Public Option Likely to Be Managed by Private Insurance Company

Source: Washington Post / Raw Story

Public option likely to be managed by private insurance company

By John Byrne
Saturday, October 24th, 2009 -- 7:31 am

A little-noticed tidbit in Saturday's Washington Post is sure to raise eyebrows among liberal supporters of a gorvernment-run healthcare plan: the plan is likely to be administered by a private insurance company, the very companies that progressive activists are trying to unseat.


Supporters of the public plan contend that it will help to trim healthcare costs, as a public insurer wouldn't need to generate profits. Health insurance companies typically earn profits of around two to four percent, which amounts to billions of dollars for some firms. A physicians' group notes: "Advocates of a “public option” claim that the “option” will look like Medicare. They say this about the “option” in both bills that have been introduced to date – the House “reform” bill, HR 3200, and the bill written by the Senate Health, Education, Labor and Pensions (HELP) committee. But this statement is not true."

Read more: http://rawstory.com/2009/10/public-option-managed-private-insurance-company

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http://www.washingtonpost.com/wp-dyn/content/article/2009/10/23/AR2009102304081_pf.html

If the private insurance industry can't be trusted to treat people as anything other than cash cows.. HOW THE HELL can they be trusted to act in the public interest in THIS??

:shrug: We are so lucky to live in America where anything is possible..

My head WAS about to explode, now it's exploding.

I have LEVELS of PURE RAGE.

They don't fucking get the whole fucking point of a COMPROMISING for a public option was to fucking get the fucking PRIVATE COMPANIES *OUT* OF THE LOOP.

Our tax dollars right into corporate hands.

it's called "Maximus".

http://www.yourtickettowork.com/program_info

The Ticket to Work and Self-Sufficiency Program is an employment program for people with disabilities who are interested in going to work. The Ticket Program is part of the Ticket to Work and Work Incentives Improvement Act of 1999 – legislation designed to remove many of the barriers that previously influenced people’s decisions about going to work because of the concerns over losing health care coverage. The goal of the Ticket Program is to increase opportunities and choices for Social Security disability beneficiaries to obtain employment, vocational rehabilitation (VR), and other support services from public and private providers, employers, and other organizations.

Under the Ticket Program, the Social Security Administration (also referred to as the Agency) provides disability beneficiaries with a Ticket (Click here to see an image of a Ticket) they may use to obtain the services and jobs they need from a new universe of organizations called Employment Networks (ENs).

MAXIMUS, a private company, has been contracted by the Social Security Administration to function as the Operations Support Manager (OSM) and the Ticket Program Data Operations Center Manager (TPDOCM). It is MAXIMUS responsibility to administer oversight and process support necessary to sustain ongoing Ticket Program Operations.

:scared:

Just a spoon full of sugar...

after the 2008 election I have been getting the feeling We, the American Public, are being manipulated by our two-faced Congresspeople. And the media are doing their part in keeping us on edge by alternately reporting what is happening as if it is already decided what kind of reform we will have. The third act in this play has already ended and we just don't realize it.

HR 3200’s “public option” will not resemble Medicare

"Medicare is larger than any private insurance company; the “option” in both bills will be small. The traditional Medicare program is a single program with uniform benefits; the “option” in both bills will be a balkanized program that may not be available in all parts of the country. Medicare is administered by public employees; the “options” in both bills will be administered by private-sector corporations, some or all of which will be insurance companies. The “option” in neither bill resembles Medicare."

http://pnhp.org/blog/2009/09/13/sullivan-publicoptionin3200unlikemedicare/


It's much easier to keep people ignorant by discrediting legitimate sources of info and re branding reform for maximum political gain.

A privatized public option with an opt opt available to a small fraction of americans accompanied by a legal mandate with punishing financial penalties. Smoke and mirrors equals a corporate wet dream.

Wait until folks find out since every single news show and so called "expert" are referring to the public option as medicare for all or medicare plus 5.

government contracts. That means any reports of unethical behavior brings the Feds (IRS, OIG etc). They descend on the company and will recover any losses. The government dictates the terms and goes with the lowest cost bidder. For some insurance companies there is no profit in administering Medicare contracts, they do this as a way to build a trusted relationship with the government for future opportunities. There are no bonuses for employees working on a gov contract like this. It's not surprising that they would contract out the work to companies that have the infrastructure to manage claims processing and administration including call centers. What is surprising is that it is not a uniform program like Medicare. The ones to watch in this scenario are not the usual suspects, but the ones you might not see coming, like the financial institutions. Their ability to manage electronic transactions makes them contenders in this. We could potentially have the public option health care run by both the insurance industry and the banking industry. Imagine calling with a claim question and the service center is in India.

This would have been simpler if it was an expanded Medicare program where anyone who wanted the public option could opt in. My guess is that it would be greater than 5% of the population who would opt in. There was no reason for this to get so twisted and complicated. This is the result of too many people trying to influence the outcome. What we have here is Monkey fucking a football. It's not what anyone wanted, it doesn't serve a useful purpose and it makes no sense.

We are not getting anything close to medicare so comparing the companies that administer medicare to what would happen if they got a hold of a weak, underpopulated, regionally split up public option is apple and oranges.

For traditional Medicare, no cherry picking or recission allowed.

I know that "medicare for all" and "medicare for everyone" is mere "re-branding" bs. It will be used, regardless of the actual nature, form and extent of the so-called "public" option, robust, anemic or whatever.

This is no surprise at all.

But a private plan of last resort for those with no other choice. People who would suggest that a plan like that can rightly be called either public or an option are weasels and liars. Nothing less than weasels and liars. And the ploy will bring them all down. They want to sell a pig in a poke by claiming that the words 'sack of money' now mean pig in a bag. Option is a word with an actual meaning. So is public.
The lexicon of the politician means that they are all corrupt beyond measure. They have no language, only terms of art.

not-for-profit-semi-option-for-one-tenth-pf-the-population was taken!

No sarcasm intended. Without it the frustration can be unbearable.

Medicare claims processing, provider enrollment, appeals, etc., are currently administered by insurance companies. Depending upon your locality, Blue Cross, CIGNA, United, etc., administer Medicare.

The government sets the rules for the Medicare coverage, covered services, payment rates, etc., and these companies handle it.

Truthfully -- with the profit motive removed to a large extent and no incentive to deny service from a profit standpoint -- it works reasonably well.

I'd gladly sign onto a public option managed by what is left of insurance companies.

Why in hell wouldn't they use this access to screw around with things?

the cuts and savings Obama has talked about in Medicare are all supposed to come from the areas in which private companies do take part, the Medicare Advantage programs. So if they are not cutting those programs, tell me, what sort of cuts to Medicare are they really intending to do? Big Red Flag.

Meidcare Advantage (Part C) was initially set up to give beneficiaries a choice of a privatized plan over traditional Parts A & B. The per capita subsidy amount was then diverted from Parts A & B on behalf of an individual to a private company so the private sector could do its magic.

But these companies couldn’t compete with traditional Parts A & B. The Bush administration and his GOP lapdog Congress came to their rescue by authorizing a Medicare Advantage per-capita subsidy that is 14% greater than the one going to traditional Medicare.

The 14% additional subsidy is wrong and Obama wants to eliminate it. Insurance companies said they wanted a level playing field so that the can compete with traditional Medicare. Eliminating this extra subsidy will give them exactly what they said they wanted.

The Medicare law allows the government to subcontract certain functions of Medicare A/B to private entities. Medicare Advantage is Part C. The most detailed description of the Public Option adopts the subcontracting provisions from Medicare A/B directly from the statute.

The government runs the Medicare program - it just doesn't perform all the functions in house; some of them are contracted out.

It might also be possible to run the health insurance industry like a regulated utility.

CMS is a US federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program.

medicare has been administered by the private insurance companies since day one.the mentioned 2-4% charge is rather reasonable.

remember the facts are irrelevant when no one listens

Run in circles, scream and shout.

Some are in such dire need of bad news that they take every negative story posted at face value. :(

We administer TRICARE, which is a "government run" health care program for veterans. We also administer Medicare. We are a not-for-profit. Last year the entire company received a 0% raise. Our CEO makes several 100 thousand a year, and no huge bonuses.

These programs have been administered by private insurance companies from day 1. We have contracts which stipulate the amount of profit we can make, and they are iron-clad, or you lose the contract. We go through very scrutinizing auditing by the federal government - if you screw up you will lose your contract.

Just telling the truth about this controversy - there isn't one. I pray every day that we receive one of the "Public Option" contracts!

On edit: There is something very misleading or outright false about this statement:

"Health insurance companies typically earn profits of around two to four percent, which amounts to billions of dollars for some firms."

That is the total overhead, not the "profit". Out of that money we have to pay for our employees (we have about 4000), with 500 being the IS department (we have a huge IBM mainframe and have huge infrastructure costs). We actually make very little "profit". Our main objective is to keep the company afloat, not ripping of Joe taxpayer.

I have to say this is definitely the most frugal place I've ever worked for. Not alot of money being thrown around here.

between MAC, the current private part of medicare, and what is being proposed in the reform bills.

Unfortunately we are not getting anything close to medicare in numbers enrolled, cost cuts or quality and consistency of the plan available.

"Even if HR 3200 stated clearly that the “option” will be run by public employees and not corporations, it would still be reasonable to conclude that the “option” program won’t be a single, uniform program like Medicare, but will instead consist of many programs that vary by state and region. The obstacles that will have to be overcome to create “option” insurance will be the same regardless of whether public or private employees are in charge. Those obstacles will vary from one insurance market to another. The primary obstacle will be the power of the insurance industry in any given market, and this power will be determined primarily by how concentrated the industry is. It will be more difficult to establish the “option” in those markets where one or two insurers insure a majority of the local population than in those markets where no single insurer dominates.

Depending on how successful the corporations in charge of creating “option” insurance are, some parts of the country may have no “option” coverage available at all, some might have “option” insurance that meets only the minimum criteria for coverage spelled out in HR 3200 and the HELP bill, and some might have “option” insurance that exceeds the minimum coverage. Other significant features of the “option” could vary as well, including the premiums and how tightly managed the coverage is (including how much freedom enrollees will have to choose their own doctor)."

http://pnhp.org/blog/2009/09/13/sullivan-publicoptionin3200unlikemedicare/

The proposed opt out is a divide and conquer tactic tailored to the needs of private health insurance companies.

they all have different things they cover and some don't cover what the traditional medicare covered and people who work in an office have to figure out which one covers what and then charge the patient or in form them before their prodedure that they will have to cover part of the costs. It has just created more paper work and less coverage for those on medicare. Thats great if they can't make a huge profit but if they are limiting coverage than that is not great. Most people don't even know that they have signed up for a different medicare plan until they go to use it.

Eagertolearn,

Since I went on Medicare+AARP Medigap, I have not had to fill out one scrap of paper regarding insurance nor pay one deductible nor pay one copay. Zero hassle, after a lifetime of insurance paperwork hassle. Your mileage may differ depending on what plan you choose.

What Medicare Advantage plans do, on the other hand, I have no idea. They were a Repig+Blue Dog gift to the insurance companies and ought to be abolished.

and perhaps my reasons will help explain what they do.

Mine offers the assurance of "no nasty surprises" when it comes to the co-pay for appts., services, surgery etc. They get my monthly Medicare payment automatically (now just short of $100) , plus presumably a much larger payment per member direct from the govt.

For this I know I'll only have to pay a $10 co-pay for each appt. with a "primary care" doctor and $20 for an appt. with a specialist. My prescriptions are now all generics, at a cost of $3 each, although when I first joined, since there was no generic yet for one BP medication, it cost me $66 a month. I do not, however, have to "buy into" a separate Part D prescription plan, since my Medicare Advantage already includes prescriptions.

I had surgery a few years ago and the total cost to me, including a Fri-Monday hospital stay, was exactly ZERO.

I'm not trying to defend insurance companies, just pointing out that there are considerable financial incentives which, so far, makes it a better deal for seniors with limited funds. I'm uncomfortably aware that these come at a price to the govt. But *&$#@ it all, if there weren't such big holes in traditional Medicare coverage, I'd rather have that. It's NOT FUN to have to change from a doctor you like because he doesn't belong to the network, nor to find that the plan's network includes NO specialist of the type your condition seems to need. Or, having to get my Pain Clinic appt.s reauthorized each year. These are among the drawbacks of belonging to a Medicare Advantage plan.

OTOH, to equal the financial set-up under traditional Medicare, I'd have to pay over $300 a month for a "Medicare Supplemental" insurance policy. It's true that some doctors' co-pays for the 20% they're allowed to charge probably aren't much more than what I pay. But in the short time I had it, I remember being hit up in a gynecologist's office for a $75 co-pay before they'd even look at me. A hospital stay costs the Medicare patient over $1000 (I have no idea HOW much more by now) before Medicare even kicks in.

For retirees who have a nice nest egg, this may be no big deal. It's certainly a lot less than uninsured people would get charged. But there are lots of us seniors who _don't_ have such assets, and who have to budget out each month carefully. Even more so now, since so many of our pensions' payouts have shrunk. A$300 extra charge a month, or a four-figure hospital bill, might as well be half-a-million to us!

"Medicare for all" is an OK rallying cry, and even starting point for publicly-run coverage, but I wonder if most of the people pushing it have any idea how much Medicare actually doesn't pay?

They have to use standard paperwork. Any subsidies for the new plan would have to get all new money. The major part of the premiums in the new program will have to be paid out of pocket by most people in it. Premiums will be regulated, but liberally, and will be similar to the current cost of group coverage for large groups. And no matter how overpriced you feel they are, if you are not covered elsewhere, you will be mandated to pay them, minus whatever your sliding scale subsidy pays. The public option in the exchange is required by law to charge as much as the private options whose fees are figured first. (The infamous "level playing field". So it will exert no downward pressure.) If tax rates aren't raised on the ultra-wealthy, the subsidies will have to be picked up as usual by taxes on the struggling middle class, and many will also be paying most of their own premiums. So the monthly expense for most people would be nothing like any current form of Medicare.

Medicare plans by virtue of covering only the non-working, don't affect the burden on business of health insurance. Since the new plans will be fairly costly (much higher than Med.Adv.) it leaves the pressure for employer coverage intact, and the resulting downward pressure on the economy.

two staff writers get their day in the sun by writing a summation of this week`s "dithering" in the saturday `s edition of the washington post.


tomorrow will be the big day! everyone on the teevee morning circle jerks will have the inside scoop on what is really going on with the public option.

You people need to grow the fuck up.

They would get my vote anyway. :D

Telling US WE need to grow up when all along the public option was talked about as a GOVERNMENT RUN alternative to the private companies - but woah wait - now people are being told otherwise? What kind of reaction did you expect? Why are you mocking hippie lesbians as well as the intelligence of DU readers? Why so mean telling people to "grow the fuck up"? So seriously, what is your problem? And why are you acting so mean today?

Obama and Pelosi and Reid are going to accomplish the greatest health care program since Medicare, in some ways better than Medicare, against huge opposition, and a bunch of dippy trippy hippies on this board are going to cry about it and call them every name in the book.

It's not single payer, so you'll cry about it and call Obama a sellout.

It's not a public option for everyone, so you'll cry.

It's going to have an opt-out that no state is going to invoke, and you'll cry about it.

Administration is going to be contracted out to private businesses, and you'll cry about that.

You Kucinichites are just fucking stupid, you're the leftie equivalent of birthers. You're just going to have to watch the grown ups save this country, and you can go cry about it.

there is absolutely no need to make it "government run". The insurance companies have the expertise to do this. They make no life or death decisions based on profits or stock prices. They make no bonuses for denying coverage. They just administer a plan.

and it is a failure.

It died to purposeful mismanagement and Phil Bredesen.

and the one who did were complete bottom feeders. then, the deductibles were outrageous -- i was better off, WAY fucking better off without it and never trying to go to the shitty fucking bottomfeeder docs that accepted it. there was no way i'd have ever met the deductible for the year. it was complete bullshit. and the fact that you blame Bredesen for it is really telling.

It's been a cock up since shortly after its inception, long before Bredesen came into the picture.

That's how "the smartest guys in the room" make their money.

If this is what happens, I will consider health care reform a complete failure.

As administrators they have no judgment in coverage. As administrators, they make no decisions for profit and/or to benefit stockholders. They simply do what the plan calls for and pay claims.

:crazy:

so you really should keep your comments to yourself. You look pretty stupid right now

What are the odds we get ceilings on executive pay for insurance companies? Or limits on golden parachute plans?

"FUCK FUCK FUCK FUCK!"

"OH FUCK."

"OH MY GOD."

"JESUS!"

If you've seen the episode of "Peep Show", the reaction I had to reading this was akin to Jeremy and Mark's reactions after the answering machine message to Sophie. Really fucking disappointed and embarrassed.

This is hardly a public option. Administered by a private insurance option? Give me a break. This is ridiculous.

The whole point of a public option is to provide relevant health care to those who cannot afford it. Key statement - cannot afford it.

There should be no 'buying in.' It should be freely and readily available to the most needy. There should be no copayments, no premiums. The whole nature of the public option has disappeared.

Health care reform: failed.

uh uh

There was no problem with that as long as the government sets the rules.

I don't know about right now but you used to have a choice between almost any of the major health care groups here in MN

(I haven't checked the rules for Medicaid - but it sounds more like Medicare Part C)

Medicare A/B - which looks like the government running the program entirely - has certain functions farmed out to (insurance company) subcontractors. The public option bill (at least HR 3200) adopts the Medicare A/B model for the Public option.

If Obama leaves as his legacy, getting rid of the Safety net,
why should anyone call themselves a Democrat. It is obvious
they are movng every thing they can out of Government Control.

would likely be administered by a private insurance provider, charging premiums and copayments like any other policy
charging premiums and copayments like any other policy
premiums and copayments

I rather have my premiums and copayments paid by taxes. Even if it's mostly be sales taxes (because I have little hope of gaining employment)

Single-Payer now, let the insurance companies fight over the scraps.

can't get sick . . . can't afford health care.

let us please keep trying.




Join the Democratic Donor Strike for a Robust Public Option:
http://www.democrats.com/donor-strike-for-public-option?cid=ZGVtczQ3NTdkZW1z

It's not clear what this means. I have plain Medicare and also AARP's Medigap policy, the latter administered by United Healthcare. UHC sucked eggs big time when it ran my employer's health insurance plan, but I have no complaints about the way my Medigap policy is run. I assume the government/AARP is setting the policies, or it wouldn't work so well.

who would get put out of work in the event of single payer healthcare.

I guess we found em something to do, lol.

But srsly, I'm not sure how I feel about this.

clinic, and if I remember right, WPS insurance handled the processing and payments for Medicaid, or as we called it then, medical assistance, for Wisconsin. They simply facilitated the billing and payment logistics, made sure medical claims were properly coded and filled out, and sent a check for the government approved amount. Simply the government contracting a private company to handle the process.

Neither do nonprofits -- like Kaiser, hardly a shining beacon of quality health care. :eyes: They're just disguised as "administrative fees" instead of "profits".

Nonprofit insurers (HMSA in Hawai'i is another flagrant example) often distribute their ill-gotten gains in the form of obscene, Wall Street-style bonuses to executives, rather than as dividends to shareholders. That's the big difference. :sarcasm:

Group Health used to offer a single benefit package--no age rating or anything. Then for-profit HMOs started offering young people bare bones cheaper insurance and GH had no choice but to imitate that.

Did anyone here actually believe that a new bureaucracy would be created from thin air to deal with the needs of millions of people who might flood into a public option? And that those new bureaucrats would suddenly just give things away for free, without questions asked?

I've been working for a regulated utility company for almost a year now, and I sure do hear the way that most of my fellow employees treat the public. There's little or no profit motive in our organization, they are guaranteed a reasonable return on investment by the regulators, and thus have no incentive to trim costs. People who I've dealt with always ask to speak with me whenever possible, since I treat them with respect. And I learned all of that behavior while working for private sector companies for decades.

The only answer to this is single payer, where all of the people working in the healthcare reimbursement industry are on one standard, accountable to elected officials. Perhaps the position of healthcare czar should be a nationally elected office.

Its what it has always been about.... MONOPOLY.

Any public plan is likely to have a relatively narrow scope, as it would be offered only to people who don't have access to coverage through an employer.

And, thus, it is doomed to failure.

Anything that reduces the risk pool for any kind of insurance, especially health insurance, will make it far too expensive to sustain.

What is happening here is that any "public option" is being carefully crafted so it will be nothing more than "the insurer of last resort" for those most likely to make a claim. By doing this, the private insurance companies will benefit enormously by offloading high-risk classes of people onto the "government plan" while enjoying unfettered profits by insuring only those least likely to ever make a claim. They will make out like bandits while the "government plan" will be saddled with the small pool of high-risk participants, driving the plan into fiscal chaos. In other words, this is another back door into the treasury by the private health insurance racket. They will collect the premiums from healthy people while "the government" (the taxpayer) will be saddled with the cost of paying claims of the sick.

A republican's dream business plan -- let the taxpayer cover all of your expenses while you collect all the checks.

remind me why we're outraged?

The language of HR 3200 points to the Medicare A/B statutes for the Public Option.

That language authorizes the government to subcontract certain functions to authorized private entities (most of which are insurance companies). If Medicare can subcontract a function out - so can the public option. If a certain provider is authorized to perform those functions for Medicare, it can also provide those functions for the public option.

If you are fine with how Medicare A/B runs, you should be fine with the Public option since all they are doing is authorizing the Public Option to run the exact same way (in terms of providing services - the premium structure will be different because seniors don't pay the entire cost of the program). The recent uproar seems to mainly come from people who believe Medicare A/B is carried out entirely by government employees - and it isn't.

STFU and let this thing get done.

Needs to fucking FAIL, and I do not give a damn how "good" the Democrats 'think' it is for the people. Nor do I give a shit about any alleged 'foot in the door' bullshit gimmick, that is just a fucking excuse to not do what the American People elected them to do.

Once again Democratic Politicians.... When you actually represent and work for Corporate America, instead of the American People, you will be scratching your heads trying to figure out why people would vote against their alleged 'best interests.'

Because you aren't fucking representing and working for the People's best interests!

Your fucking Chump Change Token Efforts are NOT what the People elected you to do!

The People also did NOT elect you to merge the fucking Government with Corporate America either.
They elected you to crack down on Corporate America and remove it's power from the Government.

Scratch your fucking heads all you want after 2010 & 2012, because it's coming and you deserve it, you stupid arrogant dumb fucks.

I drew a picture of FDR voting for him; isn't that enough?!11

about not only who will adminster the plan, but also whether it not it will be a national plan or a variety of plans. This was writen back in August, there are other articles since that time.


http://pnhp.org/blog/2009/08/14/the-senate-help-committee-%e2%80%9cpublic-option%e2%80%9d-will-be-multiple-%e2%80%9coptions%e2%80%9d-and-these-will-be-run-by-insurance-companies/

"...To get some idea of which insurance companies meet current MAC standards, and are therefore the ones likely to get contracts with the Secretary under the HELP Committee bill, consider this list of the companies that now have MAC contracts with the Centers for Medicare and Medicaid Services (CMS, the agency that runs Medicare):


...Decoding Section 3106: Is it one “option” or multiple “options”?

Section 3106 proposes multiple “options,” not a single Medicare-like program, but this is not apparent at first. The first three sentences contradict each other....


....But as we read on, we encounter provision after provision that indicates the HELP Committee definitely envisions a balkanized “option.” Some provisions reveal that intention by referring to “options” plural. Others reveal it by giving the states the authority to determine essential features of “options” sold within their boundaries, such as the required reserve levels and maximum benefits. A single national program can’t have 50 different reserve requirements and 50 different benefit levels....

Implications

If my interpretation of Section 3106 is correct – if the Senate HELP Committee’s “option” program is going to be balkanized and run by the nonprofit wing of the insurance industry – then reasonable people have to conclude that the deck is really stacked against the Committee’s “option” program. Even if Section 3106 authorized public employees, not Blue Cross Blue Shield employees, to create the dozens or hundreds of “community health insurance options” called for by Section 3106, the program would fail to pose any challenge to the insurance industry and might even die in the cradle. The health insurance industry has been very difficult to break into since at least the 1980s, and has become more so in the wake of the merger madness that swept through the industry in the early 1990s. But if public employees are not going to be directly responsible for creating the “community options” – if the nonprofit wing of the insurance industry is going to be doing that – then the entire “community option” project of the Senate HELP Committee amounts to a cruel joke on the public. Should the public trust corporations like Blue Cross and Kaiser Permanente to make a good faith effort to build competing insurance companies?

Section 3106 is a mess, but its meaning becomes clear after several readings. Section 3106 does not create the “Medicare-like” program promised by Jacob Hacker, HCAN, Howard Dean, and other “option” advocates. Instead it proposes a program that authorizes DHHS to create numerous health insurance companies tied to geographic areas, and to contract with members of the existing insurance industry to create and possibly run those companies..."

Where do those numbers come from?


knr

which are to be figured first. This is the infamous "level playing field" which means that the public option can't put downward pressure on premiums.

The amount of the private premiums are to be cost plus 1/3, costs figured on the highest possible basis (including all overhead), and high enough to attract enough private insurers to create "competition". Mention is also made of value for insurees, but I don't see how that would change the final amount which has to follow the formula. {Don't ask me how plans required to offer the same QHBP (basic plan) and charge the same amount would "compete".}

As I've been saying, this pretty much echoes the Massachusetts plan which mandates and partially subsidizes private insurance at exhorbitant cost to individuals both directly and through state expenditure.

The costs are not to include overhead, fortunately. I reread the relevant parts of H.R. 3200.

All the talking points for selling this flim flam, boondoggle,
sellout are right here in flashing neon letters that are oh so soothing. Just look how well the oversight was on the govt "ironclad" contracts in Iraq that are still continuing to this day whilst the contractors are amassing billions while performing little function.

There is a lot of admirable language in H.R. 3200 that prevents exclusion for pre-existing conditions, being dumped when you get sick, etc. There is even half-decent language preventing skyrocketing deductibles and copays. ($5k max for individual & $10K max for family per year) The mandate will mean more healthy people insured, lowering the average costs. There is at least stability for the premiums even if there will be a pretty high amount above cost charged.

The big problem is by allowing that very high amount above cost to satisfy private insurers, the continued expensive paperwork of dealing w/ multiple insurers added to provider costs at every level, and requiring the gov't to partially subsidize the premiums to a level of "affordability" for all formerly uninsured allowed into the exchange, the program (as in MA) will cost A LOT. While a middle class person or family will get partial subsidies for their insurance, the bill for all that expensive insurance will have to fall somewhere. With no prospect in sight of restoring higher rates for the top incomes, that burden will fall where it always falls--on the middle class. So though you might be given a credit for insurance on the one hand, you are likely to have an overall higher tax bill on the other, as gov't tries to satisfy the demands for the program to stop increasing the deficit, especially with the planned depreciation of the dollar raising your bracket (you'll get paid nominally higher amounts that will buy less). As the cost of insurance to a working person would still be considerable, even w/ subsidies, there will still be pressure for employer-based insurance, continuing U.S. businesses' disadvantage vs. businesses in the rest of industrialized countries.

If this was the only option, I wouldn't object. But, of course, it isn't. Single-payer would cover us all completely for much less, and take the pressure off U.S. businesses to provide health insurance, expanding the economy. Despite losses of jobs in the insurance industry, economists have determined that the net effect would be a jobs increase and lower unemployment.

Administration costs are the major overhead of commercial insurance companies.

:shrug:

They promised they would, but didn't. Even after a number of e-petitions asking them to.

:argh:

Force currently covered high-risk employees to the "public option" plan--but still be able to keep hefty rates on the employers.
The public option can be a watered-down Medicare...lots of out of pocket expense--less-than-adequate coverage.
This is going to be mercenary.
Who the fuck thought up THIS one??

"article". He bases his "conclusion" on extremely thin evidence that is based entirely on a couple of off-hand comments and his interpretation of a couple of clauses. Very thin, indeed.

this is a good thing, why this is what was always meant by public option.

It aint public and it ain't an option. It's just more money for insurance companies. As it ever was and ever shall be.

Your money and your health are being bartered for campaign funds. You can say how wonderful it is. You can say how it's going to be wonderful. It isn't and it won't be.

Whatever is signed will be the bestest ever. Screw the people, reward the corporations. It's time to party.