Sunday, December 06, 2009

A New Health Assistance Bill Proposal

From Big Tent Democrat here.


There appeared to be serious consideration of a new proposal on the table: a national health plan similar to the Federal Employee Health Benefits Plan, which provides insurance to members of Congress and federal workers. It would be administered by the Office of Personnel Management, which oversees the federal plan, and all of the insurance options would be not-for-profit.

Devil in the detail as always, but this seems a viable way to run an Exchange. The Federal Employee Health Benefits Plans negotiate very well. Should also solve the Stupak Amendment problem. This is not a Public Option of course, but since the federal government could, in theory, negotiate the rates and benefits on par with what federal employees get, the expansion of health insurance to 30 million Americans can be done in a positive way. Of course this is not health care reform, but it could be acceptable health insurance assistance.

It's perfectly obvious that health care reform will not happen with this bill. But this could be an acceptable health insurance assistance bill. Let's see the details.

NOTE: When I was reading the Politico article and clicked to go to page 2, my computer was attacked by malware (similar to Anti-Virus Pro, which I had a while back). Be warned.

From page 2 of the Politico article (yes, I tried going to page 2 again and this time wasn't attacked):

Following an afternoon session, Rockefeller said the group made "more progress than we’ve made in any meeting so far.”

"People are open in ways that they have not been open before," he said. "Sometimes people just out of sheer fatigue can agree to things.”

Senators said they were hoping Obama would provide more direction during their Sunday afternoon caucus meeting.

Harkin said he wants the president “to take leadership, that is what the president is supposed to do, to use his bully pulpit.”

Asked if Obama has done that so far, Harkin said: “I haven’t seen much of it, no.”

See here too.

They represent abandonment of the public plan idea altogether. One proposal that is being floated, for example, is the chartering of a national nonprofit plan, similar to the "cooperatives" that Senator Kent Conrad has advocated. But the whole point of the public plan is to create a plan that is up and running quickly and constructed on the existing infrastructure of Medicare so that it can create competitive pressure for insurers and serve as a backup for consumers on day one. In 35 states, after all, the largest private insurer enrolls more than half of privately insured patients. Many of these plans are nonprofits already--the problem is that they don’t face a credible alternative.

Another, even stranger idea is to offer the nonprofit plans available in the Federal Employees Health Benefit Plan (FEHBP) within the exchange. Since the FEHBP is itself a form of exchange, this amounts to offer a new set of private plans within a new set of private plans. How is that going to provide real pressure on private insurers in a consolidated insurance market in which nonprofit plans already have a large presence (and often act little differently from for-profit plans)?

In short, the new compromise proposals are anything but. They represent calls for advocates of the public plan to eat their crumbs and be happy. But a majority of Senators support the public plan. At least two--Senator Bernie Sanders, an independent from Vermont and Senator Burris of Illinois--have said having a real public plan in the legislation is a precondition for their support. Those who believe in the public plan—and, more important, who believe in the principle it embodies: that no American who lacks access to good insurance should be forced to buy coverage from the private plans that got us into our present mess--should stand firm in the face of these non-compromises.

This includes President Obama. He made the public plan part of his promise of change in 2008. Now he needs to put his weight and influence behind the public plan and its essential goals, rather than allow them to be gutted. This is in our nation’s interest. It is also in his and his party’s political interest. A bill that forces people to take private insurance but doesn’t create competition or a public benchmark is a prescription for unaffordable coverage, runaway costs, and political backlash. The "middle ground" is nowhere to stand if it’s going to crumble beneath you. [emphasis mine]

(That was mcjoan quoting Jacob Hacker, "the healthcare expert who authored the original public option idea," writing here.)

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