Last month, I posted this diary on a solution to the public option, building upon the compromise in the Senate that called for the creation of at least two privately-run profit/non-profit, national or multi-state insurance plans. My diary didn't get a lot of attention, most likely because I published it a month after the compromise was announced.
No matter...I still pressed on with my research, because I wanted to see if it held merit. To my pleasant surprise, I discovered someone else had a similar idea:
Proponents of the public option envision it functioning just like a private-sector insurance company, as one of the options accessed through the "purchasing exchange". To do so, it would engage in a number of activities: (a) it would market the program, and pool together individuals, families, and small businesses who choose to enroll; (b) the Federal government would underwrite the program and take on the financial responsibility (i.e., assume the risk); (c) the government would establish the premium rates; and (d) the government would administer all aspects of the program, including collecting premiums, enlisting providers, and paying claims.
However, the goals of the public option could be achieved by fulfilling just some of these roles, and, in so doing, placating its opponents. A hybrid model could serve this market through a true public-private partnership between the government and the insurance companies, with a blend of roles:
As you can see, Brad's plan is much more fleshed out than mine, as far as the actual implementation and administration of the public-private hybrid is concerned. I share his view that this compromise "has the potential to satisfy a broad range of stakeholders and achieve sufficient support to enable the health reform legislation to proceed on to other issues."
Brad is not the only person to have come up with such a solution -- other experts have gone so far as to call for creating federally-chartered health insurers. (I believe the Senate compromise only calls for insurers to enter into a contract with the government.) And back in 2004,long before this current debate, Republican Senator Bill Frist of all people,
floated the idea that the country should create a publicly-chartered private insurer that would help create a big secondary market for health insurance. If it ever came into being, Healthy Mae, patterned after the mortgage market-maker Fannie Mae, would be designed to give individual buyers access to a more stable insurance market — which presumably would feature lower rates that could keep more people covered. (Bold quote mine)
So here are the theories. But could this theory of a public-private hybrid insurance plan be transformed into reality? Well, it already is: FEMA'S National Flood Insurance Program, created in 1968:
The National Flood Insurance Program (NFIP) is administered by the Federal Emergency Management Agency (FEMA), which works closely with nearly 90 private insurance companies to offer flood insurance to property owners and renters.
The Senate compromise, if I read it correctly, calls for such a partnership between public and private entities.
So,if we have some creative lawmakers/policymakers on Capitol Hill put this proposal on the table (hopefully, THIS policymaker), I truly believe it could bridge the gap between liberal/progressive and moderate/conservative House and Senate Democrats, and may, FINALLY, get us over the one-yard line. (Forget the Republicans. We all know they've gone bye-bye on this. The most this will do is put them on the defensive -- but intellectually, they're outta here.)
P.S. As I spelled out in my previous diary, I would have the program administered by HHS's Health Resources and Services Administration, and have the participating insurers contribute a portion of their profits to a fund to support a non-profit health care provider system, with HRSA's Community Health Center program as the linchpin.
As far as the federally-chartered health insurance idea, I'd rather wait until a proposed National Insurance Consumer Protection Act, which creates the Office of National Insurance, becomes reality. The proposal does not cover health insurance, but the office could provide technical support for HRSA in their oversight of the federally-chartered health insurers.