“No one has ever put up a plan to compete that exploited the bargaining leverage that you have with Medicare,” said John F. Sheils, a senior vice president at Lewin, which is owned by UnitedHealth Group, a major insurer. “It’s never been done, and if it’s never been done there’s not much you can conclude from looking at these state plans.”
Mr. Sheils estimated that only 12 million people with private coverage would migrate to a public plan if Congress provided protections for insurers, along principles suggested by Senator Charles E. Schumer, Democrat of New York. Seeking to broker a deal that might attract Republican support, Mr. Schumer is promoting many of Mr. Nichols’s proposals, including that a public plan be subject to the same regulations as private plans and that it pay providers at higher levels than Medicare.
The question, at a time of deep concern over health costs, is whether that proposal would compromise away the full potential of a public plan to suppress provider payments and control the growth of premiums.
And it's rather interesting how a lobbyist for UnitedHealth, one of the WORST insurers, thinks that the Schumer so-called "public option" compromise would be okay. This is why I always specify what kind of a public option to fight for--a strong, robust Medicare-like public option, NOT the Schumer so-called compromise.
This is what I wrote about what I viewed as the dangerous parts of the so-called Schumer "public option" compromise:
I don't think the public plan should be self-sustaining, because if it's wholly reliant on money raised from premiums and co-payments, that means that the premiums and co-payments will be higher than those of the premiums and co-payments offered by private health plans.
And yes, the government should compel doctors and hospitals to participate in a public plan, otherwise the doctors and hospitals will refuse to take the patients in the public plan just like they refuse to take on any new Medicare patients. In order for the public plan to work, it has to have widespread participation by medical professionals which translate to universal access for Americans. In any city, town, or state, they should be able to go to a doctor who can't refuse to take them on. In a small town, a doctor might be enticed by private plan insurers to refuse patients from the public option. That's why I'm against the second bullet point in Senator Schumer's cockamamie proposal.
And there should be NO private officials to manage a public plan. It MUST be managed by the government to promote efficiency and to reduce administrative overhead in the public plan. There can be NO appointment of officials from the private health insurance industry to manage the public plan.
This sort of "middle ground" is unacceptable for me.
We NEED have a strong, robust Medicare-like public option with NO "7-year triggers" or "conditions" designed to weaken it in favor of private health insurance companies.
On Friday, the Congressional Progressive Caucus, which numbers over 80 Democrats in the House stood up for a strong, robust Medicare-like public option in their principles below:
The Congressional Progressive Caucus calls for a robust public option that must be:
• Unconditional. Enact concurrently with other significant expansions of coverage and must not be conditioned on private industry actions.
• Actually Public. Consist of one entity, operated by the federal government, which sets policies and bears the risk for paying medical claims to keep administrative costs low and provide a higher standard of care.
• Available to All. Be available to all individuals and employers across the nation without limitation
• Choice of Doctors. Allow patients to have access to their choice of doctors and other providers that meet defined participation standards, similar to the traditional Medicare model, promote the medical home model, and eliminate lifetime caps on benefits.
• Paid for Wellness, not Sickness. Have the ability to structure the provider rates to promote quality care, primary care, prevention, chronic care management, and good public health.
• Built on Proven Model of Medicare. Utilize the existing infrastructure of successful public programs like Medicare in order to maintain transparency and consumer protections for administering processes including payment systems, claims and appeals.
• Can negotiate payments. Establish or negotiate rates with pharmaceutical companies, durable medical equipment providers, and other providers to achieve the lowest prices for consumers.
• Equally Supported. Receive a level of subsidy and support that is no less than that received by private plans.
• Real Competition. Ensure premiums must be priced at the lowest levels possible, not tied to the rates of private insurance plans.
Now, what is this "7-year trigger" for the public option in health care reform, you ask? Basically, they'll insert a strong Medicare-like public option in the final bill but have it as a "trigger" only to set in SEVEN YEARS FROM NOW if private insurance fails to make health insurance affordable for Americans.
Robert Reich, as I posted before, has said that this is being floated as an attractive compromise to attract Republican votes in order to give this health care reform bill the sheen of "bipartisanship" that is craved by politicians.
All this will be decided within days or weeks. And once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal -- Snowe's "trigger" or any other -- the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well.
This is it, folks. The concrete is being mixed and about to be poured. And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle.
Which is why WHENEVER we refer to the public option, we ALWAYS should refer to it as a "strong, robust Medicare-like public option" in our phone calls, e-mails, and letters to the White House, the House of Representatives, and the Senate.
Here's the talking points that you can and should use when calling in favor of a strong, robust Medicare-like public option, and remember, the "trigger" may happen if we don't let up in our opposition to it in our phone calls:
Tell Senator [Name] that you DO NOT want the 7-year trigger for the public option and take it off the table, and that you want him to support an affordable strong, robust Medicare-like public option. We NEED a strong, robust Medicare-like public option NOW OPEN TO ALL AMERICANS AND AFFORDABLE, not more of the SAME broken system that's given us unaffordable premiums, little private insurance coverage, and rising co-pays. Also, DON'T TAX OUR EMPLOYER HEALTH BENEFITS. Instead, follow the proposal by President Obama to tax the wealthy above $250,000, eliminate the overpayments in Medicare Advantage, and put tax capital gains to help fund health care reform. TELL YOUR SENATOR NO ON THE SCHUMER COMPROMISE.
CALL the White House at: 202-456-1111 and E-MAIL them as well!
Please CALL Senator Max Baucus at (202) 224-2651
Please CALL Senator Olympia Snowe at (202) 224-5344
Please CALL Senator Charles Schumer at 202-224-6542
Please CALL Senator Edward Kennedy at (202) 224-4543
Please CALL Senator John Rockefeller at (202) 224-6472
Please CALL Senator Ron Wyden at (202) 224-5244
Please CALL Senator Kent Conrad at (202) 224-2043
Please CALL Senator Jeff Bingaman at (202) 224-5521
Please CALL Senator John Kerry at (202) 224-2742
Please CALL Senator Blanche Lincoln at 202-224-4843
Please CALL Senator Debbie Stabenow at (202) 224-4822
Please CALL Senator Maria Cantwell at 202-224-3441
Please CALL Senator Bill Nelson at 202-224-5274
Please CALL Senator Robert Menendez at 202-224-4744
Please CALL Senator Thomas Carper at (202) 224-2441
It's really important that we CALL these Senators on the Senate Finance Committee because some of them are still SERIOUSLY considering the 7-year trigger for the public option in case private insurance fails. Well, here's a frickin' news alert--private insurance ALREADY has failed us.
We have to get them to stop considering the public option as a "fall-back trigger" seven years from now, because we NEED a Medicare-like public option NOW that is affordable and OPEN TO ALL Americans.
Also, can you please CALL these THREE chairmen in the House of Representatives, especially Rep. Waxman who's leading the charge on health care reform below?
Ways and Means Committee Chair Charlie Rangel (202) 225-3625)
Energy and Commerce Committee Chair Henry Waxman (202) 225-2927)
Education and Labor Committee Chair George Miller (202) 225-3725)
And remember, don't trust whatever Senator Baucus says about a public option in health care reform and we should always verify until we trust.
So, PLEASE CALL and let them KNOW that you want a Medicare-like public option in health care reform! Ask them not to pass a bill out of the House that does NOT include a strong, robust Medicare-like public option that is AFFORDABLE AND OPEN TO ALL AMERICANS.
A Medicare-like public option is the line in the sand for me. Is it the line in the sand for you as well?
If so, then CALL, and please help keep this on the rec list so others can see the phone numbers, call today, and help fight against the swiftboating of a strong, robust Medicare-like public option in health care reform.
I've also started my own blog called "The Line In The Sand" where I'll be posting more than once a day about health care reform, the latest news with disability legislation, and other political subjects that you might be interested in as well.
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