Every DUer Should Read grantcart's Journal Entries On The Senate HCR Bill

[berni_mccoy]

This is very important and probably the least talked about points of the HCR Bill out of the Senate. It's why the House will support a final bill without the House version of a Public Option. Why? Because there actually is a Public Option in the Senate bill, it's just not run by the Federal Government. And furthermore, the OPM will strictly regulate the cost of plans and ensure the MLR is enforced. When I first learned of the Senate's bill with no PO, this was my biggest concern. That there would be too much wiggle room for insurance companies to play with the numbers. It turns out that there will be far more price regulation than I imagined and why it isn't discussed more here, I have no idea.

State Driven Public Options
Every private plan will need to compete with minimum standards set forth by a State regulated and non-profit run plan. The plan must adhere to strict standards set forth by the OPM.

From grantcarts first journal article on the topic ( http://journals.democraticunderground.com/grantcart/256 ):

In Kerry's recent long explanation of the bill he included the often heard "American citizens should have the opportunity to buy the same health care plans that federal employees and members of Congress enjoy" is repeated and this is what they are talking about.

Every state exchange will also must have atleast one "non profit plan".

The alternative in having OPM negotiating plans for small and individual buyers is not as desireable as having a clearly identifiable Robust Public Option. It is probably better than the severly more limited Public Option that we was being restricted to a small population simply because it is an established option that can be introduced relatively easily.

States have significant options to use this HCR and make it even stronger, for example States can increase the MLR in their state, reducing the gross margins

That's pretty powerful and shows how the current Senate bill may actually be stronger than the weakened PO that had originally been considered by the Senate.

A New Beginning

It's been recognized by even Dean that this bill could be what brings about a true Universal Single Payer system as each state has the power to go there. From grantcart's second journal entry on the topic ( http://journals.democraticunderground.com/grantcart/257 ), we find that Saskatchewan did something similar in Canada:

Yesterday on MTP Dr. Dean said, "We should pass the bill and improve it in conference. There are many good things in the Senate bill that we can build on . . . The House bill has a public option and we should include that. They say the Senate Bill has a substitute for a public option but it isn't really.


He is referring to the requirement that every state public option include atleast one non profit option.

As a reference point here is the Canadian timeline for single payer.
http://en.wikipedia.org/wiki/Canadian_health_care

1946 Saskatchewan Passes the Saskatchewan Hospitalization Act providing free hostpital care.

1957, the federal government passed the Hospital Insurance and Diagnostic Services Act paying 50% of province plans

1961 All provinces enact participating legislation, Saskatchewan enacts first full single payer plan.

1966 Medical Class Act allows provinces to establish universal care.

1984 Canadian Health Act prohibits userfess and any extra billing by physicians becoming truley a single payer system.

Ultimately nothing in the bill prevents states from
- passing legislation establishing a state non profit that operates as a Public Option?

- a collection of like minded states from joining such a non profit?

- pass legislation increasing private companies MLR.

- effectively eliminate private companies from the market place.

As grantcart points out:

If Tommy Douglas could do it in Saskatchewan then why can't we do it in states like Vermont?

The Senate Bill has slipped under the radar of the opposition and those focused on the Public Option. I too was one of those people focused on a PO or bust, and totally missed these incredible aspects of the bill. If this bill is passed, it would be the beginning of a massive revolution of the health care system of the United States.

I would like to publicly thank grantcart for his in-depth research and reporting on this topic and sticking to the facts of the bill. He is an invaluable member of Democratic Underground and I appreciate his work here.