Robert Reich: How Pharma and Insurance Intend to Kill the Public Option

[marmar]

How Pharma and Insurance Intend to Kill the Public Option, And What Obama and the Rest of Us Must Do


I'ved poked around Washington today, talking with friends on the Hill who confirm the worst: Big Pharma and Big Insurance are gaining ground in their campaign to kill the public option in the emerging health care bill.

You know why, of course. They don't want a public option that would compete with private insurers and use its bargaining power to negotiate better rates with drug companies. They argue that would be unfair. Unfair? Unfair to give more people better health care at lower cost? To Pharma and Insurance, "unfair" is anything that undermines their profits.

So they're pulling out all the stops -- pushing Democrats and a handful of so-called "moderate" Republicans who say they're in favor of a public option to support legislation that would include it in name only. One of their proposals is to break up the public option into small pieces under multiple regional third-party administrators that would have little or no bargaining leverage. A second is to give the public option to the states where Big Pharma and Big Insurance can easily buy off legislators and officials, as they've been doing for years. A third is bind the public plan to the same rules private insurers have already wangled, thereby making it impossible for the public plan to put competitive pressure on the insurers.

Max Baucus, Chair of Senate Finance (now exactly why does the Senate Finance Committee have so much say over health care?) hasn't shown his cards but staffers tell me he's more than happy to sign on to any one of these. But Baucus is waiting for more support from his colleagues, and none of the three proposals has emerged as the leading candidate for those who want to kill the public option without showing they're killing it. Meanwhile, Ted Kennedy and his staff are still pushing for a full public option, but with Kennedy ailing, he might not be able to round up the votes. (Kennedy's health committee released a draft of a bill today, which contains the full public option.) ...............(more)

The complete piece is at: http://robertreich.blogspot.com/2009/06/public-option-smokescreens-and-what-you.html

[Cleita]

1. This is why I'm against insurance companies being in any health care

reform. They don't want to play fair because they know they can't compete without losing their big, fat profit margin. I was for a while ready to compromise and say okay, let them compete on the open market with a publicly run plan. Then I started reading about how they are going to fight any public plan or get it so watered down as to be useless. Screw them. We don't need them. I swear to God if this happens, I'm going to do what I can to put together an insurance company that offers comprehensive health insurance to businesses and unions, undercutting the insurance companies in every way I can to run them out of business. Then I hope to be able to offer it to everyone. It will result in being single payer just not government run single payer. It will be non-profit and maybe even employee owned like a cooperative. I'm looking into the financing and hope I can pull it off. If I can't maybe somebody can.

[snappyturtle]

5. Good luck to you! I feel the same way. I was ready to cave for the public

option until I learned that they will be stripped of attributes to sustain it. So, now I'm again, once again, e-mailing and calling and signing any on-line petition I run across to fully support single payer which is what I've wanted anyway.

[tomm2thumbs]

43. Our Congress should be required to use the LEAST of our insurance offerings as their coverage

They can reap what they sow. Maybe they'll get it then.

[DaLittle Kitty]

47. These People Of BOTH Parties Are Criminals! John Russell FAXED His Health Plan

yesterday to Miller, Waxman and Rangel. They have all the information they need. These klowns are bought and paid for. If Obama thinks that he is gonna get re-elected with a Bullshit health care plan such as described by Reich he has got another thing commin. This sort of BS totally opens the door to third party players for Congress Senate etc. BOTH parties need to be held accountable... to the people! John Russell's Health Plan http://www.johnrussellforcongress.com/page.asp?PageId=35

[B Calm]

2. We have the best government corporations can buy!

[MannyGoldstein]

3. Change? Or Change For A Dollar?

I guess we'll soon find out more.

[snot]

4. k&r'd.

[customerserviceguy]

6. I don't think a public option would be competitive

I think that over time, it would become a dumping ground for those that the insurance companies don't want to cover. They've built an entire business model off of cherry picking the healthiest groups, then denying coverage when those people actually start needing something. Having a public option just makes it easier for them to get away with that.

Single payer is the only thing that makes sense. Public option delays the day that we get to that sort of sensibility.

[Faryn Balyncd]

7. That's what would happen without OPEN ENROLLMENT in all plans (& why Obama's letter stated that ....

....reform needs BOTH a Public Option and Open Enrollment (no pre-existing condition exclusion).

Open Enrollment in the private plans is the key to whether the public option becomes the high risk insurer, allowing continued cherry picking protected by the taxpayer support of the public plan, OR whether the private plans are forced to compete with the public option. In the latter case, if they don't drastically cut their administrative expenses, they will lose customers to the public option. Grassley has said (negatively in his view) that 119 million Americans are ready to dump their private insurance for a public plan.

Open Enrollment in all private plans is one of the keys to whether or not the Public Option will be viable. And to whether or not it has the potential to evolve into a near Single Payer system voluntarily.

[sandnsea]

32. Two days before Robert Reich's column

Obama's letter was posted here so I really don't know how people can dismiss its existence and act as though Robert Reich is presenting new info here. Groups were already fighting the trigger before this. I love Robert Reich, but I will never understand how two people can say the exact same thing and one is glorified and one is villified.

[my future me]

20. I have to agree with you completely

Private businesses have the right to refuse service to anyone that they wish, therefore they would clearly reject those at risk or with previous conditions. This would leave the government with a higher cost per person covered. Similarly, one way the companies could greatly increase profits would be to design "exclusive" health plans creating different "standards" of care based on income.

[ProudDad]

36. Not true...

"Private businesses have the right to refuse service to anyone"

In Vermont they passed a law requiring all insurance companies to accept anyone who can pay and they were NOT allowed charge more than 20% over the base rate for those with pre-existing conditions.

A Federal law requiring all insurance companies to accept all persons equally would overrule your fallacious assumption.

[customerserviceguy]

48. It's just like all those "We reserve the right to refuse service to anyone" signs

that you see out in redneck country. All the for-profit institutions have to do with any individuals or groups is just target which ones to give lousy service to, and hope that they say the hell with it, and go for the public option.

You don't have to actively state that you want to discriminate in order to do it. I'm pretty sure that's a lesson that we've learned over the years.

[dflprincess]

29. I think you're right about the public option becoming a dumping ground

(regardless of whether or not it will be legal to do so) and by doing that, the public option will cost more and will fail. Then the private insurers can point at it and say "told ya so" and we will never get single payer.

[DAMANgoldberg]

34. Quite true

After all, the Auto Insurance companies cherry pick their best clients "drivers" and dump the rest onto the high risk, state mandated pool. I'm not saying it's right, but there is a precedent. Access to personal transportation is a necessity in most of the US, and certainly in flyover country (CLT). The question is simple. Do we as a nation want everyone to have health insurance or health care? These are not the same thing.

[ProudDad]

37. When I was young and got my first driver's license

there was single-payer car insurance -- a state pool that was financed from registration and license fees...

And covered all uninsured motorists.

No fights, no legal battles, no muss, no fuss, no profits!

The real question is: "Is health care a right or a privilege to be rationed by the sociopaths in the 'free market'?"

[customerserviceguy]

49. Did it actually charge everybody nothing?

I despise the auto insurance companies for their "legal" discrimination based on age, gender, and marital status, but I do support higher premiums for people who have demonstrated themselves to be inept drivers. Did your state take that into account?

[ProudDad]

51. No, it charged everyone included in car registrations and license fees

to fill the pool.

Worked a lot like Single-Payer Health Care would.

The insurance companies hated it and spent a few million lobbying state legislatures to pass car insurance MANDATES -- and made billions.

If we actually had a Community, we wouldn't need "insurance"...

[ProudDad]

35. This "public" option would work if backed up by legislation

reigning in the insurance mafia and big pharma...

1) A comprehensive public option made available to ALL persons who desire to join

2) Private health plans MANDATED to accept all who apply regardless of “pre-existing conditions”, health history, etc.

3) Minimum Basic Requirements for health care included in the public option and MANDATED to be included and paid for without question by all basic PRIVATE PLANS including drug coverage, all OB/GYN services, etc. In other words, a level playing field for claims coverage – private and public.

4) A health insurance coverage mandate for all persons with entry into the public plan automatic for those who have no other plan with the cost covered by payroll deduction – no FINES or penalties!

5) Automatic entry into the public plan and strong subsidies for lower income folks and the unemployed – replace Medicare, Medicaid, etc. with a strong public plan

6) Complete negotiating power over fees, services and drugs given to all public plans, Medicare, Medicaid, etc. folding these other plans into the new Public Option. Give the public plans immense negotiating power from the start!

7) A Universal Claim Form and software specifications that MUST be used by all basic private/public plans to cut down on administrative costs. Since the fee, service and drug price schedules will be uniform we can use a single-form

Along with these;
8) A decentralized system of primary health care delivery

9) More emphasis on prevention and health promotion

10) Significant financial aid for educating Health Care Professionals



But those clowns in Washington have neither compassion nor vision. They just know money, money, money...

[YewNork]

45. There would have to be a law that prevented insurance companies from refusing to cover people

who have pre-existing conditions, or who develop a serious illness.

That would prevent them from dumping the sick ones into a public plan.

[customerserviceguy]

50. Like I said before

you just have to "chase" away the undesirables, no law can enforce high standards of customer service, even if you use things like "Must reimburse within X days," that always have exceptions that can be exploited.

[ProudDad]

52. Correct-a-mundo (n/t)

[Wednesdays]

8. K&R

:kick:

[Better Believe It]

9. K & R

[B Calm]

10. Competitive Market Place is from now on not a conservative idea. . .

[tridim]

11. Did anyone really expect them not to fight for their obscene profits?

[FJeff]

26. Did anyone really expect

congress not to cave in to their share of those same obscene profits?

[AllyCat]

39. Nope. No surprise there

[Jakes Progress]

12. No one speaks for the people.

Kennedy could if he could, but he seemingly can't. Obama is lost, outmaneuvered by big business and his own advisers.

[MasonJar]

13. Hopefully this will not fly. The Progressives in the House are on record

demanding a public option. They have spelled out some excellent minimum requirements. Please do not let them be bought out; please let them stand tall. I'd prefer no reform to a dead-end one that the politiciane can then claim as a success, including Obama. Let it fail rather than be another nail in our country's soul. If we do not get a bill passed this session, after the 2010 elections we can try again. By then Obama will be pleading for a reform proposal. He wants this on his resume for 2012.

[ProudDad]

38. Good point...

"If we do not get a bill passed this session, after the 2010 elections we can try again. By then Obama will be pleading for a reform proposal. He wants this on his resume for 2012."

You've got that right!

We can blame the additional 36,000 needless deaths from lack of health care on the repukes and the DLC and blue-dog Dems...kick a few out of office and get some REAL progressives in...

[Bread and Circus]

14. I don't think Obama and the Dems realize that if they ruin our chance at good health reform...

they are really going to hurt themselves politically. There's a large number of people who are really expecting them to do this right and many of us, me included, will turn our backs on them and close our wallets if they fail.

Honestly, with this President and majorities in the House/Senate, if they can't get this done right exactly why do we even bother?

[Selatius]

17. The failed health care reform in the early 1990s partly explains why Dems lost Congress in 1994.

That, and NAFTA. A lot of voters were let down or alienated. They stayed home and didn't bother to vote.

[eridani]

44. I know that personally. I helped straighten out registration problems for a woman

--who hadn't bothered to vote since she voted for Clinton in 1992. If the Dems do nothing to help her this year, she'll stay home next year, as will millions of others whose hopes were raised in 2008.

[Lorien]

18. Agreed. I believe that this issue will destroy us if our reps choose to

represent special interests over the will of the people. This is their one and only chance, and they had better get it right.

[bl968]

15. How to sway them over to our side

Tell them that how they vote on this issue will determine your vote for the rest of their career. They side with the people or they are with the drug and insurance companies. Then list exactly what would assure them your vote for a long long time.

Their vote for a single payer, Medicare like, public health care system, with no seven year trigger.

If enough people deliver this message, it won't matter how much money the drug and insurance industries bring to the table...

[Lorien]

19. Welcome to DU bl968!

:hi:

And I agree; I'll be doing just that!

[KoKo]

16. If Obama's Health Insurance for all ends up like what Summers, Bernanke and Geithner are Giving Us.

for our Financial Sytem...then we gotta know it's going to be something very different than what we hoped for. And, it won't work out well for those of us still alive for them to "work out the bugs in the system."

WE will be their LAB RATS for EXPERIMENTATION! That's my worry.

[veritasvg]

25. That's Why...

...I'm beginning to think we're gonna end up with no bill at all.

[inna]

21. greedy evil bastards. this makes me mad. rec #46

:grr:

[inna]

22. this pic says it all

f'ng bastards.

[Kansas Wyatt]

23. Until the Democrats stand up to the Insurance & Pharmaceutical Industries...

I will NO longer argue for people supporting the Democrats on the job site. If all the Democrats care about is their own personal position, over the People, and their pathetic Chic Special Interests, then they deserve the ass beating that will be coming to them. Then they all can sit around and ponder why people vote against their 'best interests.'

Here's a clue for you dumbfuck Democratic politicians and/or their minions... You AREN'T representing the Peoples 'best interests' and you don't even know what the hell are the Peoples 'best interests!'

[veritasvg]

24. Going To?

It's already gone. Ask Steny Hoyer what he thinks.

Did you know that forced purchasing of health insurance is actually the Republican plan from the nineties? It's also Romney's plan from Massachusetts.

Something tells me this isn't going to happen at all.

[certainot]

27. lobbyists need RW radio to mobilize the constituency that enables politicians

on these issues.

if americans want health care reform maybe they need to start picketing at the 1000 offices of the loudmouths who have been screaming big pharma's talking points for 20 years and who did the heavy lifting when it came to obstructing hillary clinton the first time around.

[bkkyosemite]

28. HR 676

[farmboxer]

30. America does not need the damned insurance companies

those criminals are causing so many people to die needlessly, but people mean nothing to the insurance companies, nor the drug companies, nor most of our crooked politicians. America is a plutocracy.

[solstice]

31. As always, the rich will win. Doesn't matter who is president.

[Puppyjive]

33. We can do it better than Congress

Maybe we are missing the boat on this. Maybe we the people who want health care for all ought to start our own insurance company. We can invest money into a non profit company for 3 years and see how much money we can build up. We can offer policies to everyone including employers. We won't discriminate and I guarantee that most people will jump ship from their existing insurance companies. This will bring down the price, and we don't need congress to make a law for us. HMO's and insurance companies are sprouting up all the time. If they can do it, we the people can do it and we can do it better. It didn't take an act of Congress to create United HealthCare or Blue Cross Blue Shield. United Healthcare has got to be one of the worst insurance companies in existence. Why don't we beat them at their own game?

[ShortnFiery]

40. Perhaps we're better with gridlock? At least these assholes won't put us deeper in debt.

:crazy:

[democrat2thecore]

41. Answer: ELIMINATE the health insurance industry. Single-Payer. PERIOD! -nt

[tomm2thumbs]

42. Perhaps we should throw open the doors to Canadian providers - I'd buy into that /nt

[stlsaxman]

46. Hope this makes it on to a "Market Place" segment...

but somehow i'm not holding my breath.