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View Diary: Obama to Propose Federal Oversight of Rate Increases (153 comments)

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  •  The insurers will love this. (13+ / 0-)

    They know how to play the regulation game.  After all, how much has state-level regulation restrained the growth of health insurance premiums.  Obama is getting good at giving gifts to industry while making it seem he's tough. Same ol', same ol'.

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Mon Feb 22, 2010 at 06:34:18 AM PST

    •  agree. looks and smells political to me. (3+ / 0-)
      Recommended by:
      Randall Sherman, output, dinotrac

      "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." Groucho Mark

      by hester on Mon Feb 22, 2010 at 06:36:09 AM PST

      [ Parent ]

      •  And rife with practical problems. (2+ / 0-)
        Recommended by:
        hester, output

        There are a few bright red inflation flags out in the economy right now -- what fun that could be for regulators.

        What? You want to raise rates 50%

        But our costs have gone up 52%!

        And, needless to say, a gazillion practical problems. F'rinstance, that Anthem increase -- we keep hearing the "up to", but that doesn't mean that the average increase was anywhere near that high.  Certain classes of patient may have been horrendously undercharged in light of the cost structure.  More likely, of course, is that the company doesn't want to seve those patients and is not-so-gently encouraging them to leave, but...the reality is that it could actually be an out-of-whack cost structure.

        And that's without even getting into the politics....

        Free speech? Yeah, I've heard of that. Have you?

        by dinotrac on Mon Feb 22, 2010 at 06:41:59 AM PST

        [ Parent ]

        •  Who's looking for the regulators to have it easy? (2+ / 0-)
          Recommended by:
          hester, dinotrac

          This is true, but it means we have to finally deal with the WHY of increased prices like they do in Europe and Canada. Actually, change practices and reform to keep our costs down.

          This provides the pressure for Congress to constantly monitor health care issues in this country.

      •  So why beat around the bush? (1+ / 0-)
        Recommended by:
        hester

        President Obama should call those SOB execs from Anthem Blue Cross and chew them out, and then add:

        "Oh, by the way... I just got a call from the Director of the IRS, who told me that they have penciled you in for a full tax audit for next week.  What a coincidence!"

        Oh, I know he wouldn't do that, but it makes me feel better just to imagine that.

    •  Up is down, day is night, black is white (12+ / 0-)

      He proposes to regulate insurers, but he's giving them a gift?  I suppose for some people he can do no right even when he's...doing right.

      It reminds of Bush saying we shouldn't raise taxes on the rich because they're good at avoiding taxes.  

      I'm shocked to learn that 1 in 12 Americans do not know that the bird, is in fact, that word.

      by dansac on Mon Feb 22, 2010 at 06:37:00 AM PST

      [ Parent ]

      •  It's unbelievable (4+ / 0-)
        Recommended by:
        Kitty, dansac, Bush Bites, jtown
      •  The point is that saying they will (3+ / 0-)
        Recommended by:
        hester, poxonyou, output

        regulate insurers means little because it depends on how well they regulate.  The insurers have been playing the regulation game a long time and quite successfully.  Why would this commission be any different than those in states who continually fail to reign in premium increases?

        We'll see if Obama's plan includes a public option.  Without one, there is no benchmark for premiums and with premiums relative to what only the insurers set them to be, the insurers remain in the cat bird seat.  In this case, the bird is the word on premiums.

        The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

        by accumbens on Mon Feb 22, 2010 at 06:42:17 AM PST

        [ Parent ]

        •  Well, wouldn't you agree that having the power (6+ / 0-)
          Recommended by:
          dansac, Fabienne, Seeds, TomP, zizi, jtown

          to regulate the prices is better than not having it?

          •  I'm saying it makes such little difference (0+ / 0-)

            it essentially doesn't matter.  A strong public option would create a benchmark for rates.  Without it, it's all up to the insurers to define the playing field.  Would you rather have rates determined by insurers with some nibbling at the edges or by a strong public option?  A short time will tell if the public option is in Obama's plan.

            The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

            by accumbens on Mon Feb 22, 2010 at 06:49:36 AM PST

            [ Parent ]

            •  The CBO says the public option (4+ / 0-)
              Recommended by:
              Fabienne, Bush Bites, TomP, MariaWr

              will actually be more expensive than private insurance because it will likely have a large pool of very sick people, while private insurers will get most if not all of the healthy uninsured because of the mandate. So...there's that.

              I'm in full support of the public option. Always have been. Not only because of its price benchmark, but because of its base package of benefits benchmark. Still, that won't happen overnight. Rate control is a heavy hand of government, but it will most certainly work if applied. It will actually control prices better than the public option that is currently in the House bill.

              •  the cbo was talking about the overly restrictive (0+ / 0-)

                "public option" in the (Senate?) that appears to have been designed as a dumping-ground for the sick, before it was trashed in favor of some other bad idea. We're talking about a robust public option that provides meaningful competition to the private plans.

                " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                by output on Mon Feb 22, 2010 at 06:58:22 AM PST

                [ Parent ]

              •  Not sure how everybody fell in love with the PO. (0+ / 0-)

                It was always just a means of lowering costs that would hopefully buy over the blue dogs; there are other, more direct, means.

                Bush Bites is a subsidiary of Bush Bites Inc., a registered corporate personhood.

                by Bush Bites on Mon Feb 22, 2010 at 07:33:36 AM PST

                [ Parent ]

                •  the only people who loved the cbo-scored (1+ / 0-)
                  Recommended by:
                  Bush Bites

                  PO (the one in the House Bill) were the insurance companies who would have benefitted from a back-door subsidy once the six million sickest people in America were shunted off to said plan. That so-callled "public option" was a boon to the insurance industry that was bound to fail the CBO test because it was not designed to save taxpayer mone.

                  " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                  by output on Mon Feb 22, 2010 at 07:42:05 AM PST

                  [ Parent ]

          •  I would; given the lackluster HCR proposals (2+ / 0-)
            Recommended by:
            Pescadero Bill, accumbens

            I've seen coming out of the Senate. However, Bush's Blue Skies Initiative served to turn over the EPA to corporate interests. The devil is in the details and I have little doubt the insurers will game the system as this goes forward - maybe, not today but give it time.

            If they can regulate insurers via reconciliation, then I want to see a straight up or down vote on Medicare expansion even if they limit it to those 55 and over - which I don't agree with the limitation.

            Personally, anything less than a Medicare buy-in for all who want it is merely business as usual in DC. Corporate giveaways without really constraining costs or lowering the GDP expenditure. I don't want the mirage - I want the water.

          •  false dichotomy. please. nt (0+ / 0-)

            " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

            by output on Mon Feb 22, 2010 at 06:55:52 AM PST

            [ Parent ]

            •  As of today, (1+ / 0-)
              Recommended by:
              J M F

              the federal government has no power whatsoever to regulate the prices of private insurers. If this provision is enacted, it will. The choice isn't false. It's clear.

              •  let's get real: the point of these (0+ / 0-)

                comments is that this plan is, at best, an ineffective and inefficient way to lower premiums; and at worst, an intelligence-insulting political stunt. i say that it's a false dichotomy because even if it were a halfway sincere effort, the power to regulate comes in many shades of gray that cannot be reduced to "the power to regulate" (already residing, by the way, in the states) or not.

                " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                by output on Mon Feb 22, 2010 at 07:06:11 AM PST

                [ Parent ]

                •  You're flailing... (0+ / 0-)

                  I understand the instinct to oppose the President on just about everything. I've been opposed to this healthcare bill for some time. But a good idea is a good idea. You either want to give the federal government the power to regulate health insurance prices or you don't. It doesn't affect any other issues on which I probably agree with you. Even if we had a Medicare for all bill, i'd be in favor of giving the Federal government the power to regulate prices.

                  •  flailing? can't you address the substance (0+ / 0-)

                    of my comment? are we down to me not being sufficiently hopeful?

                    " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                    by output on Mon Feb 22, 2010 at 07:11:56 AM PST

                    [ Parent ]

                    •  Here's your quote: (0+ / 0-)

                      this plan is, at best, an ineffective and inefficient way to lower premiums; and at worst, an intelligence-insulting political stunt.

                      You rest that conclusion on this premise:

                      The insurers have been playing the regulation game a long time and quite successfully.  Why would this commission be any different than those in states who continually fail to reign in premium increases?

                      This is called the fallacy of inductive generalization or statistical generalization. It's a common argumentative error for the untrained.

                      The argument for the policy rests on different premisis, rather than such fallicies.

                      1. Federal regulation is, both generally and specifically, more effective than state regulation.
                      1. Some states do not have the power to regulate insurance rates. Federal review will solve this problem.

                      If you agree with #1 and #2, it isn't difficult to conclude that federal regulation of prices is a better scenario that not having it.

                      Now, as you say, it all depends on how vigorously one regulates. Well, you can't regulate at all if you don't have the authority. So that is the discussion one should have after said power is granted, correct?

                      •  you're MISQUOTING now? you guys do play dirty! (0+ / 0-)

                        The insurers have been playing the regulation game a long time and quite successfully.  Why would this commission be any different than those in states who continually fail to reign in premium increases?

                        I didn't say that.

                        " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                        by output on Mon Feb 22, 2010 at 07:26:34 AM PST

                        [ Parent ]

              •  yep.. cherry picking and lemon dropping ends now! (0+ / 0-)

                standardizing the benefit packages, so everybody knows what they're paying for, will force companies to compete with the voluntary Public Option.  Once people understand that they can get the SAME benfits, with fewer administrative hassles and without contributing to shareholders' profits, then "we the people" can vote with our pocketbooks on which plan we choose.

          •  Question...do states currently have this (0+ / 0-)

            power?

            "I know, I know.  I could google it.  But I figured someone here would know."

            "Just today, Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." Sen. Barack Obama

            by justmy2 on Mon Feb 22, 2010 at 07:20:07 AM PST

            [ Parent ]

            •  Some do, some don't. (0+ / 0-)

              Problem is, the states are less immune to the power of the insurance lobby than the Federal government. FAR less. Most state ethics and lobbying regulations are in the dark ages. Add in a monopoly player to a place where there is lax ethics and lobbying regulations and you've got the current situation: lax regulation of insurance prices.

              •  Thanks, that is what I thought but I wasn't sure (0+ / 0-)

                Although states are far less immune to lobbyists (and this was one of the key rationales against the opt-in proposal), I don't think that it is unreasonable to state the federal government is sufficiently immune to eliminate concern here.  Our experience the last nine months gives us some insight.

                If states are 80% influenced by their lobbies, the federal government could be 50%.  That is far less, but it still presents an issue.

                "Just today, Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." Sen. Barack Obama

                by justmy2 on Mon Feb 22, 2010 at 07:37:05 AM PST

                [ Parent ]

              •  industry would much rather a weak *federal* (0+ / 0-)

                regulator to fifty varied state systems. it makes for far more efficient bribing lobbying - fewer rules to master and oppose, and fewer checks to write.

                " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                by output on Mon Feb 22, 2010 at 07:47:35 AM PST

                [ Parent ]

                •  Quite true. The industry would much prefer (0+ / 0-)

                  a federal regulator. But this is a double eged sword. Politics in Washington are volatile...much moreso than state legislature. Would was probably cheap before could prove far more expensive when you add in the fact that a Washington campaign requires not only contributions, but paid media. Not so in state legislatures.

          •  Also, I think one of the issues raised (1+ / 0-)
            Recommended by:
            output

            when this part of the bill was first reported was that it would be dependent on the Administration.

            If Evan Bayh, Mitt Romney, or John McCain were elected, it seems like this would have limited teeth.  In the same way EPA regulations move and shift as Administrations come in and out.  I believe the point people were making was the facade of regulation could give explicit permission to insurers to hike rates.  "The Government okayed it".  Similar to the line energy lobbies use.

            The question is will the people hold the Administration in power accountable for not regulating effectively, and our current financial industry experience doesn't lead to optimism.

            Just another side of the coin.

            I think people are asking for something that has teeth, clearly provides competition, and doesn't rely on the whims of the electorate.  I would submit health care regulation should not be managed or influenced by politics, which this almost certainly assures.

            Thoughts?

            "Just today, Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." Sen. Barack Obama

            by justmy2 on Mon Feb 22, 2010 at 07:24:59 AM PST

            [ Parent ]

        •  If government cost controls via regulation are (1+ / 0-)
          Recommended by:
          J M F

          hard wired to fail, what makes you think that the same won't be true of the public option?

          all of these idea work in theory. whether they work in practice will always depend on whether we can get real committed people into the right positions an shelter them from manipulation from the indsutry and their allies in congress.

          that is always what this is about.

          as for the tactical value of this proposal, clearly is has some political benefit to our cause because of what it forces the GOP and conservadems to do in response. let's not be so quick to declare it a giveaway.

          •  So far, there's little indication that the (1+ / 0-)
            Recommended by:
            J M F

            Republicans can be forced into anything.  If they just keep saying "no" they will be seen to stand by their principles.  If they go along with Obama (how likely does that sound?), they would be failing on their own and right-wing base's terms and they are not likely to let that happen.

            The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

            by accumbens on Mon Feb 22, 2010 at 06:52:10 AM PST

            [ Parent ]

            •  The PO (1+ / 0-)
              Recommended by:
              J M F

              The public option, if it's still alive, is something that would be managed by the HHS.  

              If regulation of the system doesn't mean anything because insurers can rig the game, then how in the world could we be expected to think that the PO would do any better under the direction of the HHS?  

              It's a pretty legitimate question, if you ask me.

              People don't get up in the morning and ask, Do I want single-payer or managed competition? Wellstone

              by otto on Mon Feb 22, 2010 at 06:55:46 AM PST

              [ Parent ]

              •  Because they would be creating a benchmark (0+ / 0-)

                for rates not trying to regulate the numbers proposed by insurers.  They would take the lead instead of playing catch up.

                The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

                by accumbens on Mon Feb 22, 2010 at 07:02:25 AM PST

                [ Parent ]

                •  They do that with medicare rates now. (2+ / 0-)
                  Recommended by:
                  Seeds, output

                  There's no benchmark; they just get together and decide on a fair rate.

                  (it's too low, most health professionals will tell you. But the point remains, it can be done.)

                  Bush Bites is a subsidiary of Bush Bites Inc., a registered corporate personhood.

                  by Bush Bites on Mon Feb 22, 2010 at 07:04:30 AM PST

                  [ Parent ]

                  •  the dirty little secret about the relatively low (0+ / 0-)

                    rates paid by Medicare is that provider still come out ahead because they don't have to spend hours fighting with insurance company bureaucrats - before and after services are rendered - every time they see a patient.

                    " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                    by output on Mon Feb 22, 2010 at 08:01:48 AM PST

                    [ Parent ]

              •  that was my point (0+ / 0-)

                all it would take is a GOP election somewhere down the road, and they would stick in a Brownie type to run the PO into the ground, and then trumpet it as an example of how  the government can't do anytying.

                they ideas, all of  them, work so long as they are sheltered from this kind of politics. Medicare works (for now)because its enemies have not found a politically safe way to destroy it. so they are trying to starve it.

                •  I see that (0+ / 0-)

                  I'm trying to understand how someone could be cynical about this legislation, but still be supportive of a public option.  

                  That's not saying that I am against a public option, that's me trying to square some opinions that appear to contain conflicts.  

                  People don't get up in the morning and ask, Do I want single-payer or managed competition? Wellstone

                  by otto on Mon Feb 22, 2010 at 07:10:05 AM PST

                  [ Parent ]

                  •  I think it is based on the assumption (0+ / 0-)

                    that it would be politically unpalatable to mess with the public option in the same way it is a third rail to mess with Medicare.

                    One off regulation doesn't appear to have the same public impact if changes are made (EPA, SEC).  

                    At least I believe that is the thought...

                    "Just today, Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." Sen. Barack Obama

                    by justmy2 on Mon Feb 22, 2010 at 07:39:40 AM PST

                    [ Parent ]

              •  your conclusion does not follow from your premise (0+ / 0-)

                As it happens, DHHS now runs the largest insurance plan in the country, Medicare, with the highest "medical loss" ratio and customer satisfaction in the land. This is the administratively successful, fiscally responsible reality. There's nothing at all theoretical about it.

                " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                by output on Mon Feb 22, 2010 at 07:55:59 AM PST

                [ Parent ]

                •  It does (0+ / 0-)

                  My question was in response to the notion that a PO managed by HHS would be a good idea, but insurance price regulations under HHS would be a bad idea because they could be manipulated.

                  There's a dissonance that needs to be addressed.  

                  People don't get up in the morning and ask, Do I want single-payer or managed competition? Wellstone

                  by otto on Mon Feb 22, 2010 at 08:13:11 AM PST

                  [ Parent ]

                  •  you said, (0+ / 0-)

                    If regulation of the system doesn't mean anything because insurers can rig the game, then how in the world could we be expected to think that the PO would do any better under the direction of the HHS?

                    in essence, what i understand you to ask is how a board convened under the auspices of HHS is too weak to regulate private premiums, how can HHS, in providing insurance, avoid the corrupting influence of the industry.

                    no one said that regulatory boards are inherently manipulable. they are saying that this particular one is. what i said was that DHHS has a track record of successfully administering an insurance plan (a PO, really), and that it does not follow that creation of a sham regulator would alter that plan, or upset the effects of competition and supply and demand.  

                    " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                    by output on Mon Feb 22, 2010 at 08:39:12 AM PST

                    [ Parent ]

            •  the point is not to get their votes (0+ / 0-)

              the point is to use their united opposition to everything  obama says against them, in this case forcing them to stand in favor of rate increases. of course they will still be opposed to it, but if you make them take the unpopular road while they are doing it, you give cover to democrats who will need to go it alone.

          •  no one is saying that *all* regulatory (0+ / 0-)

            schemes are hard-wired to fail; only that this one seems to be. in fact, it sounds to me rather like an advisory body, not  (even) a (toothless) regulatory one.

            " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

            by output on Mon Feb 22, 2010 at 07:51:48 AM PST

            [ Parent ]

            •  i know no one is saying itq (0+ / 0-)

              but the question is still unanswered. if commissions can't control costs their designed to control becuase industry or their allies are set up as the oversears, what makes anyone think that the PO won't be vulnerable to the same problems? I can easily see the PO set up to fail once industry allies get themselves into position to appoint its managers.

              •  not sure what kind of public option (0+ / 0-)

                I can easily see the PO set up to fail once industry allies get themselves into position to appoint its managers

                you're proposing here. the most obvious means of establishing a PO is medicare. and the notion that a sham commission will have no effect on premium prices has nothing to do with whether DHHS can manage a health plan -  they already do.

                " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                by output on Mon Feb 22, 2010 at 09:34:18 AM PST

                [ Parent ]

        •  well why not wait and see (0+ / 0-)

          before declaring it a gift?

      •  Regulation can be a huge gift. (3+ / 0-)
        Recommended by:
        justmy2, poxonyou, J M F

        Think about regulated utilities for power and gas, or the old AT&T regulated telephone monopoly.

        They were typically regulated on a "cost plus" basis and guaranteed a certain percentage profit.  

        Very cool deal if you can get it.  If you can raise costs, you can raise profits.

        I worked for a while (under contract, not as an employee) at Lucent. It was a rather amazing place in many ways -- very very bright people, very cool stuff, but also a development process that could choke a horse. So much procedure, so many reviews, so much bureaucracy.

        Made tons of sense for a regulated monopoly: Spend the money you need to make sure you don't have outages and service calls.  Their workhorse 5ESS switch was classic 5 9s hardware, and making changes to the system required you to traverse a gantlet unlike most "mere" commercial work.

        And -- the extra cost meant extra profit.

        Free speech? Yeah, I've heard of that. Have you?

        by dinotrac on Mon Feb 22, 2010 at 06:48:17 AM PST

        [ Parent ]

      •  Here's my question, dansac: (0+ / 0-)

        Isn't this exactly what the Prudent Purchaser language is all about -- that the Exchange Board, if it sees an insurance company/plan as not acting in the best interest of its customers, the Exchange Board can kick the insurance company off the Exchange?

        Here is Sec. 1313(e)(2) of the Senate bill (H.R. 3590):

        (2) PREMIUM CONSIDERATIONS.—The Exchange shall require health plans seeking certification as qualified health plans to submit a justification for any premium increase prior to implementation of the increase. Such plans shall prominently post such information on their websites. The Exchange may take this information, and the information and the recommendations provided to the Exchange by the State under section 2794(b)(1) of the Public Health Service Act (relating to patterns or practices of excessive or unjustified premium increases), into consideration when determining whether to make such health plan available through the Exchange. The Exchange shall take into account any excess of premium growth outside the Exchange as compared to the rate of such growth inside the Exchange, including information reported by the States.

        In other words, insurance companies each year are required to show and justify their rate increases to the Exchange Board.  If the Exchange Board finds these rate increases to be unjustified, and the insurance company sticks their middle finger at them, then the Exchange Board can kick the insurance company off the Exchange.

        The House bill's provisions on which plans are and aren't allowed in on the Exchange are even stronger.  Here's Sec. 304(a)(2) of the House bill:

        (2) SOLICITING AND NEGOTIATING BIDS; CONTRACTS-

        (A) BID SOLICITATION- The Commissioner shall solicit bids from QHBP offering entities for the offering of Exchange-participating health benefits plans. Such bids shall include justification for proposed premiums.

        (B) BID REVIEW AND NEGOTIATION- The Commissioner shall, based upon a review of such bids including the premiums and their affordability, negotiate with such entities for the offering of such plans.

        (C) DENIAL OF EXCESSIVE PREMIUMS- The Commissioner shall deny excessive premiums and premium increases.

        (D) CONTRACTS- The Commissioner shall enter into contracts with such entities for the offering of such plans through the Health Insurance Exchange under terms (consistent with this title) negotiated between the Commissioner and such entities.

        In other words, in the House bill, the Exchange Board can prohibit an insurance company from even going on the Exchange if the Exchange Board finds the company's rates to be unreasonable, and the insurance company doesn't remedy this.  And like the Senate bill, the House bill also requires insurance companies to show and justify their rate increases each year, and allows the Exchange Board to kick the insurance company off the Exchange if the Board finds the insurance company's rate increases to be excessive, and the insurance company sticks their middle finger at the Exchange Board.

      •  I don't believe it anymore when they pass (0+ / 0-)

        regulations-

        I believe it when regulations are ENFORCED.

    •  acting like you are doing something while (2+ / 0-)
      Recommended by:
      hester, poxonyou

      opening a loophole as big as  canyon for Lobbyist navigate through, gaming the system.

      keep the bureaucrats and give us the public option.

      •  This is bigger than the public option dude. (4+ / 0-)

        The public option won't touch a fraction of the people that need help in this country; allowing those 55+ to buy into Medicaid would do more to help actual people than the public option.

        This provides a direct means to regulate the insurance industry and stop rate hikes.

        That's huge and affects EVERYONE that has insurance or will purchase insurance. How can you dismiss this rationally?

    •  That left fringe is coming out (8+ / 0-)

      You just can't help yourself. Stop trying to find negativity with anything and everything.

      •  oh stop. if the president came out for medicare (3+ / 0-)
        Recommended by:
        Alumbrados, CoolOnion, J M F

        for all, or just medicare buy in for 55 or some age group there would be round of applause from us "fringe" members. many of us don't see that mandating ins. purchase w/o government sponsored competition is much change.

        I happen to believe that Medicare buy in is the best option b/c the program is already in place.

        But with all the regulations states have in place, the insurance industry sure has made out like bandits.

        frankly it has NOTHING to do w Obama. It has to do with his Proposals and ideas and leadership. Not the man.

        "Outside of a dog, a book is a man's best friend. Inside of a dog, it is too dark to read." Groucho Mark

        by hester on Mon Feb 22, 2010 at 06:51:01 AM PST

        [ Parent ]

    •  No they won't. They can't game national regulator (7+ / 0-)
      Recommended by:
      dansac, Fabienne, Seeds, Bush Bites, meldroc, zizi, jtown

      It's like saying companies love the EPA.

      This will be direct power to stop exessive rate increases and there will be political fallout if any executive doesn't act on something every American can feel in their pocket books.

      This is huge and to dismiss it is willfully overlooking the progressive moves this president is making.

      I swear, I think some at DailyKos are determined to turn Obama into some Black Jimmy Carter to feed their own views of him.

      •  Remember who Obama picks for these things (2+ / 0-)
        Recommended by:
        hester, poxonyou

        Obama Appoints Monsanto Man as FDA Food Safety Czar

        http://current.com/...

        Something about foxes and henhouses.

        •  Why are u willfully trying to dismiss this? (3+ / 0-)
          Recommended by:
          dansac, Fabienne, Bush Bites

          Seriously.

          EVERY rate hike will be something that can be brought up against an elected official. This is something EVERY American will feel in their pocket books and a place for them to seek recourse through their elected officials. This is huge and means a path for consistent reforms as the burden of constantly pushing for innovation and good coverage will fall on Congress.

          This is a path to real health care reform continually occurring IMO. We may disagree, but this is a purely progressive measure and if you don't trust Obama to implement it I can tell you it's something EVERY politico will hear about as they run from their constituents.

          •  Fool me once, shame on you (1+ / 0-)
            Recommended by:
            linusben31

            We've been screwed so many times now, it's quite foolish to not look at everything in a critical light no matter which party, or politician/president, it's coming from.

            •  Then make a critical argument. (0+ / 0-)

              Because I haven't read one yet.

              This to me seems like an a purely good idea.

              Create a regulator with the power to stop excessive rate hikes. Every senator and house member will have their constituents calling about increases in their insurance bill. This will lead to sustained discussion of the health care industry in this country and that leads to sustained reform. Plus, this becomes a bipartisan issue as the NHS is in England. Conservatives and Liberals will be on their constituents pocketbooks sides; because the industry can't run an ad dismissing the real money they're vacuuming from American pocketbooks.

              This aligns Congressional interests with those of the people; that's why I bet the fight to kill it is HUGE.

              And STILL the President can't count on progressives to stand up for this reform, it's sad and pitiful of you IMO.

          •  "Trust" ? (0+ / 0-)

            New Evidence of Pharma's Sweetheart Deal

            http://www.tnr.com/...

            Sorry. The S.S. Trust sailed out of port a long time ago.

            •  This puts Congress on the side of voters money. (0+ / 0-)

              No commercial can mask the rate increases and with the power to control this in Federal hands; Congress will take a sustained interest in the health care industry. That leads to sustained reform that will undoubtedly be bipartisan.

              You don't need to trust in that; just read the proposal and tell me how this isn't good news for reformers.

              It's a path to continued change and innovation, IMO.

          •  Because we're Democrats (0+ / 0-)

            We think things through instead of following in lock-step like Republicans do.

            Sure, it means there's dissent in our ranks, but at least there's intelligent debate.  I wouldn't belong to a party that required lock-step loyalty.

            Change TX-32, Change the Nation. Send Democrat Grier Raggio to Congress.

            by CoolOnion on Mon Feb 22, 2010 at 07:16:17 AM PST

            [ Parent ]

        •  Of course, you could also pick up OSHA. (1+ / 0-)
          Recommended by:
          Dirtandiron

          The Chamber and other business groups have been complaining vociferously about Deborah Berkowitz. Seeing as how she came straight from the Culinary Union and AFL-CIO and what not.

    •  I dunno. That doesn't pass the smell test. (3+ / 0-)
      Recommended by:
      dansac, TomP, jtown

      The state regulators are largely powerless because of monopoly power of the insurers. No such monopoly exists on a national level. AHIP would have to be the force that would scramble the regulatory apparatus at the federal level.

      Furthermore, the national spotlight would probably work well since this would occur on a state by state basis. That brings a lot of Senators into the mix.

      I think this is a pretty good idea.

      •  Without a strong public option, there is no (2+ / 0-)
        Recommended by:
        poxonyou, output

        benchmark and premium rates are set by the insurers.  Would you rather rates be relative to what the insurers say they should be and then fiddled with by a commission or would you rather the government set the rate to begin with?

        The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

        by accumbens on Mon Feb 22, 2010 at 06:46:23 AM PST

        [ Parent ]

        •  I'd rather it be neither. (0+ / 0-)

          I'd rather there be price competition which is why I support the public option. But I also know monopolies don't break up overnight and some federal price control would be fantastic with or without a public option.

          So, even if you had a robust Medicare based public option, its still a good idea to have some federal price oversight.

          •  disagree. monopolies DO break up overnight (0+ / 0-)

            when you pass antitrust legislation.  but what are the odds of it being included in the full WH proposal?

            " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

            by output on Mon Feb 22, 2010 at 06:54:23 AM PST

            [ Parent ]

            •  Listen, (1+ / 0-)
              Recommended by:
              Fabienne

              I've worked as an antitrust lawyer. Read my diary history. Monoplies take years of litigation to break up.

              •  i don't care if you're a professional ferris (0+ / 0-)

                wheel owner. this particular monopoly could be broken up with the stroke of a pen repealing the anti-trust exemption. not to mention establishing Medicare for all; which would do nicely too.

                " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                by output on Mon Feb 22, 2010 at 07:10:02 AM PST

                [ Parent ]

                •  LOL (0+ / 0-)

                  Okay, you're starting to sound ridiculous. Facts be damned, huh?

                  You can't find one single example in the history of American competition law where a monopoly was broken up outside of a court of law.

                  •  we're talking about REPEAL of an (0+ / 0-)

                    anti-trust exemption; not the breakup of a "natural" monopoly. and we're not talking about history. i think you're being very disingenuous. and i couldn't help but notice that you didn't address the effect of establishing Medicare for all on monopoly power. please do me the courtesy of addressing that point.

                    " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                    by output on Mon Feb 22, 2010 at 07:31:16 AM PST

                    [ Parent ]

                    •  I've written extensively (0+ / 0-)

                      on this site on the repeal of the exemption in numberous diaries, beginning with this one from last May. I've also tried to inform this community on antitrust matters generally in a long list diaries on the subject.

                      Repealing McCarran-Ferguson will not, in and of itself, end monopoly. What it will do is give the federal government the power to fight monopoly...a similar sort of authority you seem to be against when it comes to price control. Breaking up a monopoly requires litigation under either the Sherman,  Clayton, or Robinson-Patman acts, notwithstanding action by the FTC under the FTC Act. These are civil court actions, not executive regulatory fiat.

                      To address your question of Medicare for all, which isn't under significant consideration by anyone with the power to make it happen, it wouldn't...in and of itself, end health insurance monopoly. If health insurers were smart, they'd simply buy a shitload of hospitals and refuse to take Medicare. In the end, Medicare would win, of course. But in the transition period, monopoly would continue to exist without antitrust action.

                      •  as an antitrust atty you know this would be (0+ / 0-)

                        If health insurers were smart, they'd simply buy a shitload of hospitals and refuse to take Medicare.

                        illegal, not to mention prohibitively expensive, time-consuming and speculative; anythng but smart.

                        " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                        by output on Mon Feb 22, 2010 at 08:06:50 AM PST

                        [ Parent ]

                        •  They already do. (0+ / 0-)

                          Look it up. Plenty of health insurance companies also own plenty of hospitals. Of course, they don't need to own a lot of them now because the current system is more profitable than owning hospitals. But if Medicare for all were enacted, I suspect they'd ramp up this area signficantly and use profits to litigate it to their favor.

                          •  and each and every one of them has to show that (0+ / 0-)

                            they will not create a monopoly in the process, which is why hospital chains are not bigger than they are,  probably why insurance companies don't own them all.

                            " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                            by output on Mon Feb 22, 2010 at 08:15:28 AM PST

                            [ Parent ]

                          •  if they want to be providers, i say let 'em! (0+ / 0-)

                            I suspect they'd ramp up this area signficantly and use profits to litigate it to their favor.

                            the upside is that they would at least be out of the business of rationing care and they would finally be earning an honest living.

                            it's like the old joke:
                            Q: who would you most like to have with you on a dessert island?
                            A: joe lieberman, because at least it would get him out of the senate

                            " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                            by output on Mon Feb 22, 2010 at 08:24:07 AM PST

                            [ Parent ]

                      •  competition from the largest insurer in the land (0+ / 0-)

                        To address your question of Medicare for all . . . it wouldn't...in and of itself, end health insurance monopoly.

                        would not end the insurance monopoly?

                        . . .  Medicare for all, which isn't under significant consideration by anyone with the power to make it happen . . .

                        it's not in the sorry little proposal described in the nyt piece, but it could most certainly could be enacted under the reconciliation process. yes we can!

                        " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

                        by output on Mon Feb 22, 2010 at 08:12:55 AM PST

                        [ Parent ]

        •  a robust PO is not only the ultimate market (2+ / 0-)
          Recommended by:
          accumbens, Bush Bites

          regulator, it has the advantage of making health care (as opposed to just insurance, because is isn't that really the point of this whole endeavor?) available, immediately, to all. anything else is just diddling around the edges; fiddling, while Rome burns.

          " unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most" - Paul Krugman

          by output on Mon Feb 22, 2010 at 06:51:25 AM PST

          [ Parent ]

        •  The public option that is being considered isn't (2+ / 0-)
          Recommended by:
          Fabienne, looking and listening

          A strong public option and isn't tied to Medicare rates and has no cost controls and can limit a fraction of the population.

          This regulatory power, however, deals directly with insurance profits and demands explanation for any increase and requires Congress to face these issues directly and sustained attention to the health care industry.

          This is the path to sustained reform.

          •  That's a damn shame, isn't it? (0+ / 0-)

            And who was the most visible Democrat to back away from a strong public option? I'll give you three guesses and the first two don't count.

            The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

            by accumbens on Mon Feb 22, 2010 at 06:55:25 AM PST

            [ Parent ]

            •  Leave aside the PO, how is this not totally good? (0+ / 0-)

              I don't get it.

              I want to understand.

              Why are you suspicious of this and do you want it to happen? Because without sustained support from the left; the president will be fighting another three front war and that will doom another good reform IMO.

              Industry will work double time to kill this.

              •  Because regulatory bodies are reactive, (0+ / 0-)

                they depend on who appoints them, they have been unsuccessful in keeping insurance rates down on  a state level, and without a benchmark (public option) they are always playing the insurers game.  As to the last point, imagine the EPA with no standards for water pollution except those set by industry.

                The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

                by accumbens on Mon Feb 22, 2010 at 07:12:51 AM PST

                [ Parent ]

                •  They can STOP some of these rate hikes. (0+ / 0-)

                  Given that they have that power; you don't think it's in the interest of elected officials to do their best to keep hikes manageable or eliminated?

                  As for the EPA, they set the standard not the industry and that's why Republicans and corporations hate them. The EPA, even when hampered by Bush, put out credible information that the Obama administration is acting on right now.

                  HHS will have support from a broader constituency for it's regulatory power IMO and that makes it more powerful no matter who is in the WH or controls congress b/c it's like Medicare: people have direct interaction w/their money. They aren't ideological about cash and there's not commercial to distort the reality of a rate hike.

                  This is significant legislation that aligns voter interest w/Congress and the WH in a significant way IMO.

        •  I think price regulation is better than the PO. (0+ / 0-)

          The public option was always just a way to get realistic pricing into the market anyway.

          This does that without going through the "free market, supply and demand" stuff that was just a sop to the blue dogs anyway.

          Bush Bites is a subsidiary of Bush Bites Inc., a registered corporate personhood.

          by Bush Bites on Mon Feb 22, 2010 at 07:00:48 AM PST

          [ Parent ]

      •  Do you think Anthem would be able (0+ / 0-)

        to justify there increases based on costs increases?  Seems like they could find a rationale.  

        I mean we have reached the point where we are justifying bonuses for companies we have bailed out, and torture.  Justifying rate increases doesn't seem that hard to me.

        Are we looking for a spotlight on insurers with the hope of then finding the political will to change the system, or are we looking to change the system now?

        I think that is where the disagreements come in.

        "Just today, Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." Sen. Barack Obama

        by justmy2 on Mon Feb 22, 2010 at 07:44:38 AM PST

        [ Parent ]

    •  Buy off the regulators/exhaust them through lobby (1+ / 0-)
      Recommended by:
      accumbens

      ing. That's all it takes. It's what they do with everything else. The lobbyists are paid to hound the politicians all day long, everyday, and can do so more directly than we can.

    •  Fed has more power than the states. (0+ / 0-)

      I imagine that's the idea behind it.

      Bush Bites is a subsidiary of Bush Bites Inc., a registered corporate personhood.

      by Bush Bites on Mon Feb 22, 2010 at 06:57:08 AM PST

      [ Parent ]

    •  Obama is evil. (2+ / 0-)
      Recommended by:
      ManhattanMan, Bush Bites

      Any news that we hear can only mean that he is up to no good! Golly, how I miss having Bush in charge! I'm so glad that there are so many Kossacks that can interpret everything to mean that we are getting screwed by that Dem President of ours.

      Sarah Palin has all the answers in the palm of her hand.

      by kitebro on Mon Feb 22, 2010 at 07:03:57 AM PST

      [ Parent ]

      •  I don't think Obama is evil. I think his heart (1+ / 0-)
        Recommended by:
        IndieGuy

        is in the right place.  I just think he's failing at leadership (being a non-directive leader and all) and is quickly becoming ineffective.

        The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

        by accumbens on Mon Feb 22, 2010 at 07:15:00 AM PST

        [ Parent ]

    •  I thought this was in the bill... (0+ / 0-)

      And I thought your point was the exact point made when this was stated as the mechanism for ensuring competition?

      "Just today, Senator McCain offered up the oldest Washington stunt in the book - you pass the buck to a commission to study the problem." Sen. Barack Obama

      by justmy2 on Mon Feb 22, 2010 at 07:17:53 AM PST

      [ Parent ]

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