A little-discussed provision of the Affordable Health Care Act (i.e., "Obamacare") provides an extraordinary opening for Democratic gubernatorial and state legislative candidates to deliver a simple message that will resonate with voters and sweep them into office. Yes, this year.
Moreover, they will be loved for the enemies they make -- the health insurance industry.
In a nutshell, this is it: Although a federal 'public option' failed to make it into the law, states were granted the power to generate their own public option.
Let us recall that the public option was insanely popular. Further evidence of that popularity emerged recently when it was "discovered" that 30% of those who said they "do not like" the healthcare reform were disappointed that it did not go further.
That was the federal public option, attacked as a 'federal takeover', nonsense that the populace seemed to shrug off. After all, Medicare was a federal takeover of care for the elderly and that has worked out pretty well for them. Even Tea Partier Marco Rubio in Florida is running an ad claiming that his opponents took money from Medicare -- and he, Rubio, would restore it! How's that for right wing piety! [And, if you believe it, I have a war in Iraq to sell you].
But, the state public option alternative even avoids the federal takeover nonsense.
If I were running anywhere this year, for governor or state legislature, I would propose that my state enact a public option for itself. Its costs would be negligible, as the federal government provides the necessary subsidies to enable those who cannot afford it to buy it, whether it is from a private insurer or the state. The state would establish it as "just another" insurance option, with individuals paying premiums -- only the premiums would likely be lower as the advertising, administration and salaries would all be lower. It would be run not at a loss, but at slightly above break-even. If, as is likely, the insurance companies lowered their premiums to be competitive, the premiums would be the same as the private sector, but lower than they would have been without the competition of the state public option.
Negligible cost to state taxpayers. Lower EVERYONE's rates in the state. Make the state more competitive for businesses to grow jobs because the state public option would keep health insurance premiums as low as possible.
Too good to be true? Well, almost. The one flaw is that this program could not kick in until 2014 according to current law. That is not so bad, as the elections will be held in November 2010, the laws would be passed and signed in 2011. It would take about a year to get the program established, so the earliest it could be implemented would be 2012 anyhow.
What pressure do you think governors, legislatures and the people of each state would bring upon Members of Congress to accelerate the implementation date in the federal law? That would be an inexorable force. Moreover, even if it would only take effect in 2014, is it not better to get it enacted, and be ready for it?
And, what about the politics in 2010? Democrats ought to be able to take this simple message, based upon an entire year of discussing it at the national level, and make it resonate with voters in their states, who already supported the national public option by large majorities anyhow. The state public option should be even more wildly popular.
And the Republicans? What can they do? Twenty attorneys-general have filed specious lawsuits to overturn health care reform. To be a Republican candidate, you must oppose it. So, they are going to deny the citizens of their states a very low cost insurance plan that will lower EVERYONE's premiums? And, allow other states to become a more attractive environment for growing businesses...and jobs?
And, stand forthrightly with the...insurance companies?
I would take that contest in any state, any day of any week.
And, what about those Republican candidates and members of Congress who voted against this bill in the first place, and now want to repeal it? They will have to conduct their campaigns in the face of this "state" onslaught.
If there is anything we should have learned this year, it is that election chances can turn around on a dime. Nearly all the Tea Party victories came in the last week or two, closing enormous gaps with the anointed party candidates.
So, Democratic Governors' Association, what are you waiting for?
The checks to clear from the lobbyists....
Just say no to the lobbyists......
I can hear the Republican argument already - "They want ANOTHER government takeover of your insurance!" The idea's dead in one sentence, since voters rarely get beyond the initial shout.
But, there are no costs--it's a public insurance company into which people who want it pay premiums, calculated, as with all insurance, to cover costs. It's just that costs will be less.
You are quite right that the initial labeling will be as you say--but, one has to grit teeth and get through that. Afterwards, the more the Republicans attack it, the more publicity it gets, and the more people can see the benefits.
The insurance company forces the hospital/doctor's office to pay them to include the provider in their network. The provider and insurance company then agree on the rate/schedule for covered costs, like $50 per Tylenol or $300 for an x-ray. The insurance company then takes the position that it won't pay the full amount, but only a portion (say $35 for the Tylenol and $250 for the x-ray). This is still a huge markup over the actual cost of the procedure/product; but it makes the insurance company look like a good option to their customers - even when the customer pays a large premium, a co-pay, a large deductible, and many procedures aren't covered. It's almost humorous to note that the co-pay is about what the actual visit would cost, in most cases, if insurance wasn't running this massive racket.
Note, also, that a large portion of other costs in healthcare are in the additional administrative costs of handling/processing insurance claims.
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You know the answer. It's all that corporate campaign cash that funds both major parties.
Theoretically, Republicans should be calling for this anti-trust legislation too, since they claim to love "free" markets. Turns out they love corporate campaign cash even more.
And the Republicans? What have they done? Twenty attorneys-general have filed specious lawsuits to overturn health care reform. They are going to deny the citizens of their states a very low cost insurance plan that will lower EVERYONE's premiums? And, allow other states to become a less attractive environment for growing businesses...and jobs. Is that what any American in is right mind wants? Nope.
What are you going to do??? Remember, you have to keep your paymasters happy!
By the way, the Democrats are the ones who passed the bill as it is, and it mandates everyone buys health insurance. I think the Democrats have the same "paymasters".
And, you know how much they don't want it--Republicans "Pledge" will enact it after they repeal it!! Read the idiotic Pledge.
Oh, and people really don't want government messing with their Medicare, do they? You mean Medicare IS the government? I did not know that
BTW - what kind of dog is that??? Mutt?
kind of bill if it were put on his desk.
The insurance company forces the hospital/doctor's office to pay them to include the provider in their network. The provider and insurance company then agree on the rate/schedule for covered costs, like $50 per Tylenol or $300 for an x-ray. The insurance company then takes the position that it won't pay the full amount, but only a portion (say $35 for the Tylenol and $250 for the x-ray). This is still a huge markup over the actual cost of the procedure/product; but it makes the insurance company look like a good option to their customers - even when the customer pays a large premium, a co-pay, a large deductible, and many procedures aren't covered. It's almost humorous to note that the co-pay is about what the actual visit would cost, in most cases, if insurance wasn't running this massive racket.
Note, also, that a large portion of other costs in healthcare are in the additional administrative costs of handling/processing insurance claims.
I'm wondering if you believe the above scenario for state-run public options described by Abrams would help alleviate the insurance industry problems (gouging racket) you refer to.
However, there are many variables; and a public-option certainly is not a panacea. I believe either the state or federal government should enact anti-trust laws; or the federal government should revoke the laws protecting insurance companies. Doing these things concurrently would provide the best protection for consumers...
The same concept could be used to negotiate lower drug prices.
But the real cost savings, reduction in medical errors and advancement in medical research comes from determining what "Best Medical Practices" are, on a continuing basis, and implementing them across the country.
Cram-down for mortgages
Cap and rebate on energy
"Home Star" program with financing through PACE bonds
Removing the anti-trust exemption.
But I can only hope.
Now the government has predicted the future, because of that, investors can invest and innovators can innovate. Now the home medical office is a reality.
References
EHR http://en.wikipedia.org/wiki/Electronic_health_record
XML http://en.wikipedia.org/wiki/XML
XML schema http://en.wikipedia.org/wiki/XML_schema
XForms http://en.wikipedia.org/wiki/Xforms
web-services http://en.wikipedia.org/wiki/Web_service
IETM Class V http://en.wikipedia.org/wiki/IETM
DITA http://en.wikipedia.org/wiki/Darwin_Information_Typing_Architecture
A presentation by IBM using DITA
IBM http://dita.xml.org/sites/dita.xml.org/files/IDCMSBlue.pdf
Cloud Computing http://en.wikipedia.org/wiki/Cloud_computing
SaaS http://en.wikipedia.org/wiki/Software_as_a_service
An excellent article from a Brookings Institute Study from a medical standpoint http://www.brookings.edu/reports/2009/0901_btc.aspx
BTW, if they make it Android, instead of iPhone, you'll already have the barcode reader, voice recognition, and GPS. Plus, more manufacturers and telecoms support Android, it's a mostly open platform, and it's generally lower cost. Just my 1/50th of a dollar...
F & F'd
Why do you think that government provided insurance would have lower administrative costs or salaries?
That is, we know both sides from long experience. It is not a guess or pie in the sky.
http://www.realclearpolitics.com/articles/2009/06/27/the_adminstrative_cost_benefit_myth_97193.html
http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf