Affordability and the Public Option

As the nation looks forward to President Obama's Wednesday address on health care, progressives need to be concerned about reports that some in the White House are pushing to scale back proposals in two areas: making health care affordable and the public health insurance option. We should be equally concerned about both.

In a column this week, David Brooks argued that Obama was losing support with independents because of being seen as big spender. The implication was that spending on health care should be scaled back. But doing so would result in fewer people getting subsidies for affordable health care or a reduction in the level of guaranteed benefits. And that's the last thing that voters, including independents, want.

In a poll taken by Joel Benenson, the president's pollster, and commissioned by AFSCME, SEIU, and Health Care for America Now (HCAN), voters were asked to choose between limiting federal spending or assuring affordability for families and small businesses. The results were strikingly clear.

• 66% agreed that, "As long as we don't increase the federal deficit, we should invest enough in health care to make sure that health coverage is really affordable to middle-class families and small businesses."


• 18% agreed that, "It is important that we put a spending cap on health care reform at one trillion dollars so the cost doesn't spiral out of control, increasing our deficit and weakening our economy overall."

HCAN asked pollster John Anzalone to ask a similar question to voters in Blue Dog districts where people were slightly more likely to have voted for McCain than Obama. Here are the results from that question:

• 66% of voters and 63% of independents agreed that "The key to health insurance reform is making coverage affordable to families and small business. As long as we don't increase the federal deficit, we should invest enough to make sure that health coverage is really affordable to middle-class families and small businesses."


• 21% of voters and 20% of independents agreed that, "It is important that we put a spending cap on health care reform at one trillion dollars so the cost doesn't spiral out of control, increasing our deficit and weakening our economy overall."

This makes sense. At the end of the day, the way that most Americans will measure reform is by asking, "Do I have good health care that I can afford?"

The health care reform bill in the House includes several key provisions designed to make health care affordable to families: a requirement that health insurance policies offered by employers and through the new health insurance "exchange" include decent benefits with limits on out of pocket costs; a requirement that employers pay a reasonable share of premiums for employees and their dependents; subsidies for families that earn up to $88,000 to purchase coverage; and the creation of a public health insurance option that will lower costs both directly and by forcing private insurers to compete.

The public option is a key structural change to affordability because without it, the same private insurers that have driven costs through the roof will be getting a gift from the government. If reform mandates everyone buy insurance but there is no public health insurance option in the mix, then we are just delivering millions of new customers - and billions more in profits - to the private health insurance industry. And as an example of how a public option could lower costs all around, Medicare actually has a lower rate of health care inflation - 4.4% from 1997-2007, compared to private insurance's increase of 7.4%.

Affordability and the choice of a public health insurance option are both essential to legislation that will achieve the president's goals of making good health care affordable to everyone. We have come too far not to get it right.

Comments

[no body]

An excellent explanation of WHAT we need to accomplish in Healthcare Reform can be found here http://www.brookings.edu/reports/2009/0901_btc.aspx. HOW do we do this? By using the finest physicians, best scientists and evidence-b­­ased-medi­c­ine from around the country and the world to come up with “Best Medical Practices” electronic medical workbooks using:
XML (http://en.wikipedia.org/wiki/XML) ,
XML schema (http://en.wikipedia.org/wiki/XML_schema) ,
XForms (http://en.wikipedia.org/wiki/Xforms) and
web-services (http://en.wikipedia.org/wiki/Web_service)
(savings Director Orszag's 700b, less medical errors) which are IETM Class V compliant documents (http://en.wikipedia.org/wiki/IETM) that when filled out are checked for accuracy and completeness in real-time and saved to a third-party (savings malpractice 100b). The workbooks are created, maintained and continuously updated (always learning) by the regional Health Information Technology Research Centers, CDC and HHS in conjunction with the Health care Industry to provide an effectivity rating for the different treatments, the ability to produce a prognosis and cost of treatment in real-time. In addition, Senator Sanders 400 billion in administration costs would be greatly reduced because we would only have one set of forms country-wide and they can be easily automated. Also because IBM (http://dita.xml.org/sites/dita.xml.org/files/IDCMSBlue.pdf) and the DOD for their interactive electronic training manuals are already using these technologies the CBO can score the savings.

[WinterParkMom]

The public option should be:
Coverage for EVERYONE who applies
Structured premium payments of not more than 100 per individual, 300 per family
Deductibles capped at $2000 and based on income (means testing every year like the va)
No mandates forcing people to purchase insurance (a windfall for private carriers)
No triggers (also a windfall to private carriers)
No subsidies to private insurance carriers
No taxes on employer provided benefits
If someone has private insurance and wants the public option, they can drop private with no problem and be covered immediately under public.
No mandates on employers to buy into the public option to cover employees. Has to be free choice.
Everyone with coverage gets treated for new or pre-existing conditions.
Fairly negotiated reimbursement to private pracitce, specialty doctors and hospitals
Fairly negotiated prices for medications, even on name brand stuff which has no generic equivalent.
AND IT HAS TO BE EFFECTIVE IMMEDIATELY. Within 1 month of the above bill passing, Americans must be able to start buying in and using it.
It must be administered by an autonomous federal agency. Monies paid in must not be co-mingled with any other money, does not go into the general fund so it can be looted.
The ONLY payouts from this fund will be for: payments to practicioners, pharmacies and admin. In 5 years if we see significant overages, those overages will only be used to suplement medicare and fund medical research and maybe scholarships.
See next post on funding

[WinterParkMom]

47 million un insured
20 million under insured
Subtract 10 million poor/indig­ent/mental­ly ill, etc, who are uninsured and will have to get free care = 37 mill un-insured who can pay.
18.5 million can pay $50/mo = 925,000,000
18.5 mill can pay $100 = $1,850,000,000
20 mill under insured will switch and can pay $100 = 2,000,000,000
That is a grand total of $4,775,000,000
That is FOUR BILLION, SEVEN HUNDRED SEVENTY FIVE MILLION DOLLARS IN PREMIUM PAYMENTS PER MONTH. FIFTY SEVEN BILLION THREE HUNDRED THIRTY MILLION PER YEAR IN PREMIUMS FOR ONE SET OF PEOPLE.
That does'nt count the millions who'll switch from private companies if they can pay $100 or 200 per month and have their entire family covered even with pre-existing conditions. Repeal bush tax cuts asap another 700 billion.
After thinking about it more, institute a 1 penny federal sales tax on EVERY item. I can hear the opponents shouting about making the poor poorer, but my statement is 1 cent on each item NOT on every dollar or hundred dollars. From candy bars to big screen tv's to your house. 1 cent on everything. If your grocery bill was $100. for 53 items, your bill would be $100.53. That's not putting people in the poorhouse especially when we've been dealing with price increases. Also, if you're saving 300-500 per month on insurance, you have that money to spend and put back in the economy, save, or invest.

[CTtransplant]

NO trigger!!! And NO waiting five years !!!

Never ever ever give up!!! Folks, do not forget the marches on September 13th!!!
If not now, when? If not us, who?

Kennedy was one of our greatest champions of health care reform. He carried the torch for a long time...and now it is up to us to continue to carry it!

Our elected officials in Congress receive health care mostly paid for by us tax payers, yet many are trying to make it impossible for us to purchase an affordable plan of our own :

While many of us are struggling to afford medical insurance/medical bills.
While Congress people try to stop healthcare reform.
While Congress people accept large contributions from lobbyists to prevent health care reform.

Please sign these petitions - and by all means, spread the word! Thank you!

http://www.petitiononline.com/PubOp676/petition.html
http://www.democrats.com/honor-ted-kennedy?cid=ZGVtczQ0MTA5OGRlbXM=
http://salsa.wiredforchange.com/o/5649/t/4922/content.jsp?content_KEY=2763&tag=hk1_typ-e1

[PlaceboStudman]

you can have the best insurance in the world, but insurance can't pay for something that doesn't exist, and for many of us, there does not yet exist a treatment option to cure such things like MS, MD, CP, ALS childhood lukemia, childhood brain tumors, etc. Until and unless those issues are dealt with, thre's no point for many of us to support insurance reform that has no chance of helping us because we will be disabled or terminally ill whether we have insurance or not

[gummibear]

" thre's no point for many of us to support insurance reform that has no chance of helping us"

Hmm, only if you are totally selfish and never think of anyone but yourself. What a dreadful society we would have if everyone had this attitude.

[BBackSoon]

While I am sorry you are suffering from one of these incurable diseases it is rather self-centered of you to hold off your support for reform since there is no guarantee of a cure for your condition.

Everyone else should suffer and Insurance Companies should continue to profit until your disease is defeated?

So by this logic it is in the current health care systems best interest to never find a cure so they can continue to keep you on their side.