We Already Have Public Options, And They Work!

[babylonsister]

http://www.truthdig.com/report/item/20090914_the_other_public_options/

The Other Public Options

Posted on Sep 14, 2009


By Marie Cocco

snip//

The number of uninsured climbed by 682,000 in 2008, another figure that is sure to rise as the impact of job losses and benefit cuts in 2009 is felt. There are 6.6 million more Americans without insurance now than there were in 2001, at the bottom of the last recession, according to the Center on Budget and Policy Priorities.

The number of uninsured would have been far higher had there not been an increase in coverage through Medicaid and Medicare. While private health policies continued to decline, Medicare and Medicaid enrollment rose, and these programs now insure 29 percent of Americans. The recent expansions of Medicaid to cover more children have been particularly effective. “The uninsured rate and the number of uninsured for children are the lowest since 1987,” the Census Bureau says.

Those on the opposite end of the age spectrum also have been spared the worst of the recession. People 65 and over were shielded from the drops in income that fell on the working-age population—as a group, income among the elderly was unchanged. The reason, of course, is Social Security. (The report does not measure the decline in wealth or real estate values that have diminished the net worth of some older Americans.) Since Medicare is a universal, guaranteed plan for everyone 65 and over, the elderly have been able to keep their health coverage as well.

The government has safeguarded the weakest in society from the worst of our economy’s failures. It has done so through government-funded (but not government-run) health insurance that relies on private doctors and hospitals to deliver care and, in Medicare particularly, offers a wide choice of providers. Its cost is high. But the growth in Medicare spending per patient has been slower in recent years than the growth in per-patient spending in the private insurance market.

Those who complain that Medicare is “bankrupt” conveniently forget that the Medicare payroll tax rate has been frozen since 1985. The last infusion of new tax revenue into the program came in 1994, when the cap on the amount of income subject to the payroll tax was raised. So the future fiscal imbalance in Medicare is caused partly by our unwillingness to adequately fund it. What private insurer has refused to raise its prices in 15 years?

Truth is almost always a casualty of politics, more so when fear is the tactic used to obscure the facts. The Massachusetts state insurance program is the model for President Barack Obama’s approach, and is a template once hailed by Republicans as a victory for “choice” and private insurance. Yet more than half of the newly insured get their coverage from the two “public options” that were made available, according to the Kaiser Commission on Medicaid and the Uninsured.

We know what can work. Yet the shrillest voices and the most entrenched special interests are insisting that Congress jettison a public insurance option in health overhaul in favor of untested private insurance “co-ops.”

If they fail, there will be more disillusion and anger. And, we can only hope, electoral punishment for those responsible.

[ejpoeta]

1. And opening up medicare to people under 65 would do a couple of things...

you have an existing program already in place. It's not perfect, but wouldn't it be easier to fix what's already there than to start a new thing altogether and have to deal with problems later with that anyway??? it would probably be cheaper than starting from scratch, that's for sure. Also, the infusion of premiums into the medicare system from people who are young and healthy would mean more money for the system from a group of people who probably won't need to use it for some time. A big part of the problem with a system like Medicare is that by the time people are in it, they generally need a lot more healthcare usage than their younger counterparts. So generally that pool is full of people who need to use it. The pool only works when a few use it at a time.

I just don't understand why this avenue is not being seriously considered. Well, I am sure I know why.... people who aren't really interested in fixing the problems with healthcare and who seem to be trying to just get more money in the insurance companies hands would want to make a cumbersome bureaucratic situation which would take a long time to set up. I know I am being cynical, but it's hard not to be when you see how much money is exchanging hands between the insurance industry and our 'representatives'... and of coure the way the media 'reports' on it all.

[raccoon]

2. I for one would love to see that happen.

K&R.

[Old Codger]

3. Too easy

Open medicare to all would be too easy, pols rarely if ever do it the easy, best, right way.. they already have infrastructure in place, a few minor tweaks and it would be up and running. That won't happen but nice to dream a little....

[dajoki]

4. K&R