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BeckyDem

(8,361 posts)
Wed Oct 16, 2019, 11:03 PM Oct 2019

The 'Public Option' on Health Care Is a Poison Pill

Last edited Wed Oct 16, 2019, 11:58 PM - Edit history (1)

Some Democratic candidates are pushing it as a free-choice version of Medicare for All. That’s good rhetoric but bad policy.
By David U. Himmelstein and Steffie Woolhandler
October 7, 2019

Health care reform has been the most hotly contested issue in the Democratic presidential debates. Bernie Sanders and Elizabeth Warren have been pushing a single-payer Medicare for All plan, under which a public insurer would cover everyone. They would ban private insurance, except for items not covered by the public plan, such as cosmetic surgery or private rooms in hospitals. The other Democratic contenders favor a “public option” reform that would introduce a Medicare-like public insurer but would allow private insurers to operate as well. They tout this approach as a less traumatic route to universal coverage that would preserve a free choice of insurers for people happy with their plans. And some public option backers go further, claiming that the system would painlessly transition to single payer as the public plan outperforms the private insurers.


That’s comforting rhetoric. But the case for a public option rests on faulty economic logic and naive assumptions about how private insurance actually works. Private insurers have proved endlessly creative at gaming the system to avoid fair competition, and they have used their immense lobbying clout to undermine regulators’ efforts to rein in their abuses. That’s enabled them to siphon hundreds of billions of dollars out of the health care system each year for their own profits and overhead costs while forcing doctors and hospitals to waste billions more on billing-related paperwork.

Those dollars have to come from somewhere. If private insurers required their customers to pay the full costs of private plans, they wouldn’t be able to compete with a public plan like the traditional Medicare program, whose overhead costs are far lower. But this is not the case: In fact, taxpayers—including those not enrolled in a private plan—pick up the tab for much of private insurers’ profligacy. And the high cost of keeping private insurance alive would make it prohibitively expensive to cover the 30 million uninsured in the United States and to upgrade coverage for the tens of millions with inadequate plans.

Public option proposals come in three main varieties:

§ A simple buy-in. Some proposals, including those by Joe Biden and Pete Buttigieg, would offer a Medicare-like public plan for sale alongside private plans on the insurance exchanges now available under the Affordable Care Act. These buy-in reforms would minimize the need for new taxes, since most enrollees would be charged premiums. But tens of millions would remain uninsured or with coverage so skimpy, they still couldn’t afford care.

https://www.thenation.com/article/insurance-health-care-medicare/

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
38 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
The 'Public Option' on Health Care Is a Poison Pill (Original Post) BeckyDem Oct 2019 OP
Yup. HerbChestnut Oct 2019 #1
Totally. BeckyDem Oct 2019 #2
M4A $34 trillion over 10 years. Yes your taxes will go up. wasupaloopa Oct 2019 #3
But so will the amount of care avalible for you. SterlingPound Oct 2019 #4
That fact is lost on some. BeckyDem Oct 2019 #7
YUP SterlingPound Oct 2019 #8
The fact that is lost is voters, therefore congress is never going to pass a 32 trillion $ bill! Thekaspervote Oct 2019 #24
You mean quality? Not necessarily for those with good plans ---some are affordable or paid for by emmaverybo Oct 2019 #22
That's fine. It will likely be cheaper than paying for private insurance. HerbChestnut Oct 2019 #13
Indeed. And I'm willing to pay a lot more taxes in order to get rid of the giant PatrickforO Oct 2019 #34
The DU rules specify a 4 paragraph limit, to avoid violating copyright limit. pnwmom Oct 2019 #5
+1 crazytown Oct 2019 #9
"The Nation" is a RW source nt NYMinute Oct 2019 #10
lol BeckyDem Oct 2019 #11
that is simply a false assertion, regardless of whether you agree with the OP or not Celerity Oct 2019 #15
It certainly has some pretty far out there ideas. Stopped reading anything they print Thekaspervote Oct 2019 #25
That's flat out false...it endosed Sen. Sanders in '16 AncientGeezer Oct 2019 #27
No it's not. What kind of talk is that? PatrickforO Oct 2019 #29
+10000 Yo_Mama_Been_Loggin Oct 2019 #20
Ah, that explains it. The Nation attacked Hillary. PatrickforO Oct 2019 #30
And The Nation has promoted Edward Snowden. n/t pnwmom Oct 2019 #33
From 2017 BeckyDem Oct 2019 #6
Oh please! Of course repubs favor repeal.. and replace with nothing Thekaspervote Oct 2019 #26
I think you're missing the point here ... compare and contrast the OP with this 2017 article mr_lebowski Oct 2019 #35
Please self-delete .. The Nation is a RW source nt BlueMississippi Oct 2019 #12
No, it is no such thing. The authors are also not right wing, not in any shape or form. BeckyDem Oct 2019 #14
DU was sued for copyright infringement and one reason it won the suit pnwmom Oct 2019 #19
You've got to be kidding. crazytown Oct 2019 #16
+10000 Celerity Oct 2019 #18
Thank you. BeckyDem Oct 2019 #21
yw Celerity Oct 2019 #23
lol, the same bollocks as the other poster making the exact same erroneous claim Celerity Oct 2019 #17
Who told you that? blm Oct 2019 #31
Horse pucky as we geezers say. AncientGeezer Oct 2019 #32
Wrong kcr Oct 2019 #37
Interesting logic, and compelling. PatrickforO Oct 2019 #28
Essential reading for all, but especially those who oppose M4A Fiendish Thingy Oct 2019 #36
Or will die PDittie Oct 2019 #38
 

HerbChestnut

(3,649 posts)
1. Yup.
Wed Oct 16, 2019, 11:05 PM
Oct 2019

It leaves the core of our current broken healthcare system intact. There is a reason most other industrialized countries have figured out some form of national health insurance.

If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

wasupaloopa

(4,516 posts)
3. M4A $34 trillion over 10 years. Yes your taxes will go up.
Wed Oct 16, 2019, 11:16 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

SterlingPound

(428 posts)
4. But so will the amount of care avalible for you.
Wed Oct 16, 2019, 11:23 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

BeckyDem

(8,361 posts)
7. That fact is lost on some.
Wed Oct 16, 2019, 11:35 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

SterlingPound

(428 posts)
8. YUP
Wed Oct 16, 2019, 11:37 PM
Oct 2019

How I will never know, but it sure is.

If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

Thekaspervote

(32,605 posts)
24. The fact that is lost is voters, therefore congress is never going to pass a 32 trillion $ bill!
Thu Oct 17, 2019, 12:55 AM
Oct 2019

CBO out today... these are the figures

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

emmaverybo

(8,144 posts)
22. You mean quality? Not necessarily for those with good plans ---some are affordable or paid for by
Thu Oct 17, 2019, 12:00 AM
Oct 2019

employers or retirement benefits. So the “you” needs to be qualified.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

HerbChestnut

(3,649 posts)
13. That's fine. It will likely be cheaper than paying for private insurance.
Wed Oct 16, 2019, 11:40 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

PatrickforO

(14,514 posts)
34. Indeed. And I'm willing to pay a lot more taxes in order to get rid of the giant
Thu Oct 17, 2019, 01:30 AM
Oct 2019

premiums I have to pay, and the financially crippling copays. Thus, I will have lower total costs for healthcare.

Do you know, this year is open enrollment time at my employer, and my premiums are up over 17%? And, if I end up in the hospital my yearly out of pocket max is 3 large. For each member of the family. And, they've put in a nice little loophole, too. Now, they say the 'max' out of pocket isn't necessarily the max - they can just say no, you have to pay more if they have even a little, tiny, weak justification for that.

Aren't you tired of hoping you don't get seriously sick and have to count on one of these companies to care for you? Because they don't care about you. They care about profits (or retained earnings, in the case of the not-for-profits).

What everyone needs to understand is that there is a direct conflict of interest for an insurance company to pay out on the treatments you need. They use complex actuarial tables to determine what your premiums ought to be, and that calculation is based on the statistical probability that you will ultimately pay in more than you cost. So, just with THAT, the insurance company has incentive to deny or skimp on treatment, and when we add in the concept of shareholder primacy, providing you the treatment you actually need is in direct conflict with profits.

This is why our system sucks so bad.

Now, look at what's happening. The corporate owned media are dutifully posing the question, 'won't M4A take away the private insurance plans of millions of Americans?'

And, during the debate, Warren got hammered when she answered the question of whether middle class taxes would go up with 'your costs will be less.' That is a true statement but I wish she would admit that taxes would go up, and then add 'and you won't have to pay premiums any more, or copays, or coinsurance. So your costs WILL actually go down.'

What is happening here is unconscionable, but then there are MILLIONS of dollars lined up against our politicians doing the right thing. For profit healthcare and big pharma are going to fight, and fight, and fight tooth and nail, 24/7/365 against even a public option, which as the Nation article points out, wouldn't necessarily work too well.

We're trying out a public option in Colorado, but I'm not sure how, or if, it will work. And, honestly, I'd rather have M4A because then not only would I and my family have enough, but everyone else would, too. And people who wanted could still purchase supplemental policies as they do in other, more civilized, countries than ours.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

pnwmom

(108,925 posts)
5. The DU rules specify a 4 paragraph limit, to avoid violating copyright limit.
Wed Oct 16, 2019, 11:25 PM
Oct 2019

And the Nation, which attacked Hillary frequently in 2016, isn't one that deserves an exemption from the rules, IMHO.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

NYMinute

(3,256 posts)
10. "The Nation" is a RW source nt
Wed Oct 16, 2019, 11:38 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

Celerity

(42,637 posts)
15. that is simply a false assertion, regardless of whether you agree with the OP or not
Wed Oct 16, 2019, 11:45 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

Thekaspervote

(32,605 posts)
25. It certainly has some pretty far out there ideas. Stopped reading anything they print
Thu Oct 17, 2019, 12:56 AM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

AncientGeezer

(2,146 posts)
27. That's flat out false...it endosed Sen. Sanders in '16
Thu Oct 17, 2019, 01:10 AM
Oct 2019

From the Nation's website...."About The Nation

Principled. Progressive. The Nation speaks truth to power to build a more just society."

If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

PatrickforO

(14,514 posts)
29. No it's not. What kind of talk is that?
Thu Oct 17, 2019, 01:13 AM
Oct 2019

You know very well the Nation is a left-leaning publication.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

PatrickforO

(14,514 posts)
30. Ah, that explains it. The Nation attacked Hillary.
Thu Oct 17, 2019, 01:15 AM
Oct 2019

One person below is calling it a right wing source, which is not true. The poster should probably edit and cut to four paragraphs, but just because the Nation was critical of Clinton in 2016 does not necessarily put it in opposition to the Democratic party.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

pnwmom

(108,925 posts)
33. And The Nation has promoted Edward Snowden. n/t
Thu Oct 17, 2019, 01:27 AM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

BeckyDem

(8,361 posts)
6. From 2017
Wed Oct 16, 2019, 11:34 PM
Oct 2019

Single-Payer Reform Purported to Save Estimated $504 Billion

The latest repeal and replace plan from GOP leaders contains various references to limiting Medicaid spending through set state budgets. But Steffie Woolhandler, MD, MPH, and David U. Himmelstein, MD, do not support the GOP plan, citing significant economic and social impacts whether the ACA is kept or repealed. The pair claims that a single payer healthcare can improve patient outcomes with affordable and fiscally sustainable alternatives.

“The ACA has helped millions. However, our healthcare system remains deeply flawed,” write Woolhandler and Himmelstein.

“Reforms that move forward from the ACA are urgently needed and widely supported,” they continue. “Even two fifths of Republicans (and 53% of those favoring repeal of the ACA) would opt for single-payer reform (10). Yet, the current Washington regime seems intent on moving backward, threatening to replace the ACA with something far worse. Polls show that most Americans – including most people who want the ACA repealed, and even a strong minority of Republicans – want single-payer reform. And doctors are crying out for such reform.”

According to their findings, streamlining a single payer system could produce an estimated savings of $220 billion on insurance overhead. Over $150 billion in hospital administration costs can potentially be saved and $75 billion in paperwork costs could be reduced under a single payer program.

https://healthpayerintelligence.com/news/single-payer-reform-purported-to-save-estimated-504-billion

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

Thekaspervote

(32,605 posts)
26. Oh please! Of course repubs favor repeal.. and replace with nothing
Thu Oct 17, 2019, 12:58 AM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

mr_lebowski

(33,643 posts)
35. I think you're missing the point here ... compare and contrast the OP with this 2017 article
Thu Oct 17, 2019, 01:53 AM
Oct 2019

And you should find that there's been a significant change in these 2 author's rhetoric re: a single-payer plan.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

BlueMississippi

(776 posts)
12. Please self-delete .. The Nation is a RW source nt
Wed Oct 16, 2019, 11:39 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

BeckyDem

(8,361 posts)
14. No, it is no such thing. The authors are also not right wing, not in any shape or form.
Wed Oct 16, 2019, 11:41 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

pnwmom

(108,925 posts)
19. DU was sued for copyright infringement and one reason it won the suit
Wed Oct 16, 2019, 11:51 PM
Oct 2019

is because of the 4 paragraph limit.

So why won't you just follow the rule? It's in the Terms of Service

Respect copyrights
Excerpts from copyrighted sources must be no more than four paragraphs and include a link to the source. See our DMCA Copyright Policy for more information.
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

crazytown

(7,277 posts)
16. You've got to be kidding.
Wed Oct 16, 2019, 11:48 PM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

Celerity

(42,637 posts)
17. lol, the same bollocks as the other poster making the exact same erroneous claim
Wed Oct 16, 2019, 11:48 PM
Oct 2019

Regardless of whether you agree or not with the OP, it serves no legit purpose to posit falsehoods

https://mediabiasfactcheck.com/the-nation/

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

blm

(112,919 posts)
31. Who told you that?
Thu Oct 17, 2019, 01:21 AM
Oct 2019
If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

AncientGeezer

(2,146 posts)
32. Horse pucky as we geezers say.
Thu Oct 17, 2019, 01:21 AM
Oct 2019

They endorsed Sen Sanders in '16.....from the "About" pg...
"About The Nation Principled. Progressive. The Nation speaks truth to power to build a more just society."

If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

kcr

(15,300 posts)
37. Wrong
Thu Oct 17, 2019, 03:52 AM
Oct 2019

Don't know who told you that, but you were misinformed.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

PatrickforO

(14,514 posts)
28. Interesting logic, and compelling.
Thu Oct 17, 2019, 01:11 AM
Oct 2019

I saw another post on here that used the analogy of us getting nickel and dimed by the airlines after they were deregulated to show that the public would not buy the argument that overall cost would go down.

But, you know, that post made me think maybe we ought to re-regulate the airlines.

Your post, I agree with. Medicare for all would be the right thing to do, but it will take major political courage on the part of the whole Democratic party to roll over the billion dollar healthcare provider and big pharma lobbies.

If I were to vote in a presidential
primary today, I would vote for:
Joe Biden
 

Fiendish Thingy

(15,361 posts)
36. Essential reading for all, but especially those who oppose M4A
Thu Oct 17, 2019, 01:57 AM
Oct 2019

Just as Warren refuses to utter a word about taxes regarding her M4A plan, those candidates who oppose M4A refuse to acknowledge the shortcomings of their proposals, especially the millions who will remain without coverage, or will still go bankrupt from medical debt.

If I were to vote in a presidential
primary today, I would vote for:
Undecided
 

PDittie

(8,322 posts)
38. Or will die
Thu Oct 17, 2019, 07:48 AM
Oct 2019

because they cannot afford their meds, or to go see the doctor because they shudder at the thought of the bills they'll get. EVEN THOSE WITH GOOD INSURANCE.

If I were to vote in a presidential
primary today, I would vote for:
Undecided
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