An Option to The Public Option?

The recent deal on the public health insurance option is making my head spin.

According to Senate Democratic leader Harry Reid, a tentative agreement among Senate Democrats would sideline but not kill the public option supported by liberal Democrats in Congress as a way to create competition for the private insurance companies and drive down costs.

Under this agreement, people ages 55 to 64 could “buy in” to the Medicare program that is currently the only single-payer health care system available to Americans. A federal agency, the Office of Personnel Management, would negotiate with insurance companies to offer national health benefit plans that resemble plans offered to federal employees, including members of Congress. Should these private plans fail to meet "certain goals" for making affordable coverage available to all Americans, Senate Democratic aides said, then the government itself would offer a new insurance plan similar to the public option.

So the public option is itself an option now.

Many liberals, along with a majority of Americans who want and would likely use the public option, probably won't like this idea, as it only expands the scope of private insurance companies and makes it no less complicated to buy health insurance than it already is. One skeptic is Senator Russell Feingold. “I do not support proposals that would replace the public option in the bill with a purely private approach,” the Wisconsin Democrat said. “We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars.”

This deal, however, is likely the bet we can expect in these United States. For the U.S. remains a country guided by the principles of private enterprise. To the politicians, lobbyists, and moneyed interests who actually run the country, anything "public" smacks as an impingement on personal freedom, be it public broadcasting, public transportation, or public medical insurance. Lost on these people are the popularity of such programs (in the case of public medical insurance, I refer to Medicare), and the recent polls supporting a public option bear that out. Some Republicans are aware of the popularity of such proposals, and do their best to quash them, lest the Democrats gain an upper hand by actually passing them. Opponents of progress are very good at this. They've talked Americans out of health care reform before, and they are likely to find a way to stop even this modest (very modest) Senate deal from advancing.

Will i support this? I suppose I'll have to. Something has to get through. But bear this in mind: The bill approved last month by the House of Representatives calls for a government-run health plan. This won't be the last we hear of it.

Aetna, I'm Glad I Never Met Ya

Not since Nero fiddled while Rome burned has anyone in a position of national leadership been dithering so much while a bad problem has grown worse with regards to the health care debate. As Harry Reid valiantly tries to get a health care reform bill with a public insurance option through the Senate so a bill for President Obama's signature can be worked out with the House - in the face of Republican and conservative Democratic opposition - Aetna, one of America's most ubiquitous insurance companies, has decided to drop 650,000 clients next year to increase their profit margin.

The Connecticut-based insurance firm is also raising rates on those who will continue to have coverage to secure larger profits, adding insult to injury. What's really stupefying is that Aetna has admitted as much, rather than hide behind some flowery language about the need to remain competitive and ensure quality service. Aetna CEO Ron Williams confessed to Aetna seeking greater profits in this not-so-cryptic statement: The pricing we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering. We view 2010 as a repositioning year, a year that does not fully reflect the earnings potential of our business. Our pricing actions should have a noticeable effect beginning in the first quarter of 2010, with additional financial impact realized during the remaining three quarters of the year."

Here's the clincher: Aetna still made money in 2009, but the firm was taken aback by how much medical costs ate into the health insurance end of the business. So, not satisfied with a modest profit, Aetna wants to make even more money to please its shareholders. Sound like a fair deal to you? It is, except for the clients who can expect to pay higher premiums and the 650,000 people losing their coverage - most likely, people who tend to be more chronically ill and in greater need of care.

Aetna has pulled this trick in the past. Here are the statistics, courtesy of the Huffington Post, offering the proof: Aetna overhauled its business between 2000 and 2003, starting with 21 million members in 1999 and going down to 13 million by 2003, but increasing its profit margin from about 4% to higher than 7%.

President Obama will not change the trajectory of this country unless he puts it on the path to greater public investment in and administration of economic sectors normally controlled by private enterprise. Publicly used utilities such as telecommunications, home heating and electric power are obviously not going to be deprivatized, and as much sense as such an initiative would make, it ain't gonna happen - not now, anyway, and probably not ever. Woodrow Wilson could not nationalize the telephone system, and Franklin Roosevelt couldn't deprivatize the electric and gas companies. Health care is where Obama has wisely chosen to make a stand. The privatized health care system is costing us more money than other privatized public services, and Aetna is Exhibit A of how greed is getting in the way of meaningful reform to lower costs and provide quality health care service. There's one proven way to accomplish this. But, since single-payer medical insurance is out of the question - this ain't Canada, buster! - passage of a public option is the best hope for the time being.

Harry Reid can accomplish this by doing two things - move the bill to reconciliation and tell Joe Lieberman, the independent Democrat from Aetna, to put up or shut up.

Closer To Reform

Barack Obama hasn't gotten health care reform legislation pushed through Congress yet, but he's one giant step closer. The Senate just voted to allow debate on the bill, and a public insurance option is in it, just like the House version. The President and his allies in Congress have gotten this legislation farther than any other President who who tried to reform health care ever could.

There's still a long way to go. At least three Democratic senators oppose a public option, Republicans are trying to delay the whole bill in order to kill it, and anything the Senate passes has to be reconciled with the House. Some liberals still steaming from the lack of a single-payer plan like Medicare are annoyed that the plan is being kept on a tight budget to avoid increasing the deficit.

Incidentally, I've changed my mind on letting health insurance companies compete across state lines. That idea seemed to make sense until it was pointed out that health insurance companies could easily sell policies in states like New Jersey, which has tough consumer protection laws, yet operate from Texas, where no such laws exist. It's no different from the credit card companies offering fabulous credit terms out of states like Delaware and South Dakota, where the credit card industry is unencumbered by strict regulations, to rubes all across America.

Most laws and policies that come of out Congress are wrought from compromises, although the compromises on health care reform must be making the great Kentucky legislator Henry Clay spin in his grave. But the health care bill that should eventually get to Obama's desk, while imperfect, will be better than what we have now.

Just not as good as Britain's National Health.

No Option

First, the good news - Harry Reid supports the public option. The Senate Democratic leader said yesterday that a government-run public health insurance program will be in the Senate bill.

Now the bad news, unless your politics is different from mine - it doesn't have a chance.

There are a least three senators in the Democratic Senate majority - Ben Nelson of Nebraska, Mary Landrieu of Louisiana, and Joe Lieberman of Connecticut - who oppose the public option due to opposition to a government-run health insurance program in these states. Especially in Connecticut, where the insurance industry dominates and the insurance salesman is the state bird.

Senators Tom Carper of Delaware and Charles Schumer of New York have suggested making it possible for states to opt of out a public health insurance program. Hello - it's a national system! It's not a states' rights issue, like self-serve gasoline (and I'm still ticked off at New Jersey for opting out of that!) It's a nationwide issue! We can't have a national system that leaves states out! It would be like Amtrak not serving South Dakota. . ..

Okay, bad example! :-O

Yes We Can! (Except For the Public Option!)

News leaked out last night that President Obama is going to tell his liberal base to "be good soldiers" and abandon the public medical insurance option to allow health care reform to pass. Aside from the fact that Americans will remain at the mercy of greedy (and merciless) health insurance companies without a public option and that health care reform without it will be no reform at all, Obama can't be serious when he asks Democrats to put up or shut up and fall in line. If Democrats did that, they'd be Republicans.

I will reserve judgment until I hear his speech Wednesday night. Maybe, though, just maybe, Obama let this news leak out to make his supporters and any Americans who support a public option (i.e. 77 percent of them) pressure him and the Democratic Congress to include it in the bill. Maybe, just maybe, Obama is scheming to get people angry and force this public option plan to became part of the final bill, which is what he really wants.

Nah. Democrats aren't that clever. :-O

Health Care On the Brink

With President Obama's health care reform plan in danger of falling apart, thanks largely to lies and town hall meeting disruptions Republicans have perpetrated with their smear tactics, some observers are wondering if things would be very different if Ted Kennedy were still available.

The Massachusetts Democrat, who's been at home in Hyannis for much of the year fighting a cancerous brain tumor, is not expected to last through the health care debate, much less to the end of his term in January 2013. Therefore, he hasn't been in Washington to help smooth out the rough edges on the health care issue between factions within the Democratic party and to bring in some Republicans, some of whom (like Orrin Hatch, who refuses to participate in the health care debate any further) are among Kennedy's friends.

Be that as it may, Kennedy himself knows that he won't be a part of the debate on an issue he's fought for for most of his tenure in the Senate, and may not even live long enough to vote on the bill - that is, if a bill ever gets through. The irony is monumental. Therefore, he has written Massachusetts governor Deval Patrick, another Democrat, to ask the legislature for the right to appoint an interim U.S. Senator once Kennedy's seat goes vacant through death or resignation. The seat would remain vacant until up to 160 days to allow for a special election under current Massachusetts law.

Obama lacks both Tom Daschle at the helm of the Health and Human Services Department and Ted Kennedy in the Senate. Both Daschle, a former Senate Democratic leader, and Kennedy, in office since 1962, are seen as the most experienced people in Washington with health care expertise who can make Obama's reforms happen and get enough Democratic votes for something like a public option. My mother dismissed the idea of Daschle or Kennedy being indispensable on the grounds that this issue doesn't hinge on one or two people.

Umm, it kind of does.

And, thanks to the rhetorical equivalents of dirty bombs Republicans have been setting off in this debate, now more than ever.

It's a Cruel, Cruel Summer. . . .

In an effort to keep health care reform alive, President Obama may have killed it by suggesting that a public option program may not be necessary. Well, in the case, maybe health care reform may not be necessary. Health care reform without a public program for people who can't afford private insurance may be taken off the table in order to get a bill passed in the Senate. We might as well forget reforming the medical insurance system for another fifteen years.

There aren't enough votes in the Senate to pass a bill with a public option despite a Democratic majority of sixty seats. Paradoxically, as many as one hundred Democrats in the House, led by Anthony Wiener of New York, refuse to support a health care reform bill if a public option is not included.

Health care reform in America is dead unless Obama bypasses the Republicans and gets some kind of public plan passed and twists a few arms in the Senate. I can't think of anything more depressing.

No, I'm kidding, this is America, so I can. Minnesota right-wing congresswoman Michelle Bachmann - who makes Sarah Palin look like Hannah Arendt - is thinking of running for President in 2012.

Health Care News - July 29, 2009

This may be a small bit of encouragement on the contentious health care issue. A deal with moderate Democrats, however tentative, has been reached in the House of Representatives on the health care reform bill. Among the protections agreed to are requiring health insurers to set annual caps on how much they can charge for out-of-pocket expenses, and making them cover routine tests to help prevent illness and would be required to renew any policy when policyholder paid the premiums in full.

The whole objective is to get costs done, and President Obama is pleased with the progress in the House. Much more of a pain is the Senate version, where the chairman of the Finance Committee, Max Baucus (D-Montana), seems rather reluctant to commit to the public option Obama wants. In fact, he's proposed scuttling it altogether.

Health care reform hangs so much in the balance now, perhaps an August recess to allow everyone involved to simmer down wouldn't be a bad thing.