Oops, sorry. I mean excrementalist. My bad.
“Let me also address an illegitimate concern that's being put forward by those who are claiming that a public option is somehow a Trojan horse for a single-payer system," Obama said.
And if not, in what direction do they envision public option evolving?
Well?
Ya know, all I'm asking for is the legislative strategery a couple of years down the road from the people with the big megaphone. After the FAIL over the last few years. Digby writes:
I do agree that single payer should have been the leftward position going into this, because it would have given us much more room to maneuver.
OK. So how about we start creating the room to manuever now, so that two years down the line, when the FAIL of public option becomes real, we've got some place to go?
But then, we all should have backed Dennis Kucinich in the presidential race because he's the only one who ran with single payer in his platform.
Completely specious. Let's not confuse policy with personalities. It would be perfectly possible to support any one of the major candidates and still advocate for different policy positions. Happens every day. At least among informed citizens.
That ship sailed two years ago as far as legislative strategy is concerned
Accepting for the sake of the argument that's true. What groundwork are you laying for the health care debate that will come two years from now, after a policy that everybody -- except for the insurance companies -- agrees is completely inadequate is put into place?
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Geez, Lambert!
In the middle of a circlejerk, it's awfully uncivil to ask people if they have a plan to someday have actual intercourse.
public plan
Medicare for All No Harder Politically Then The Progressive Ideal Of A Public Plan
My sense is that Digby is a bit insecure
about her support of any public option, otherwise why keep revisiting it?
But when she compared the current health coverage proposals being discussed in Congress to those of other OECD countries, I had to wonder how much she knows about health policy at all, because the plans coming out of Congress have absolutely zero to do with the social programs in place in those countries.
Medicare for All is Civil Rights
Keep hammering at single payer
This is important. I think it is highly likely that Congress will pass a health care "reform" bill that includes a, you've got it, PUBLIC OPTION! The bill will have nothing to do with reform, beyond maybe a tax credit to medical businesses to computerize their records (reform, yay! cost cutting, yay!). The bill will combine a financial giveaway to insurance companies with the right to dump any purchaser who develops an acute condition requiring expensive procedures into the public option.
People will pay more, in required premiums for their employer-based policies and in higher deductibles and co-pays. They will be told that the public option is welfare that the country can't afford. The only solution is to cut all the entitlements -- Social Security and the coverage provided by Medicare and Medicaid. Versailles
and its media will whip up resentment at the greedy old leeches and poor sickos taking all the money. Obama's right that the public option is not a Trojan horse for single payer. Instead, it's a Trojan horse for reducing the current level of social insurance.
That's when strong voices about alternatives to all the peasants fighting each other for scraps are going to be necessary. We need to keep saying NOW that a public option is bad policy. The solution is strong universal coverage which we have not had. We need to make sure that we've been saying all along that the health care reform is harmful, to counteract the propaganda that government involvement makes things worse.
Just a reminder: Part of the savings
that's supposed to keep down the cost of the full bill, is cuts in Medicare and Medicaid costs.
The devil is in the details.
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We can't afford not to have single-payer!
even worse...
some of those cuts are good, like ending the overpayments to private insurers for medicare advantage, but some of the rest of the cuts are more dubious [and these aren't being talked about as much].
My understading is that Medicare Advantage will
not be scrapped but altered so that private insurers compete for the subsidies, and for some reason the middle price point is chosen. I could be wrong about that, but that's how I read it.
Medicare for All is Civil Rights
it won't be scrapped
[it should be]
yes, basically they're going to compete for subsidies that won't be as generous as the subsidies they got in the past. this competition will make them less wasteful too [obama's faith in markets is scary]. and this will all get spun as see! we're saving our seniors billions of dollars!
the fixes in part d are similar, there are incremental steps to close the infamous donut hole, for instance. their timeframe? 15 years. yeah, like that's going to help my 80-year-old parents. and while medicare still can't negotiate drug prices, they're going to require drug manufacturers to give medicare the same rebates they give to medicaid. that'll work just fine until the drug manufacturers tell medicaid: ok we'll still give you deep discounts, but we're no longer going to use rebates as part of that structure.
So this bill, which Obama likes, will continue to subsidize the
Big Insurers for their Medicare offerings, only slightly less? But they'll make it up on all the wealth transfer from mandating people to carry insurance (which may not help them...).
I am very, very, very, very, very angry.
Nope, not BO is not following anything like the FDR model.
Hipparchia, is that an accurate summary?
If so...
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
i'll have to go back and read more closely
this is a pretty good summary of what i've been reading on the web.
obama wants insurers to be invited to bid on medicare advantage packages, and the lowest bids will be accepted. it looks like they can still add stuff to their plans that traditional medicare doesn't cover, and charge more for these added goodies like they do now, but they're no longer going to get the full 14% extra they've been getting. it does look like medicare might still accept bids that would pay insurers an amount that's, say, only 2-5% higher than traditional medicare, if they offer some additional features that traditional medicare doesn't.
i've seen 95% batted around [as in, if the private plans are more efficient than the govt, they should be able to provide the same services for 5% less cost than the govt provides these services], but i can't remember if this was a floor or ceiling for the bidding, and i can't remember right at the moment where i was reading about this number so i can't look it up easily.
the projected $177 billion savings over 10 years [mentioned in the npr link] averages out to ~$18 billion per year saved. last year, approx $98 billion went to medicare advantage plans [table on pg 11, warning: large pdf]. at 14% extra, that's roughly $11 billion we could have saved last year, and depending on how obama's advisors are projecting medicare's cost increases over the next 10 years, it's conceivable that yes, part c plan providers could still get a less-than-14%-but-greater-than-0% extra subsidy and stay within that $177 billion target range.
it's always possible that obama's health policy experts are being totally transparent with all their calculations, but if so, i haven't yet found where on the web they're showing their work.
ps. need an example of how private insurers game the system? presently, some of the added features they offer in their part c [aka medicare advantage] plans are 'wellness' things, like free gym memberships. this would appeal to younger, healthy, active seniors, thus luring them away from traditional medicare and into part c plans. but offering plans that would pay for $200+/day 'night care' for dementia patients? this would be a truly useful benefit for them [where free gym memberships are not, alzheimers patients are not going to sign up for such an hmo], but good luck waiting for insurers to offer that as part of an hmo package.
not to mention that wellness benefits like free gym memberships are great for the beneficiaries who can take advantage of them, but it's not been proven that this actually makes people any cheaper to care for. in general, they probably live longer, healthier lives, then cost about as much to care for at the end when they do finally get sick [then again, who knows? maybe the idea is for them to keel over and die of massive heart attacks while they're working out].
Scarecrow at FDL:Numbers = huge wealth transfer to Big Insurance
It's looking like Banksterville Redux.
Scarecrow does not see a very good outcome.
Thanks, progressives!
Well done, all. And thanks to Scarecrow for pointing it out.
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
So far...it seems to be about nothing but money,
and I have yet to hear how this version of reform is going to improve access to and delivery of actual CARE.
I wonder how long it will take the average person to figure out that the insurance industry and the banksters are kissin' cousins, and just like the banksters, the insurance industry will win, and the people will lose. Again.
It should no longer be called "health" insurance, because it is not insuring that anyone has good health and good health CARE; it is "wealth insurance," written to make sure the industry makes as much money as possible for its executives and shareholders, and uses our money to do it.
There are no words that can properly do justice to how disgusting this is.
"wealth insurance"
I like that.
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
you obviously didn't get the memo
we don't need any more care, we're already getting too much of that.
about "care"...
There are some provisions that seem to be aimed at controlling some of the problems we've discussed here (failing to cover procedues, etc.) but...
You know I've commented extensively on parts of the document, but those parts remain murky to me, at best, even after several goes. I won't go so far as to say deliberately murky, but if the shoe fits, well...
I too am amazed that this has received so little discussion. Often during my lifetime I've had health insurance but not been able to afford to use it (because of deductibles and copays or because the insurer would only pay for so many treatments and I needed more) or had an insurer just flat refuse to pay for something they allegedly covered until I went through their appeal process.
Let's keep bringing it up when we comment on this plan, eh?
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We can't afford not to have single-payer!