Why Not A Public Option?

39 Responses to “Why Not A Public Option?”

1. Sean Braisted writes
   October 15th, 2009 9:08 am

   What advances has private health insurance brought to the field of health care? Seriously, they take money from you, if you get sick, they give it back, unless they can find a reason not to, in which they keep the money, drop you, and hand out the profit to their share-holders.

2. SayUncle writes
   October 15th, 2009 9:11 am

   “I’m wondering why you can’t support my right to choose a government program which I would trust more than private insurance companies?”

   There’s a right to choose a government program?

3. SayUncle writes
   October 15th, 2009 9:12 am

   ‘What advances has private health insurance brought to the field of health care?’

   Serious advances in actuarial science?

4. Matthew Hurtt writes
   October 15th, 2009 9:12 am

   A “public option” is actually a “public mandate.” Establishing such a program will bump millions off private insurance and onto a complex, bloated, and inefficient government mess. Corker is right in his assessment.

5. mgajosh writes
   October 15th, 2009 9:32 am

   I’d say he explained, not “attempted to explain”. If you gave me 100 words to say that private firms cannot compete with the government that has apparently infinite deficit leeway, and why that’s undesirable for the public, I’m not sure I could do better.

6. Jon writes
   October 15th, 2009 9:41 am

   “private firms cannot compete with the government”

   Exactly! That’s why the only way to get a package from one place to another is the post office. And the only place where one can get a degree is a State University. And the only channel on television is PBS.

   Christ. There may be valid arguments for why a government entity competing in the market may have negative consequences (against which a reasonable person may then weigh the positive consequences to reach an informed decision about the net effect), but if opponents are simply going to say things that are demonstrably not true, why should anyone listen to *anything* you say?

7. SayUncle writes
   October 15th, 2009 9:50 am

   “That’s why the only way to get a package from one place to another is the post office.”

   You cannot mail a non urgent letter, by law, through any other carrier than USPS. Any letter must cost at least $3 to mail or twice the first class postal rate. To say that FedEx/UPS are competitors is only true for parcel packages.

   Of course, who writes letters these days?

8. Sean Braisted writes
   October 15th, 2009 9:59 am

   Yeah, the USPS analogy probably isn’t the best one, but private/public universities are a good analogy. If private health insurers offer such a great service and product as the Republicans seem to think, people will still flock to them over the public option.

9. Jon writes
   October 15th, 2009 10:07 am

   You cannot mail a non urgent letter, by law, through any other carrier than USPS. Any letter must cost at least $3 to mail or twice the first class postal rate. To say that FedEx/UPS are competitors is only true for parcel packages.

   Well, that would be why I said “package”. But also, the restriction against letters is a specific law (and a bad one, imo), not a general consequence of competition between public and private entities.

   The point is that private entities most certainly can compete with public ones, and the recipe is incredibly simple — offer a better product, or one more tailored to the customer’s needs, and then you become the more attractive option despite being unable to compete on price. When insurance companies say they can’t compete with a public option, all they’re really saying is they don’t want to have to improve their product.

10. SayUncle writes
    October 15th, 2009 10:23 am

    “The point is that private entities most certainly can compete with public ones’

    Yes. But they are at a disadvantage, generally. After all, they pay taxes and don’t get free money from you.

11. volvoice writes
    October 15th, 2009 10:24 am

    It is hard to compete with “free”.

12. Mark Rogers writes
    October 15th, 2009 10:27 am

    Sean,

    “private/public universities are a good analogy”

    I agree. Particularly when you look at how the costs in publi institutions of higher learning have experienced the same sort of far-higher-than-inflation cost increases that you object to in health care.

    Public colleges and universities are, if anything, poorer trustees of public money than private schools exactly because they know that the state will bail them out.

    You are sooooo correct on this.

13. Roger Abramson writes
    October 15th, 2009 10:36 am

    “The point is that private entities most certainly can compete with public ones.”

    In the same manner that Wile E. Coyote “competes” with the Road Runner, yes.

    There’s always a lot of complaining about the lack of a level playing field in private industry. Well, nothing tilts a playing field like making giving the referee his own team. And that’s what would likely happen here.

14. Memphis Man writes
    October 15th, 2009 10:38 am

    “Establishing such a program will bump millions off private insurance and onto a complex, bloated, and inefficient government mess. Corker is right in his assessment.”

    My guess is that you haven’t had to use the complex, bloated, and inefficient private health insurance system much have you? I’ve used both it and Medicare/TNCare and those public options are much easier than CIGNA, BCBS, and others.

    The bototm line is that US healthcare covers fewer people at a higher cost and more inefficiency with less to show for it than any other democracy on earth. We need a big change and the public option is needed now.

15. Roger Abramson writes
    October 15th, 2009 10:42 am

    MM –

    Could you provide an example of how you had an easier time with Medicare/TennCare than with your private options. Not saying it didn’t happen…but it’s easier to address if you give a specific example. There are a lot of factors that go into this.

16. Freddie O'Connell writes
    October 15th, 2009 11:26 am

    Roger, the playing field that needs leveling is the one on which unhealthy Americans (and, for the welfare-queen-watchers, we can restrict ourselves to people born with pre-existing conditions or afflicted by accidents or receiving diagnoses not evidently related to common self-controllable carcinogenic indicators like drinking/smoking). If health insurance reform can level that playing field without a public option and actually provide health security to the millions of Americans (including many privately insured people), then that’s an acceptable outcome (to me).

    Honestly, I don’t feel too strongly one way or the other about the public option. I do think it makes it slightly less easy for private insurers to incrementally start once again to squeeze out their unhealthy policyholders.

    But I’m also a little surprised that so many “free-market” Republicans cling to the employer-based model of private insurance coverage in this debate considering how many constraints it puts on a labor market. This is one of the reasons why I think the Wyden-Bennett approach deserves more serious consideration.

17. Sean Braisted writes
    October 15th, 2009 11:35 am

    Mark,

    And private finance/insurance firms know we will bail them out, so what is the difference?

18. Jon writes
    October 15th, 2009 11:37 am

    >It is hard to compete with “free”.

    “public option” and “universal coverage” are not synomyms.

    >Well, nothing tilts a playing field like making giving the referee his own team. And that’s what would likely happen here.

    I don’t disagree that there are consequences. But there are both positive AND negative consequences, and an informed debate needs to weigh them both. But pretending that a public option will simply and unquestionably drive all private options out of business is ludicrously out of touch with the reality demonstrated by every enterprise in which private and public options do successfully compete.

19. common sense writes
    October 15th, 2009 11:38 am

    “There’s a study…” - written by whom? Alex Castellanos?

20. Mark Rogers writes
    October 15th, 2009 11:47 am

    Sean,

    It is the Conservatives who led the opposition to the bailouts even though they are closer to the pro-business interests than the left.

    And the Higher Education Establishment gets a free pass from the media to cloak their bailouts as ‘funding for college students.’

21. Jon writes
    October 15th, 2009 11:51 am

    >This is one of the reasons why I think the Wyden-Bennett approach deserves more serious consideration.

    Agreed, that does seem to be one of the better approaches. And if people do want an approach that allows for free market principles to do what their advocates say they do, we absolutely have to first get out of the employer-provided model. A system in which the end consumer is not the one making the choice is hardly one that can be defended under the rubric of “free market” principles.

22. Sean Braisted writes
    October 15th, 2009 11:54 am

    Mark,

    The media, and the vast majority of Americans, see a value in subsidizing higher education so that people of lesser means can go to college.

23. common sense writes
    October 15th, 2009 11:59 am

    Consumers have choices, Jon. They can self-insure or get employer-based insurance. Employers get a tax break. This encourages employers to provide coverage to their employees.

    If you eliminated that tax break, more employers would drop coverage.

    I agree that more choices are a good thing, but it’s not true to say consumers don’t have choices.

    But this is why a government-run strong non-profit insurance plan - “Medicare for Everyone” - is a good idea. Let people pay into this nonprofit plan if they want to. Give them other choices besides a for-profit plan. Put patients first, not profits.

    There are other taxes to raise funds besides taxing employer-based insurance premiums. The Ways and Means Committee’s plan creates a surcharge on people with a certain income level - this makes more sense because it protects working families at the lower end of the economic totem pole, and creates more economic justice and equality.

    29% of the nation’s wealth is owned by just 1% of its citizens. This is the worst it’s been since 1929 - and we know what happened in October of 1929… it’s time to make the wealthiest Americans pay their fair share.

24. Mark Rogers writes
    October 15th, 2009 12:05 pm

    Sean,

    That isn’t the issue. Colleges, including public ones, demand more money for student loans and then ramp up costs. Remember that college cost increases are comparable to health care cost increases. The difference is that health care costs are heavily influenced by technology, staffing and, to an extent, liability. College costs are more driven by staffing.

    Yet do you see colleges axing non-productive faculty or departments that are redundant with other state institutions?

    But colleges are dominated by leftists so there is no cry to make them responsible trustees of public funding like health care.

25. Memphis Man writes
    October 15th, 2009 12:20 pm

    “”MM –
    Could you provide an example of how you had an easier time with Medicare/TennCare than with your private options. Not saying it didn’t happen…but it’s easier to address if you give a specific example. There are a lot of factors that go into this.”"

    The best is example is my Mother. She was on Medicare with two supposedly good supplements. When she became disabled and my sister and I had to handle her business, all Medicare claims were paid with no hassles at all. The supplements were a nightmare, with numerous calls, more paperwork filed, claims denied and appealed, etc. We were handling her insurance claims over a year after her death. She was in the nursing home and her savings were being drawn down to pay for it. We filed for TNCare (Medicaid) to take over when they were exhausted. We were told exactly what was needed, we submitted it with the nursing home’s help, and she was approved with no problem.

    Private Health insurance companies are there to make a profit. One of the easiest ways to do that is to take advantage of someone who is unable to take care of themselves, such as the elderly and handicapped. In the current system, if someone like this doesn’t have a good advocate, they are in a lot of trouble.

26. Clayton Farlow writes
    October 15th, 2009 12:25 pm

    common sense writes

    29% of the nation’s wealth is owned by just 1% of its citizens. This is the worst it’s been since 1929 - and we know what happened in October of 1929… it’s time to make the wealthiest Americans pay their fair share.

    Also at an all-time high is 47% of households in this country (including 70% of those earning less than $50,000 per year) having no tax liability. Despite the do-gooders’ intent, it’s activist government and its progressive policies that widen the gap between rich and poor. People who are already rich have the means and flexibility to make money in any regulatory environment. It’s poor folks, the same folks you claim you’re trying to help, for whom increased government spending equates to nothing more than higher barriers to entry.

27. Jon writes
    October 15th, 2009 12:51 pm

    Consumers have choices, Jon. They can self-insure or get employer-based insurance. Employers get a tax break. This encourages employers to provide coverage to their employees.

    If you eliminated that tax break, more employers would drop coverage.

    I agree that more choices are a good thing, but it’s not true to say consumers don’t have choices.

    I did not say there are no choices. I said that the choice as it exists under current system is not comparable to choice as it must exist for free market principles to be applicable. That the current system is driven by a tax code that encourages employer based coverage is exactly the point.

    In other words those who would frame this debate as free-market vs “socialism” (using their own loose and screwy definition of socialism) are ignoring that this industry already *is* heavily socialized, and that question before us now is not will we have a free-market or socialism, but can we design a better socialized system than the one we already have.

28. Roger Abramson writes
    October 15th, 2009 1:20 pm

    MM –

    OK, thanks. Good example. I would say that Medicare supplement plans are particularly susceptible to this sort of problem because of their status as “supplemental” plans–any secondary coverage is always going to take forever because it wants to make sure that all primary coverage avenues have been covered. I’m not saying that that’s what happened in your mother’s case, but it does happen a lot with those.

    Freddie –

    Generally speaking, Republicans/conservatives don’t really like the employer-based system. But if the choice is between that and some other things, they’ll go with the devil they know.

    Anyway, recall John McCain bringing up the concept of beginning to divorce health care from one’s job and how he was excoriated for it. Not by Republicans either.

    Generally agreed on pre-existing and catastrophic, espcially catastrophic.

29. spaz writes
    October 15th, 2009 1:32 pm

    Hey Cons - stop pretending that you actually care about the best way to address health care in this country.

    You don’t.

    You want Obama to lose.

    It’s that simple.

    Everyone knows it and that’s why they don’t listen to you anymore.

    You have chosen to CONTINUE to drive public policy along ideology and personality instead of legitimate policy arguments and that’s why 3/4ths of the people in this country are against your ideas the Republican Party.

    If you don’t change course and grow up, healthcare will just be the first in a long series of defeats - ideologically and politically - the Republican Party is going to face for a long time.

    Think the GOP is in bad shape now? Wait until you get beat on healthcare, climate change, the economy rebounds, the Dems hold 60 votes in the Senate, a House Majority, and Obama gets reelected in 2012 by an even bigger landslide than last time. It could happen. Hell, it probably WILL happen unless the GOP starts listening to the American people instead of Glenn Beck, Rush Limbaugh, and Sarah Palin.

30. Roger Abramson writes
    October 15th, 2009 1:38 pm

    Wow, Spaz. Those were some real deep thoughts there. Thanks for your contribution.

31. Matthew Hurtt writes
    October 15th, 2009 2:02 pm

    You know, if saving the republic means I want Obama to lose, then put be down for “wanting Obama to lose.”

    I’d rather save the Constitution than some politician’s ass anyday.

32. The OG DG writes
    October 15th, 2009 2:28 pm

    Matthew, disagree all you want on policy, but your categorical statement about the Constitution is empty rhetoric. You’re better than that.

33. Matthew Hurtt writes
    October 15th, 2009 2:39 pm

    I should have broadened the scope. It’s not just Obama… it’s Democrats… and Republicans.

    It’s time to hit the reset switch on the government.

34. Sean Braisted writes
    October 15th, 2009 2:43 pm

    Matthew,

    You seemed pretty ecstatic about Pat Marsh’s victory, and the impending victories of McDonnell and Christie. Are they the direction our country needs to go in, or do you just reflexively support all Republicans?

35. TNVolunteer73 writes
    October 15th, 2009 5:42 pm

    I cannot speak for Matthew, but I have reflexity to support conservitives, no matter the party.

    You see what happens when you have Liberals like GW and Obama W. Bush driving an economy, and you put them with a Liberal Socialist Democrat Congress which spoons feeds them the money to build a socialist america.

    And in the words of the Mauist Rom Emanuell, We cannot let a good crisis go to waste….

36. The OG DG writes
    October 15th, 2009 6:39 pm

    Yes, 73, you’re an automaton with a broken spellchecker, which is why no one here has a real discussion with you on any subject. But Matthew is a pretty smart and thoughtful guy, even though he did take a job as a professional partisan. I understand that– you gotta pay the bills, but he has always been honest and thoughtful enough to avoid blanket statements and to offer fair criticism of GOP strategy that goes beyond calling people “RINOs.”

    I totally disagree with Matthew but he’s a fair guy.

37. TNVolunteer73 writes
    October 15th, 2009 6:57 pm

    OG DG I would not be calling someone an Robot if I was an Obamabot.

    Oh Wait, you are holding a converstation with me.

    I dont call people RINOs or DINOs, because I am not a Republican or a Democrat.

    And the funny thing You have never been able to discredit ANYTHING I have posted.

    That is why you have only meaningless insults when you converse with me.

    Next Time you come to a Battle of Wits OG DG.. you might arm yourself with somthing other than the Brain of a 3rd Grade crybaby that spits out Pee Wee Herman style insults.

38. TNVolunteer73 writes
    October 15th, 2009 7:00 pm

    Acctually most of the nation’s wealth is found in 401Ks IRAs and the richest sector of society is the elderly.

    Wait the elderly those would be people that spent a lifetime putting money back for retirment by investing in a Captialist Economy.

    And those that don’t have wealth are those that that put their trust in the Socialist Government Programs of the Not so Great Society.

39. tgirsch writes
    October 16th, 2009 1:45 pm

    If somebody else hasn’t pointed this out already, allow me: Corker is full of crap. The public option would not drive private insurers out of business, because it would not be available to everyone. It would only be available to people who are currently uninsured, people who aren’t offered insurance by their current employer, and people who are self-employed. If your employer offers health care coverage to you, you couldn’t choose the public option even if you wanted to. (Note that Medicare and Medicaid recipients are implicitly excluded from all of this.) So there’s no way 119 million people could make the switch.

    The study Corker is referring to talks about a proposed-by-absolutely-nobody-in-power version of the public option that would be open to all American citizens, rather than just the narrow group described above.

    Now it’s true that the public option could eventually put private insurers out of business, but only if it’s expanded to be available to all citizens, which only happens if it actually delivers a better product at a better price than what the private insurers can offer — enough so that the public at large clamors to be allowed to choose it. Since government ruins everything it touches and is wholly incompetent, the insurance industry has nothing to worry about. Right?