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Linda Bergthold

Linda Bergthold

Posted: December 6, 2009 02:25 PM

Public Option Redux

What's Your Reaction:

This week there is yet another attempt to introduce a "public option" into health care that could pass the Senate. It's not really a public option. It's not really new. But it just might do the job. It's essentially an expansion of an established program, the Federal Employees Health Benefit Program (FEHBP), run by the government's Office of Personnel Management. It would open this program to some part of the population nationally. A government agency (OPM) would administer it but the plans competing for your business would be private nonprofits.

I am the lucky recipient of a number of emails that keep pushing me to explain why Congress won't give everyone access to what they have. The right uses this as an excuse to attack health reform -- if the health reform plan is so great, why won't Congress require their own members and staff to enroll in it? Why not, indeed?

This, however, is no new idea. When I worked in the Clinton White House in 1994, we considered expanding the FEHBP to everyone and the president even mentioned it in his State of the Union speech. Senator John Kerry in 2004 introduced it as the "Congressional Health Plan." The idea has gained support over time on both sides of the aisle, but it has never had enough support for serious consideration until now.

What are the advantages of doing this?
1. It would be a national and more consistent solution to the fragmented state by state opt ins, opt outs, that are currently being discussed.

2. It would build on a reasonably successful program already in place. Not much new "seed money" would be needed to get the expansion in place.

3. it would offer people a true choice of plans, something most of us don't really have. If you have an employer-sponsored plan, you usually get at most two or three choices and often they are all offered by the same insurance company (e.g. HMO, PPO, HDHP). Depending on where you live, a few plans may dominate the marketplace, offering little real choice.

4. It would not be a "public option," which could allow Congressional members to backtrack on their opposition to "government control" while still supporting this idea. (See Mike Lux's blog on the language of this....)

5. It could invigorate the nonprofit insurance industry, because only nonprofit plans could compete. Instead of seeing plans turn for-profit, we might see for-profits establishing new nonprofit entities. Whether that would make a difference is hard to say, but not having to report quarterly earnings to shareholders could be good for all of us. And the current OPM sets a 1.2% maximum profit level on all insurance plans with which it negotiates.

What are the disadvantages of this so-called "not really public option"?

1. Well, it's not really a public option in the sense that the companies offering coverage would be private nonprofit, not publicly governed or administered.

2. Jon Walker at Firedoglake pretty much sums up the objections to this idea:

This is not a public insurance entity competing with the existing private insurance companies. This will do nothing to inject competition into concentrated markets. This will not ensure the government provides people with at least one decent insurance plan structured to promote the public good. In the long run, this will not change how the insurance market operates or help rein in our out-of-control health care costs. (The FEHBP has been a failure on the cost controlling front.)

3. The FEHBP has not been spectacularly successful in controlling costs, but it has not been a complete failure, contrary to Walker's comment here. The graph he refers to in Ezra Klein's column shows the FEHBP, Employer sponsored insurance and CalPERS all running at about the same annual costs. If you're doing an expansion of FEHBP to control costs, you would need more than just multiple plans competing against each other to achieve that. But that's not to say a strong public purchaser could not put pressure on insurance companies to pay providers differently and thus contain costs.

4. It's a "late in the game" idea, and the disadvantage of it might be that it cannot be cobbled together quickly enough to make it to the final bill.

5. The fact that the OPM would run this program would require additional resources and would open the idea to charges of a government take-over, just as if the program really were public. So I'm not sure the opposition would melt away. But it would be fun to watch the same conservatives who are complaining that Congress won't give everyone what they have turn around and oppose this.

6. It would be difficult to include abortion coverage, because the current FEHBP plans offer very limited abortion coverage to federal employees. This could truly complicate the debate by conflating the two most contentious issues -- abortion and public option -- into one big mess of a concept.

But definitely stay tuned. This is truly a public option "redux" if the meaning of the word is "brought back" or "revived" or "restored." The public option has lived and died so many times, it has gone beyond feline life expectancy.

Update: In addition to this OPM/FEHBP approach to a public option, the Gang of 10 are considering opening up Medicare to people 55 and older. Not sure what that would cost the individual, but it's an option many have been suggesting for a long time. Read Jon Cohn at TNR about it.

 
 
 
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03:34 PM on 12/08/2009
Surely you jest?
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HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
04:01 PM on 12/08/2009
How about some substantive commentary on the ideas in the post... the idea of using the OPM to administer plans that are similar to what Congress gets already; or the idea that people could buy into Medicare at age 55?
02:43 PM on 12/08/2009
If the martians landed and asked to be taken to our leader, just point them to Wall Street, anyone there would do, because Obama certainly isn't exhibiting any leadership skills, no decision making skills, no commen sense. His advisors are circling the wagon like they did to Ceasar right before he was, well you know the story. It's as if, once he was pronounced the victor, the mask came off and the real victor emerged. Obama was just a face beneath the mask during the campaign.
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HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
03:27 PM on 12/08/2009
And exactly what does this have to do with the blog I just posted? You are blaming Obama for this latest innovation?
10:24 AM on 12/07/2009
Imagine the scenario if any flavor HC Bill passes which has sweeping effects, rather than targeting a few things (i.e. tort reform, competition across state lines, etc.). In such a scene the democrat losses in the 2010 and 2012 elections will be historic in their scope.

Never before in the history of America have so many voters been totally ignored by those who govern them. Never before in the history of America have the people been ordered to buy from certain organizations or be fined or imprisoned. The backlash by the people to these draconian measures will be revolutionary: except this time it will be the democrats, progressives, and liberals losing instead of the redcoats fleeing. Not only will any sweeping HC Bill be repealed but it will probably also prompt a constitutional amendment to prevent any future take-overs of private societal organizations by the state.

These are exciting times we are living in.
11:23 AM on 12/07/2009
"...Never before in the history of America have the people been ordered to buy from certain organizations or be fined or imprisoned. "


Hmmmm, seems to me that Reagan was in office when the government mandated law requiring all vehicle owners to purchase auto insurance went into effect.

The pattern of government-mandated purchase from private industries is NOT simply something the democrats, progressives and liberals need to be held accountable for or worry about. Republicans have backed it plenty of times.
12:51 PM on 12/07/2009
Reagan's "mandate" applies only if you have car; the new democrat madate applies if you simply exist and breathe.
09:53 AM on 12/07/2009
If we lose the public option, we will be held hostage by the Insurance companies themselves under the mandate that all Americans MUST carry insurance.

The law will maintain that those who can be taken care of under national healthcare, (lower income), will be... And the rest of us will be forced to keep purchasing from the private corporations, who will raise their profit margins to cover any potential losses.

Those who don't make the lower-income cut will be at the mercy of what is already an out-of-control business.

We either develop a not-for-profit public option, or we need to scrap the plan and begin again.
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HUFFPOST SUPER USER
dagmaclugh39
Nomen est omen.
09:41 AM on 12/07/2009
Remember back when ANY kind of national health care plan was considered DOA? We've come a long way, baby!
08:52 AM on 12/07/2009
When Obama comes around in two years asking for handouts for his presidential campaign, remember that it was Obama that killed the public option and single payer.
08:18 AM on 12/07/2009
This is a good post and the non-profit approach is one good alternative.
10:01 AM on 12/07/2009
I agree.
08:12 AM on 12/07/2009
This is a very bad idea because it will not spur competition in the market. Those who can't afford good insurance plans will have to settle for less. Like buying a Honda accord, Honda fit or a used Honda . There is no cost competition, no cost control and no escape from the for-profit health run business. We want a robust Public Option like Reid, Peolosi and Obama want. We want a fair, efficient Public Option now that will grow over time. My employer just dropped my relatively good $1000.00 deductible health plan, we now have 2 options to choose from. 1) A health plan with a $5000.00 deductible with a 20% co-pay or a plan with a $5000.00 deductible with 100%c0-pay (this means that you are responsible for all costs of all doctor's visits, immunizations etc until you reach your $5000.00 YEARLY deductible. The benefit (?) of the second plan is a tax free health spending account. Either plan costs $65.00 per pay check. Please note that the second plan covers NOTHING until you reach your deductible in yearly medical expenses. Health care reform of course will make this plan illegal because all plans will be required to offer preventive care (mamograms, rutine doctor's visits etc) but this is not enough we want to take PROFIT out of the equation all together. Please support Reid and Pelosi's Public Option or the insurers will eat us alive!
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usna73
We are all in this together
11:25 AM on 12/07/2009
This author's plan will work best with the removal of the anti-trust exemption for the "for-profit" insurers.
12:07 AM on 12/07/2009
Now this is a great post! This has to be at the top to enlighten HuffPost readers. The Senate is about to ki.ll the public option.
11:55 PM on 12/06/2009
" But that's not to say a strong public purchaser could not put pressure on insurance companies to pay providers differently and thus contain costs."

Yes in theory that could happen but the OPM has not done that and we are talking about the OPM.

You have provide no evidence that the FEHB has not been basically a failure at cost control. That is the finding of the GAO which shows it has be no better than most large employers. http://www.gao.gov/new.items/d03236.pdf

Frankly, the exchange is already meant to do what this "alternative" plan would do.
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HUFFPOST BLOGGER
Harold Pollack
11:37 PM on 12/06/2009
Linda, this is a great explanation. This proposal is not a true public option. It is useful because it may be a better exchange, and it gives a fig leaf for negotiation. Still this is a sad aspect of the endgame negotiation.
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HUFFPOST COMMUNITY MODERATOR
ECBA88
05:01 PM on 12/06/2009
Thanks, this is an interesting concept, and it's nice to see some analysis.
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HUFFPOST SUPER USER
TyneCrescent
A Word To The Wise Is Sufficient
03:50 PM on 12/06/2009
Thanks Ms. Bergthold for your observations, highlighting pros and cons, and explaining some of the intricacies in layman's terms. Informative, as always, and provides a basis for further delving into the health reform issues.