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Howard Dean: "The public option is Medicare for God's sakes." But it's not.

vastleft's picture
Submitted by vastleft on Tue, 08/18/2009 - 11:09am



(via Susie)

Is "public option" everybody-in, nobody-out national health insurance? Um, no. So, Medicare it's not.

How stupid a country are we that almost no one seems capable of dealing with the fact that "public option" is a vague catchall for an undetermined degree of health-care access, a degree that appears to be shrinking by the day?

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mass's picture
Submitted by mass on

When the heck are the public option advocates going to admit they are fighting for symbolism?

Valley Girl's picture
Submitted by Valley Girl on

he's the guest on FDL Book Salon @ 3PM ET, to discuss his book.

Valley Girl's picture
Submitted by Valley Girl on

Is what questions the guest answers, or doesn't answer, or gives an answer to a specific question that "answers" some imaginary question that wasn't what was specifically asked.

Oh, edit- exactly what you said- "they were a pol's replies to the question he wanted to answer in many cases" you said it better than what I said above. YES!

Those live threads can be quite revealing, and I've watched them for quite some time - not just Book Salon, but other live chats.

Actually, stuck in my memory is a BA chat at FDL with Eric Massa- or more than one chat, way back in 2006. My take was that the guy was totally upfront, stand-up, and had Integrity with a capital "I". I stand by that. ;)

vastleft's picture
Submitted by vastleft on

Someone does an ode to a progressive who pushes back on the ridiculous Right without acknowledging that Public Option is a glass house of cards.

Progressives heal thy own health plan!

koshembos's picture
Submitted by koshembos on

You are wrong. A public option without preconditions and cost a penny a year using private physicians and services (e.g. labs, physiotherapy, CT-scan) is basically Medicare for all because no sane person will volunteer to pay health care insurance. If the physician are employed by by the public option that also owns medical services you have the British system. You can show that almost all European health care systems are based on a public options with different mutation.

talking about public option without details is selling fog.

vastleft's picture
Submitted by vastleft on

Is there a broadly available plan anything like that on Congress/Obama's table?

a little night musing's picture
Submitted by a little night ... on

as described here: (You won't be surprised at whose name is mentioned!)

In the Senate, where the Finance Committee is painstakingly crafting the only bill that has a chance to win support from both parties, Chairman Max Baucus (D-Mont.) announced that his bipartisan working group had come up with a plan that would save the government money by 2019. With Congress in recess, the "Gang of Six" finance negotiators will probably continue to meet next week via teleconference, a Finance Committee aide said.

Baucus has declined to release details. But people involved in the talks said the plan would make more than $500 billion worth of changes to Medicare over the next decade, charging wealthy seniors more for prescription drug coverage, cutting $120 billion in payments to private insurance companies that serve some seniors and trimming projected payments to hospitals by $155 billion in an effort to spur efficiencies.

The measure contains a variety of other provisions aimed at bending the soaring trajectory of federal health spending, including a tax on insurance companies that offer very high-cost policies. Such policies help to drive up health-care costs, economists say. And it would create an independent commission empowered to cut Medicare spending to meet pre-set savings targets. Both ideas are being discussed in the House as well, House Democratic aides said.

Why this specifically affects the Midwest, I couldn't say.

They also mention changing the income limits for subsidies. Who could have predicted?!

[P.S. when you write "PO" I always gloss it as "Post Office".]

dblhelix's picture
Submitted by dblhelix on

I believe the issue is the hospital reimbursement gap. From their point of view, their health outcomes are superior to that in FL, CA, East Coast in general but they get paid less. They want to reward "quality, not quantity."

Right before the break, the "deal" to get that vote in committee was based on Pelosi agreeing to study the reimbursement gap.

The senate "trimming projected payments to hospitals by $155 billion to spur efficiencies" sounds really terrifying, actually.

Either the reimbursement rate stays the same/declines in the Midwest, or,
there's a transfer from minority-dominated regions to white states. Don't know how to put it any other way, because the truth of the matter is that midwestern states are fairly homogeneous w/ a much flatter socioeconomic gradient, which is probably why they have the "better outcomes."

Remember the Ryan White reauthorization fight? This is similar.

dblhelix's picture
Submitted by dblhelix on

and what they probably told the midwestern reps is that they don't want an explicit closing of the reimbursement gap (b/c blue state reps would flip), but instead, via the public option/exchange, the doctors/hospitals will make up the volume initially (something they can sell to their constituents).

However, the formation of that independent panel, which is all but guaranteed to come out of Senate Finance, will be tasked with performance metrics and Medicare will get put under a PAYGO-type trigger, so effectively, the transfer will take place and will be more or less out of the hands of Congress. Very dangerous, IMO. Stealth, unlike initial proposals out of that committee just to slash "poor performing overutilizers," per the Dartmouth Atlas.