The difference between single payer and a public option/private hybrid

Number Insured
Single-Payer: Universal Coverage
Public Option Millions remain uninsured or underinsured

Coverage
Single-Payer: Coverage for all medically necessary services.
Public Option: Insurers continue to strip-down policies and increase patients’ copayments and deductibles.

Cost
Single-Payer: Redirect $350 billion in administrative waste tocare; no net increase in health spending.
Public Option: Increase health spending more than $1 trillion over 10 years

Savings
Single-Payer: $350 billion in administrative waste. Further systemic savings achieved through negotiated fee schedule with physicians, global budgeting of hospitals, bulk purchasing of pharmaceuticals, rational planning of capital expenditures, etc.
Public Option: Add further layers of administrative bloat to our health system through the introduction of a regulator/broker “exchange.”

Sustainability
Single-Payer: Large scale cost controls (global budgeting, capital planning, etc.) ensure that benefits are sustainable over the long term.
Public Option: Uncontrolled costs ensure that any gains in coverage are quickly erased as government is forced to hike spending or slash benefits.

but instead of making this a national priority the effing Democrats can't even get together on the same page about the absolute need for universal coverage/single payer, so we'll wind up w/ a half-assed POS health care system that's not gonna work, that the right can point to and say *i told you so* and we'll end up in the same place we are now while the insurance companies will raise their rates and cite defending themselves against this as the reason and it'll be fifty years before another pol has the guts to tackle health care.

nt

PHArMA and SEIU are going to be so mad at you!

I have read a lot by Paul
Starr over the years--he is a well know medical historian--who knows his history --and its failures.


http://www.pnhp.org/news/2009/june/paul_starr_and_steff.php

......Entry into the public plan for the eligible employed would be a two-stage process. First, employers would choose between paying into the exchange and buying insurance directly to cover their workers. Unless the exchange is such a good deal that nearly all employers take it, firms with a young, healthy work force would tend to buy insurance on their own, while those with higher-cost employees would go into the exchange’s pool. As a result, the pool would suffer “adverse selection” — it would get stuck with a higher-risk population.

Second, within the exchange, the government-run plan would compete against private insurers, yet it would likely abstain from the marketing strategies used by private plans to avoid high-risk enrollees. This double jeopardy of adverse selection could then more than nullify the advantage the public plan derives from its lower overhead (as a result of less money going for salaries, profits, and marketing).

Here’s the delicate political problem: Unconstrained, the public plan could drive private insurers out of business… Over-constrained, the public plan could go into a death spiral itself as it becomes a dumping ground for high-risk enrollees, its rates rise, and it loses its appeal to the public at large. Creating a fair system of public-private competition — giving the public plan just enough power to offset its likely higher risks — wouldn’t be easy even if it were up to neutral experts, which it isn’t.

There are a lot of ways to defeat reform, not just by blocking it entirely, but by setting it up for failure. Those who think a public plan is a good idea no matter how badly designed are not thinking ahead.

(Paul Starr received the Pultizer Prize for “The Social Transformation of American Medicine.”)

The only thing they should be allowed to do is to provide for the extras not covered by the public plan. They wouldn't compete at all with the public plan--just with each other. They would turn into what life insurance companies now are. Social Security survivors' benefits put a floor in place, where every child losing a parent gets the same benefit. Private life insurance offers parents the option of leaving their kids with more income in the advent of adversity.

sure, they want their own negotiated prices to be lower than the "retail" price, but the rising healthcare costs are a justification for higher premiums, which is their source of revenue and profit.

mostly they want the ability to SHIFT costs from them to their customers. absolute low medical costs does not really benefit them.

--it will never be fully funded.

with costs not covered by public plan (some question whether this can be considered single payer - it's not according to PNHP definition because there is more than one entity paying medical costs).

Single payer does not have to be universal health care.
Non single payer can be universal health care (for example, in Germany, there is universal health care (insurance is mandatory now) but not single payer: only about 88% on public plan.

Single payer does not automatically exclude co-pays, deductibles, and so on; it also doesn't necessarily cover everything - it's all in how the details are set up. Same with public option with private insurance alongside.

There are lots of good health systems in European countries which aren't single payer.
The French have a relatively expensive system.

Just the fact, ma'am - nothing but the facts.

Lots of links, relevant facts (not to mention, differences of opinion) here:
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5934182&mesg_id=5934405

--as an unregulated for-profit insurance company, period. All single payer countries, and even those with full socialized medicine, have private insurance to cover things that the country-wide standard plan does not. In that way, those countries prevent private insurers from dictating who does and who does not deserve care.

I thought having a public option was just a way to make sure no one would fall thru the cracks.. the idea ( I thought ) is when choosing your health care provider/insurer you will have a list of choices some more expensive/comprehensive than others. BUT among the choices will be a public one.. it would the be the choice of last resort.. IF you could not afford another others you would use that AND if you can not even afford that, then the government would cover how ever much you are short of being able to pay your self..

The plain fact of the matter is we can't afford to care for those people as long as the insurance companies continue to rip off money that would otherwise be used for actual care.

A "better plan" is nothing but a license for the affluent to bankrupt or kill the less affluent. We need ONE standard comprehensive benefits package, period. If private insurers want to offer extra bells and whistles for those who want them, fine. Now, they kill and bankrupt people at will, and will continue to do so even with a public option.

(so it's not all Michael Jackson)