The Obama Presidency - 2008 & 2012

[RainMaker]

Originally Posted by CamEdwards

I wonder what the polling would be like if you surveyed those under 40 and asked them about raising the retirement age to 70 (as opposed to asking older folks). Personally, I'd be all for it.

How about just lowering the payouts and offering more tax incentives on things like the Roth IRA and company 401Ks?

[ISiddiqui]

Originally Posted by JPhillips

Without a public option I'm skeptical of a mandate. A mandate without enough regulation on insurance companies seems to be a recipe for disaster. Sure the insurance companies are for that idea, it's a free 50 million new customers.

Well, granted, I am speaking of a good deal of regulation on insurance companies. I think eliminating pre-existing condition exclusions, wide premium variances, and other shady type behavior, as well as opening up insurance companies to interstate competition is very good start. The mandates would allow for a much better spreading of the risk as well.

Now, I guess, we could start off with strong regulations on insurance companies and the government acting as a broker for the poor and unemployed, having insurance companies compete over the pool, have more requirements that employers initiate health plans, and then add the mandate in later... but I think the mandate is essential at some point, and sooner rather than later, if we want to cut costs (also essential is removing the pay for service situation we have which just encourages doctors to perform unnecessary tests).

[JPhillips]

Originally Posted by ISiddiqui

Well, granted, I am speaking of a good deal of regulation on insurance companies. I think eliminating pre-existing condition exclusions, wide premium variances, and other shady type behavior, as well as opening up insurance companies to interstate competition is very good start. The mandates would allow for a much better spreading of the risk as well.

Now, I guess, we could start off with strong regulations on insurance companies and the government acting as a broker for the poor and unemployed, having insurance companies compete over the pool, have more requirements that employers initiate health plans, and then add the mandate in later... but I think the mandate is essential at some point, and sooner rather than later, if we want to cut costs (also essential is removing the pay for service situation we have which just encourages doctors to perform unnecessary tests).

I agree, but I'm skeptical that Congress will put enough regulation on insurance companies.

[molson]

Originally Posted by ISiddiqui

I think eliminating pre-existing condition exclusions, wide premium variances, and other shady type behavior, as well as opening up insurance companies to interstate competition is very good start.

I understand how the pre-existing thing screws a lot of people but I'm not sure how you get by without it. If there were no limitations on pre-existing conditions, shouldn't I just wait until I'm sick before I start paying for insurance?

Presumably, the federal option would be particularly generous to pre-existing conditions. So why would anyone pay for it until they need it? If the public option is intended to pay for itself through premiums paid by the middle class (rich people aren't going to use the public option), that seems like a big risk.

[JPhillips]

Originally Posted by molson

I understand how the pre-existing thing screws a lot of people but I'm not sure how you get by without it. If there were no limitations on pre-existing conditions, shouldn't I just wait until I'm sick before I start paying for insurance?

That's why there's a mandate for everyone to purchase insurance.

[larrymcg421]

Originally Posted by molson

I understand how the pre-existing thing screws a lot of people but I'm not sure how you get by without it. If there were no limitations on pre-existing conditions, shouldn't I just wait until I'm sick before I start paying for insurance?

That wouldn't be an issue if insurance coverage was mandatory.

[molson]

Originally Posted by JPhillips

That's why there's a mandate for everyone to purchase insurance.

Oh right. But what if you're in the middle-class, have lots of student loans, and can't afford the public option? How much is this going to cost exactly? There's this assumption that it's going to be affordable. But how much? Or will it vary to whatever it takes to make this self-sufficient?

Without the price-checks of pre-existing conditions, companies, how does this stay affordable?

Do we have enough doctors and clinics in the U.S. for EVERYONE to have insurance?

Those are the two biggest risks of these things to me. Does the middle class know they're going to be shelling out, what, $500-$1000/month if they don't have benefits from their job, or if their job drops benefits?

[ISiddiqui]

Originally Posted by molson

I understand how the pre-existing thing screws a lot of people but I'm not sure how you get by without it. If there were no limitations on pre-existing conditions, shouldn't I just wait until I'm sick before I start paying for insurance?

Hence the need for mandates.

Regardless, I've seen too many people get screwed over by pre-existing condition exclusion to believe that a few people who would merely wait until they are sick (and even then, for an employer plan, you'd have to wait until the next open enrollment period, and for completely individual plans, I doubt it'd be all that cheap unless you were close to the poverty line or something)

[ISiddiqui]

Originally Posted by molson

Oh right. But what if you're in the middle-class, have lots of student loans, and can't afford the public option? How much is this going to cost exactly? There's this assumption that it's going to be affordable. But how much? Or will it vary to whatever it takes to make this self-sufficient?

I assume a tax subsidy would come into effect here. It'll likely be a sliding scale based on income, I'd imagine.

Yes, to some it will have the appearance of, basically, a tax increase on everyone (it should, not just on the rich). But for necessary things (and I believe affordable health care for everyone is necessary), taxes are accepted. They have been in every other developed country after all.

[ISiddiqui]

Originally Posted by molson

Do we have enough doctors and clinics in the U.S. for EVERYONE to have insurance?

Wouldn't the market expand to accommodate that need?

[molson]

Originally Posted by ISiddiqui

Yes, to some it will have the appearance of, basically, a tax increase on everyone (it should, not just on the rich). But for necessary things (and I believe affordable health care for everyone is necessary), taxes are accepted. They have been in every other developed country after all.

I'm not talking about taxes, I'm talking about the premiums the middle class will have to pay for the public option. The middle class will get screwed because rich people aren't going to buy the public option, so the only way the public option can be "self sufficient" is the middle class paying for the health care of the poor with their premiums. Bringing up the poor at the expense of the middle class would be a huge problem.

[molson]

Originally Posted by ISiddiqui

Wouldn't the market expand to accommodate that need?

I suppose, but doesn't that just mean lower standards for doctors and medical schools?

And if doctors don't like the new system, or if it doesn't agree with their wallets, we'll probably see a lot of early retirements.

[RainMaker]

Originally Posted by molson

Without the price-checks of pre-existing conditions, companies, how does this stay affordable?

Has to be something available. Pretty shitty country that doesn't give health insurance to people because they didn't win the genetic lottery.

Originally Posted by molson

Do we have enough doctors and clinics in the U.S. for EVERYONE to have insurance?

Supply and demand. Give more incentives on student loans and stuff so doctors we can produce more doctors. Let more students in from abroad if we need to. It's pretty shitty to sit there and tell 15% of the country they are fucked because the other 85% demands more. We wouldn't do this with police protection.

[ISiddiqui]

Originally Posted by molson

I'm not talking about taxes, I'm talking about the premiums the middle class will have to pay for the public option. The middle class will get screwed because rich people aren't going to buy the public option, so the only way the public option can be "self sufficient" is the middle class paying for the health care of the poor with their premiums. Bringing up the poor at the expense of the middle class would be a huge problem.

Well, I'm saying it would have the appearance of a tax increase.

Second, not sure why you are speaking of the public plan as it appears it may be dead in the water.

Thirdly, the public option, if it comes to fruition, would be a government run self-insured program. Why would it be required to be self sufficient? It most likely won't be. Hence why the talk about raising more taxes on the rich to pay for health care (of course originally it was stated that the rich would pay for all of it, but I think even the administration has backed off that fallacy).

[ISiddiqui]

Originally Posted by molson

I suppose, but doesn't that just mean lower standards for doctors and medical schools?

And if doctors don't like the new system, or if it doesn't agree with their wallets, we'll probably see a lot of early retirements.

Other countries seem to do it and have just as high standards for doctors as we do (European doctors are pretty damned good). I don't see why it would lead to that much decline. A bunch of new med schools would start up and more people who wanted to be doctors would be accepted to them.

[Galaxy]

Originally Posted by RainMaker

Has to be something available. Pretty shitty country that doesn't give health insurance to people because they didn't win the genetic lottery.


Supply and demand. Give more incentives on student loans and stuff so doctors we can produce more doctors. Let more students in from abroad if we need to. It's pretty shitty to sit there and tell 15% of the country they are fucked because the other 85% demands more. We wouldn't do this with police protection.

It's that not simple. You can't "tell" people to go into a profession. If you've noticed, we are facing a big problem with general physicians these days. Also, more doctors/surgeons are starting to a) opt out of government problems (Medicare/Medicaid) or b) retire early. Top it off with the ability to be sue at anytime.

[Arles]

Originally Posted by RainMaker

One of the benefits of offering health insurance over a higher salary is the lower turnover rate for a business. When your employee and their family are tied into your health insurance plan, they are less likely to leave (especially considering most jobs require 3-6 months before they will cover you).

It depends, if most companies in your industry (ie, manufacturing) are doing the same thing it's not really an issue.

Also, the fine is 8% of wages from what I'm reading. If you give them a raise of 5% and then they tax you 8% on the new wages, I don't see where you are getting the massive savings from. Unless your employees are making very little, the cost benefits would not be worth it, especially when you factor in the higher turnover rate and lower quality employer pool you'd be working with by not offering health insurance.

Let's look at a 35-40K factory employee (vast majority of our employees). We estimate that benefits cost around 7-9K per insured employee at that level. Plus you have expenses for managing the benefits and insurance costs. If you have to pay a fine of 8%, that's less than 3K. Add in a 5% raise and the company still saves 4-5K per employee. Figure a couple thousand employees and that's $10 million (and still not counting the cost to manage).

Again, I don't think it would happen the second the public option came out. But, 2-3 years down the round, I'd be shocked if half the companies offering health insurance still did. Plus, at some point, a push will be made for the fees will go away as few will be offering insurance (which will mean even more savings).

[molson]

Originally Posted by ISiddiqui

Well, I'm saying it would have the appearance of a tax increase.

Second, not sure why you are speaking of the public plan as it appears it may be dead in the water.

Thirdly, the public option, if it comes to fruition, would be a government run self-insured program. Why would it be required to be self sufficient? It most likely won't be. Hence why the talk about raising more taxes on the rich to pay for health care (of course originally it was stated that the rich would pay for all of it, but I think even the administration has backed off that fallacy).

The .pdf summary of the house plan claims that the public option would be self-sustaining:

http://edlabor.house.gov/documents/1...ARY-071409.pdf

"The public option will operate on a level playing field. It will be subject to the same market reforms and consumer protections as other private plans in the Exchange and it will be self-sustaining – financed only by its premiums."

[ISiddiqui]

Do you actually believe that? I doubt they really believe that.

[molson]

Originally Posted by ISiddiqui

Do you actually believe that? I doubt they really believe that.

That would kind of shed light on the lack of credibility on the whole thing, wouldn't it?

The only way I can reason that it might be just misleading, rather than a lie, is that the rich will pay taxes for the poor to get the public option (the "affordability credits"), and that isn't included in the whole "self-sustaining" goal. I.e., the plan would be self-sufficient after the affordability credits are paid for by the rich.

[Arles]

Originally Posted by molson

I'm not talking about taxes, I'm talking about the premiums the middle class will have to pay for the public option. The middle class will get screwed because rich people aren't going to buy the public option, so the only way the public option can be "self sufficient" is the middle class paying for the health care of the poor with their premiums. Bringing up the poor at the expense of the middle class would be a huge problem.

It's a lot like car insurance. If you are a 40-year old man with no accidents, your premium is helping to offset the 22-year old who's total 2 cars in intersections the past 10 months.

This is why private insurance brokers look for similar age/health people when grouping plans. In a public option, many of the top 10-15% will opt out because they have white collar/good benefit jobs. Companies will start dropping coverage on the cheaper employees (where the 8% hit makes sense) and then you'll have a group of 30-60K salary employees without employer sponsored insurance being grouped in with people in poverty unable to pay their public premiums. So, guess who pays that bill? The 30-60K crowd who now is forced with paying taxes and a premium for a plan that's not as good as what they had last year.

The public plan will be great for people who make less than 25K and people who make between 80 and 200K won't care. It will suck for people who make 30-60K and now must go with inferior insurance for the same (if not more) price, as well as the 200,000+ "rich" who's taxes get hiked to help pay for it.

Seems to me a better plan is to setup incentives to get under 25K people covered under private plans (with some restrictions on dropping people as long as they pay their low premiums) than screw the 30-60K salary people who will now be faced with dropped employer coverage because the 8% penalty isn't enough to justify keeping them insured with the public option out there.

[molson]

Originally Posted by ISiddiqui

Other countries seem to do it and have just as high standards for doctors as we do (European doctors are pretty damned good). I don't see why it would lead to that much decline. A bunch of new med schools would start up and more people who wanted to be doctors would be accepted to them.

Did any of the European countries have to cover, what, 40 million new people overnight?

Maybe there would be a shortage, maybe there wouldn't, but I'd like to know what would happen if there was a shortage, not just assume everything will be fine.

Part of the failure of the MA universal health care attempt was a poor ability to predict the future, and especially the effects of a recession and greater-than-anticipated costs. I don't think the government can predict the future. This administration has already shown to have a poor handle on unemployment numbers, something a lot less complicated than this.

[Arles]

Originally Posted by ISiddiqui

Do you actually believe that? I doubt they really believe that.

We've been told by others if you don't trust the bill you should just leave the discussion. I think the comparison was that we are saying "the sky is orange".

[RainMaker]

Originally Posted by Arles

Let's look at a 35-40K factory employee (vast majority of our employees). We estimate that benefits cost around 7-9K per insured employee at that level. Plus you have expenses for managing the benefits and insurance costs. If you have to pay a fine of 8%, that's less than 3K. Add in a 5% raise and the company still saves 4-5K per employee. Figure a couple thousand employees and that's $10 million (and still not counting the cost to manage).

Again, I don't think it would happen the second the public option came out. But, 2-3 years down the round, I'd be shocked if half the companies offering health insurance still did. Plus, at some point, a push will be made for the fees will go away as few will be offering insurance (which will mean even more savings).

That seems awfully high per insured employee. Don't know what the going rates are for everyone, but 7-9k per insured employee is much higher than our rates with United Healthcare. Certainly there are employees who can hit that level, but on average with a diverse employment base, I don't see how it would be that high.

Benefits are also an extension of salary. If you remove $7-$9k in benefits from someone and replace it with $5k, you are in fact lowering the salary of the individual.

[RainMaker]

Originally Posted by molson

Did any of the European countries have to cover, what, 40 million new people overnight?

Maybe there would be a shortage, maybe there wouldn't, but I'd like to know what would happen if there was a shortage, not just assume everything will be fine.

Part of the failure of the MA universal health care attempt was a poor ability to predict the future, and especially the effects of a recession and greater-than-anticipated costs. I don't think the government can predict the future. This administration has already shown to have a poor handle on unemployment numbers, something a lot less complicated than this.

Do you think those people are not using medical services now? That when they have a medical emergency they just curl up into a ball and die?

These people aren't being added into the system, they are just being setup in a more consistent and convenient way.

[molson]

Originally Posted by RainMaker

Do you think those people are not using medical services now? That when they have a medical emergency they just curl up into a ball and die?

These people aren't being added into the system, they are just being setup in a more consistent and convenient way.

Well you raise a good point in that a lot of these people are being taking care of on the state level. All states have some form of healthcare assistance to the poor, if not universal health care. (I'm always amazed to see how many criminals have access to free mental health care and drugs - and not as a result of their conviction, I mean before they committed their crimes. I know that's through the state, though there's surely some federal funding) Can we assume that all goes away too? Will the feds manage healthcare better than the states? How is that possible? Has the federal government ever done anything in a "more consistent and convenient way".

I wonder how well a "European health care" would work, one plan for the entire continent. Everyone's stuck with any flaws and risks, and the entire continent's economic future rests on the decisions of a few bureaucrats and the influence of lobbyists on them. Would Europeans have any concerns about that? I know it's not quite the same, but neither is comparing a small European country to a plan for the entire United States.

[RainMaker]

Originally Posted by molson

Well you raise a good point in that a lot of these people are being taking care of on the state level. All states have some form of healthcare assistance to the poor, if not universal health care. (I'm always amazed to see how many criminals have access to free mental health care and drugs - and not as a result of their conviction, I mean before they committed their crimes. I know that's through the state, though there's surely some federal funding) Can we assume that all goes away too? Will the feds manage healthcare better than the states? How is that possible? Has the federal government ever done anything in a "more consistent and convenient way".

I wonder how well a "European health care" would work, one plan for the entire continent. Everyone's stuck with any flaws and risks, and the entire continent's economic future rests on the decisions of a few bureaucrats and the influence of lobbyists on them. Would Europeans have any concerns about that? I know it's not quite the same, but neither is comparing a small European country to a plan for the entire United States.

The fed a lot of things consistently and conveniently. Social security has worked well for decades. Medicare has cost issues but still works. FDA, FBI, NTSB, and many other organizations work well too. This notion that the federal government can't manage anything is a talking point with no substance.

[JPhillips]

If the poor get insurance none of us will ever get to see a doctor again. Keep your hands off my insurance you homeless bastards.

FUCK THE POOR!

[JPhillips]

Originally Posted by molson

The .pdf summary of the house plan claims that the public option would be self-sustaining:

http://edlabor.house.gov/documents/1...ARY-071409.pdf

"The public option will operate on a level playing field. It will be subject to the same market reforms and consumer protections as other private plans in the Exchange and it will be self-sustaining – financed only by its premiums."

The government would subsidize those unable to afford coverage, hence the @1 trillion cost over ten years. There isn't any way to have a plan that covers the poor without some form of government assistance.

[JPhillips]

Originally Posted by molson

Well you raise a good point in that a lot of these people are being taking care of on the state level. All states have some form of healthcare assistance to the poor, if not universal health care. (I'm always amazed to see how many criminals have access to free mental health care and drugs - and not as a result of their conviction, I mean before they committed their crimes. I know that's through the state, though there's surely some federal funding) Can we assume that all goes away too? Will the feds manage healthcare better than the states? How is that possible? Has the federal government ever done anything in a "more consistent and convenient way".

I wonder how well a "European health care" would work, one plan for the entire continent. Everyone's stuck with any flaws and risks, and the entire continent's economic future rests on the decisions of a few bureaucrats and the influence of lobbyists on them. Would Europeans have any concerns about that? I know it's not quite the same, but neither is comparing a small European country to a plan for the entire United States.

The federal government isn't running healthcare. The grandest plan is a public option for insurance, but most everything would stay the way it is currently.

[molson]

Originally Posted by JPhillips

The government would subsidize those unable to afford coverage, hence the @1 trillion cost over ten years. There isn't any way to have a plan that covers the poor without some form of government assistance.

That's the part I don't quite understand. What's the $1 trillion going to if not to cover the poor? Clearly, the pdf and everything I've heard claims that the public option will be self-sufficient (i.e. subsidized by middle class premiums). I know there's much more to the plan then the public option, but $1 trillion worth?

[molson]

Originally Posted by JPhillips

If the poor get insurance none of us will ever get to see a doctor again. Keep your hands off my insurance you homeless bastards.

FUCK THE POOR!

You haven't won the argument with the posters, but you're doing a great job against the strawmen.

[Arles]

Originally Posted by JPhillips

The federal government isn't running healthcare. The grandest plan is a public option for insurance, but most everything would stay the way it is currently.

Until it become more cost effective for employers to drop coverage for their employees (esp middle to lower middle class ones). It's amazing to me that no one can connect the dots on this. Employers do NOT want to provide health care. They do it because they have to in order to keep people. once a public option becomes viable, they will drop coverage as soon as it's cost effective. It may not be year 1 or even year 2, but 3-5 years after this bill is passed, a significant number of employers (esp those that employ mostly middle class workers) will drop their coverage.

We'll put it in a different light. How many companies in the UK or Canada provide privately sponsored health care coverage? Employers don't want to be in that business.

[molson]

Originally Posted by SteveBollea

Again, here's what would actually happen if a public option was passed

It's a great chart to get the basics of how everything would work if you completely negate any risk factors.

The public option is a LOT smaller than I thought it was. Mostly it's just paying people to get private insurance. Does the fed predict that the public option will be that undesirable? What if, as many believe, and even Obama concedes is possible, a big chunk of that 122 million who get insurance through their employers need to suddenly get the public option?

[JPhillips]

Originally Posted by molson

That's the part I don't quite understand. What's the $1 trillion going to if not to cover the poor? Clearly, the pdf and everything I've heard claims that the public option will be self-sufficient (i.e. subsidized by middle class premiums). I know there's much more to the plan then the public option, but $1 trillion worth?

Self-sufficient in that it won't be given money outside of premiums, but premiums of those under a certain income level would be subsidized by the government through a tax on those making more than 200k. Most of the 1 trillion cost will go to subsidizing premiums.

[Arles]

Originally Posted by SteveBollea

Again, here's what would actually happen if a public option was passed

I'm not following this. The whole plan costs just $300 million? If that's the case, why does the democrat plan cost $600 bullion?

[molson]

Originally Posted by Arles

I'm not following this. The whole plan costs just $300 million? If that's the case, why does the democrat plan cost $600 bullion?

I think those are people, not dollars.

[JPhillips]

Originally Posted by Arles

Until it become more cost effective for employers to drop coverage for their employees (esp middle to lower middle class ones). It's amazing to me that no one can connect the dots on this. Employers do NOT want to provide health care. They do it because they have to in order to keep people. once a public option becomes viable, they will drop coverage as soon as it's cost effective. It may not be year 1 or even year 2, but 3-5 years after this bill is passed, a significant number of employers (esp those that employ mostly middle class workers) will drop their coverage.

We'll put it in a different light. How many companies in the UK or Canada provide privately sponsored health care coverage? Employers don't want to be in that business.

There are so many restrictions on who is eligible for the public option that I don't see your nightmare scenario being widespread. What happens to your company when you cut health insurance and your employees aren't eligible for a public plan? Are you really going to have a workforce happy with doubling their medical expenses while your company pockets the profits? And if your company is run by such bastards that will only get us to a single payer system faster, which IMO would probably be a good thing.

At the end of the day I don't think we should eliminate the possibility of reform because CEO's are going to be pricks or poor people will go to the doctor too much.

As for costs, I'm concerned about total costs, not where the money comes from. I think a public option can reduce the growth of medical expenses and I don't see much in the way of credible arguments for how that will happen otherwise.

[Arles]

So, is this plan insuring 10 million people that weren't insured before or the 25 million + the 7.2 mil + 2.5 mil?

[Arles]

Originally Posted by JPhillips

As for costs, I'm concerned about total costs, not where the money comes from. I think a public option can reduce the growth of medical expenses and I don't see much in the way of credible arguments for how that will happen otherwise.

Having a public plan that covers 10-25 million people isn't going to impact overall health care cost. The only argument I can see if you go single payer and set caps like Canada/UK. Then, you could see some cost savings (in addition to the numerous issues we've laid out in this thread).

Now, I don't think it's a terrible idea to have some sort of plan for covering people in poverty without insurance, but I'm not sure this public option is the way to go.

[RainMaker]

Originally Posted by Arles

Now, I don't think it's a terrible idea to have some sort of plan for covering people in poverty without insurance, but I'm not sure this public option is the way to go.

The proposal is a plan that would cover people in poverty without insurance which you want, but then you say it's not the way to go. How do you change your mind in the middle of a sentence?

[ISiddiqui]

Originally Posted by molson

Did any of the European countries have to cover, what, 40 million new people overnight?

Uh, what exactly do you think they had to do when they started their plans?

Part of the failure of the MA universal health care attempt was a poor ability to predict the future, and especially the effects of a recession and greater-than-anticipated costs. I don't think the government can predict the future. This administration has already shown to have a poor handle on unemployment numbers, something a lot less complicated than this.

I guess there is a crux of the difference. MA, which is considering a new way of paying for service to cut costs, has almost a 100% of the population with health care coverage. I see this as a SUCCESS, not a failure. Are the costs higher? Yes, because no plan is perfect, but they are dealing with them.

[Arles]

I'll repeat what I wrote again:

Now, I don't think it's a terrible idea to have some sort of plan for covering people in poverty without insurance, but I'm not sure this public option is the way to go.

[RainMaker]

Why is this public option not the way to go?

[Arles]

Because I think there are ways the government can subsidize that kind of coverage via private industry without having to "own it". We're talking about 10-25 million people in a country of 300 million.

[RainMaker]

Originally Posted by Arles

Because I think there are ways the government can subsidize that kind of coverage via private industry without having to "own it". We're talking about 10-25 million people in a country of 300 million.

What's the difference outside of the fact that your way would just be handing over more money to health insurance companies?

[Arles]

Originally Posted by RainMaker

What's the difference outside of the fact that your way would just be handing over more money to health insurance companies?

IMO, going public for poverty only will probably involve some kind of government cost control (like Medicare) that makes the privately insured people pay more. You also have the issue with payment (like with Kid Care in IL) where the government takes so long to pay or is fickle on paying to where many doctors/clinics decide not to accept it.

I'd rather have the government setup guidelines for coverage (restriction on dropping, certain minimum coverage requirements) and let private companies take a stipend to provide the coverage. This way everyone is on an equal playing field for cost and you give people on this coverage a shot at actually having it be accepted by their doctor.

[ISiddiqui]

I think not having the government as a market participant is a good thing. When it's a broker for the poor rather than being an insurance company in its own right, it allows for better competition and less... let's say, incentive.. for increase government power in the system.

In listening to some Dem pundits, they almost see the public option as a stepping stone for a single payer health plan.

[Arles]

Originally Posted by ISiddiqui

In listening to some Dem pundits, they almost see the public option as a stepping stone for a single payer health plan.

Exactly my thoughts. If all we want is to cover 10-25 million of the currently uninsured, we can do that at a much lower expense by outsourcing it. The only reason to go public is with the idea to have it eventually expand to a single payer system.

[RainMaker]

Originally Posted by Arles

IMO, going public for poverty only will probably involve some kind of government cost control (like Medicare) that makes the privately insured people pay more. You also have the issue with payment (like with Kid Care in IL) where the government takes so long to pay or is fickle on paying to where many doctors/clinics decide not to accept it.

I'd rather have the government setup guidelines for coverage (restriction on dropping, certain minimum coverage requirements) and let private companies take a stipend to provide the coverage. This way everyone is on an equal playing field for cost and you give people on this coverage a shot at actually having it be accepted by their doctor.

It's already like that. A private individual will pay a higher rate because insurance companies have negotiated much lower rates with hospitals. How would the government be acting any differently than the insurance companies currently do?