything else that makes sense. I do not trust many of the Democrats in the Senate and House who have taken millions of $$$ from the folks that are profiting from the current system. And finally, I have seen all the footage from townhalls and seeing the kind of hatred and idiocy displayed by the people opposing a public plan I have begun to see them as an enemy to all enlightened people everywhere. I hate for them to get their way, sort of like a spoiled rotten child that threw a ridiculous temper-tamtrum and got what they wanted.

Are my own biases causing me to oppose something that may be good??

Questions or comments??
rdemocrathillbilly@yahoo.com

---

by: RDemocrat @ Mon Aug 17, 2009 at 01:20:38 AM UTC

[ Parent ]

They are a con job. (4.00 / 1)

That's what I was referring to up there:

So small, divided, not for profit co-ops get to compete against large coporations putting the same plan into multiple exchanges ... ensuring that the competitive advantages of a not-for-profit system do not have a level playing field.

If it arrives at co-ops, of course the way to make it blow up in the faces of the health insurance lobby is to allow it to be a single co-op putting the same plan into the same exchange ... and, as a non-government organization, allow it to bargain with health insurance providers and the drug companies ... that is, the Pharma deal only applies to the public plan.

Indeed, if someone snuck that bargaining with drug companies into the co-op provision in the Senate bill, that would bring the drug companies out in force in favor of the public option.

The Words of the Prophets
  Are Written on the Subway Walls
    And Tenement Halls

---

by: BruceMcF @ Mon Aug 17, 2009 at 15:29:12 PM UTC

[ Parent ]

Thanks.... (0.00 / 0)

That is what I figured but as I said I am not very versed on insurance.

Best wishes!!

Questions or comments??
rdemocrathillbilly@yahoo.com

---

by: RDemocrat @ Mon Aug 17, 2009 at 21:33:38 PM UTC

[ Parent ]

You will here a lot of the stat that there are ... (0.00 / 0)

... "1300 health insurance companies in the country" ... but it turns out that for most of the country, there are a bunch of regional monopolies and duopolies with a competitive fringe that handles special cases.

So competition in and of itself is reform in the health insurance industry ... and like any collection of local monopolists and duopolists, they don't like it one damn bit.

The Words of the Prophets
  Are Written on the Subway Walls
    And Tenement Halls

---

by: BruceMcF @ Tue Aug 18, 2009 at 15:52:04 PM UTC

[ Parent ]

Co-ops. We' ve been down that road before (4.00 / 1)

Co-ops, of course, are how Blue Cross began:  Non-profit insurance cooperatives that would, indeed were required in most states, to provide insurance to anyone. That included people without access to coverage through employers, people with conditions that made them uninsurable privately, etc. Nonprofit, some public oversight without government control. Cost originally was not greatly different for healthy people as for unhealthy persons.

Well, I think the future of some new set of coops is about what's happened to Blue Cross:  many states have allowed BC to privatize, and many private BCBSs have been snapped up by corporate insurance conglomerates. Insurance rates, rather than spreading the risk and cost across all members, has differentially charge people depending on their health status and other things. BCBS is an option where I work. 17 years ago, it cost 300/mo, now it is $633/mo.  That's simply not affordable for most families without health insurance

BCBS, of course, has increased pay for top executives, particularly among privatized plans. Wellpoint, Inc. now operates (virtually owns) BCBS of Kentucky (and BCBS of several other states). The CEO of Wellpoint, is listed by  Forbes magazine as earning 4.07million dollars in compensation, plus more than 4million dollars in company stock, in 2008.

I can't help but note that the head of any large government bureaucracy, like the Secretary of Health and Human Services, tops out salary at $197,000 annual income. Only the President earns more. No stock, no deferred income. Good health insurance, however - but I'd guess insurance is pretty good for those CEOs too,.

---

by: Kidspeak @ Mon Aug 17, 2009 at 05:04:11 AM UTC

Thank you!! (0.00 / 0)

For the excellent reply. I am not the most educated on exactly how insurance works but your reply made a lot of sense.

I guess my knee-jerk reaction was correct. I thought the coops were a bad idea right off a month ago. Whats that old saying, your first thought is usually right??

Questions or comments??
rdemocrathillbilly@yahoo.com

---

by: RDemocrat @ Mon Aug 17, 2009 at 06:32:59 AM UTC

[ Parent ]