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(5,387 posts)
Thu Aug 1, 2019, 12:17 PM Aug 2019

Unless the "public option" is free or inexpensive it's snake oil.. and dangerous snake oil at that.

This discussion thread was locked as off-topic by Autumn (a host of the General Discussion forum).

I'll start this discussion by stating that I consider Biden's and Bennet's debate performances last night as failures. They both insist that adding a "public option" to the ACA is the healthcare system we all should have, but what does that public option actually mean to a consumer? HOW MUCH would my premiums and deductibles be relative to a comparable plan provided by private insurance? THAT'S the most important question, and neither proffered an answer.

So let's address the proposal to keep the ACA:

The ACA should not be a Democratic sacred cow just because it began with the Obama Administration and is better than what we had previously. Even President Obama considered it only a stepping stone (albeit a significant one) on our way to single payer health CARE, as opposed to profit-dominated private health INSURANCE. So, why did he SETTLE for the ACA instead of single payer? Well, because it was constructed upon a Heritage Foundation concept he thought (naively) that he could at least get a few Republicans to agree to the plan, ostensibly unaware that all those Republicans had made a compact among themselves to thwart ANY and all programs that Obama might chalk up as achievements.

Most important in its consideration, in my view, is that the Affordable Care Act is certainly not "affordable" for many Americans... 27 MILLION of us are STILL uninsured. And then there are millions of people such as myself, who barely earned $50k last year but had to fork over $900+ per month, for just myself as a single person, for medical premiums under an ACA-subsidized plan.

Second, "insurance" companies, their executives, and their agents do not wield stethoscopes and scalpels. They don't operate cat-scan machines nor perform operations. They exist to generate PROFITS. And make no mistake about it... they generate ENORMOUS profits. And any and all profits that go to such middlemen could otherwise be directed to health care, itself. We already have real world examples... should I list them? Canada, the UK, France, Scandinavia, Japan, Australia... all of whom have better health CARE delivery than our own, not to mention greater life expectancies.

So, is adding a "public option" to this present mixture a way to reduce overall costs of health care? Please tell me how, because Joe Biden certainly hasn't. How would it eliminate private insurance as the primary element in our health care allocation system? How would it eliminate those PROFITS?

Well, I'll tell you how (again, Biden certainly hasn't) it COULD work. If we're going to have a "public option" on top of the ACA then its premiums must be free or nearly free, in order that employers can eliminate arrangements with private insurers and have their employees move to the public option, or purchase group public option plans themselves. Eventually, private insurance would be replaced as our dominant factor by the sheer weight of its expense to consumers.

So why is the public option "dangerous" at COMPETITIVE rates (i.e. market rates determined by the private insurance companies)? Because unless those rates are actually significantly better they will be perceived as pointless, endangering their very existence, and thus eliminating a movement to government assistance for universal care altogether.

I CAN NOT support your "public option" Joe unless you tell me it's going to be free or inexpensive. Right now you are endangering the future of universal health care.

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Unless the "public option" is free or inexpensive it's snake oil.. and dangerous snake oil at that. (Original Post) Goodheart Aug 2019 OP
In this political environment, the Public Option is likely the quickest way to Medicare-for-All, or Hoyt Aug 2019 #1
Current Medicare receipients pay $135 a month in premiums, sometimes more if they have an Advantage stopbush Aug 2019 #2
"endangering the future of universal health care" lapfog_1 Aug 2019 #3
So your against it. pwb Aug 2019 #4
How inexpensive? Midnightwalk Aug 2019 #5
Why should it be free or inexpensive to EVERYBODY? Somebody has to pay for it. pnwmom Aug 2019 #6
Locking. OPs about the candidates belong in Democratic Primaries. Autumn Aug 2019 #7


(54,770 posts)
1. In this political environment, the Public Option is likely the quickest way to Medicare-for-All, or
Thu Aug 1, 2019, 12:32 PM
Aug 2019

whatever you want to call it.

Running on M4A increases the likelihood of a GOP victory in 2020, putting significant healthcare reform another 4 or 8 years out.

A PO -- if it is as good as we think -- will attract people to it quickly. In short order -- assuming the public plan delivers -- it will be easy to convert the remaining 20% or so of hardliners to the public plan.

Ideally, we'd all just give up what we have now and go directly to a single Public Plan. But, that ain't gonna happen, too many people don't trust it, for whatever irrational reason.


(24,415 posts)
2. Current Medicare receipients pay $135 a month in premiums, sometimes more if they have an Advantage
Thu Aug 1, 2019, 12:35 PM
Aug 2019

plan. And that is per person.

One assumes that any public option buy-in would cost at least as much as Medicare, which means that a family of four would be paying $540 a month in premiums. Not bad, but not good if your employer happens to be paying 100% of your premiums.

Then, there's the 2.9% Medicare payroll tax that is shared by employee and employer (each pays 1.45%). That's $725 per year for an employee making $50,000 a year. But that deduction is only enough to cover the current 19% of people on Medicare. That deduction may need to increase FIVE FOLD to suddenly cover 100% of the population. That's $3625 a year for that person making $50,000.

And what about covering the wife and kids in a single-income household? Would that payroll tax deduction go even higher in such a situation?

Add it all up and a family of four under MFA earning $50,000 a year could be paying over $10,000 a year in premiums and taxes. Of course, one assumes there would be exceptions and exemptions for low-wage earners. Just a matter of where those lines are drawn.

Bottom line: no way a public option can ever be free.


(29,309 posts)
3. "endangering the future of universal health care"
Thu Aug 1, 2019, 12:38 PM
Aug 2019

how does one endanger a fantasy.

Until somebody explains to me how we get 60+ votes in the Senate with the current red / blue states, any new M4A or other UHC proposal... and I mean a serious explanation as to how do we not only win back the Senate, keep the House, and fight the special interests and the huge brain washing of the US electorate to oppose this... we pass this legislation for Sanders or Warren to sign.

We passed the ACA and it cost us control of the Senate and the House... and likely contributed to Trump being elected. Now the ACA is more popular than it has ever been... and the answer is "let's chuck it all and start over... and if you are employed you are going to lose your company provided insurance".

The candidates can debate M4A all they want... not one has come out and explained how they intend to get it placed into law. Because they can't.

Back when the ACA was being debated... public option was the "bridge too far" but everyone here at DU (and I was around then) was like "we must have it"... only a few were saying "yeah, but the REAL answer is single payer". Now, all of a sudden, public option "endangers the future of universal health care".


(11,461 posts)
4. So your against it.
Thu Aug 1, 2019, 12:39 PM
Aug 2019



(3,131 posts)
5. How inexpensive?
Thu Aug 1, 2019, 12:54 PM
Aug 2019

What if you had to pay 600 to 800 for a public option instead of the 900?

I’d agree if you said that still sucks and that people in other countries pay less.

Would you agree that you and others would choose to pay 600 instead of 900?

I agree that we need to make it so most people don’t need private insurance. We probably disagree how to get there.

Draining the profitability of private insurance might seem slower, but I think it has better chance for working than outright elimination. One danger is that insurance companies will fight against an unfair advantage of the public option but if they can win that fight we have no chance for direct elimination.

The battle is not just this election cycle but the next few. We don’t win until the majority of the country is under a new plan and likes it


(109,058 posts)
6. Why should it be free or inexpensive to EVERYBODY? Somebody has to pay for it.
Thu Aug 1, 2019, 12:54 PM
Aug 2019

Right now employers are paying premiums to insurers (except those who are self-insured). Those premiums are part of compensation packages. What happens to those funds?


(45,145 posts)
7. Locking. OPs about the candidates belong in Democratic Primaries.
Thu Aug 1, 2019, 12:56 PM
Aug 2019

Please repost there. Thank you.

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