The Public Option and Momentum for Single Payer
September 22, 2016
Calls for a “public option” in healthcare – a publicly run health insurance plan that would compete with private insurers – have made a comeback in recent days. But it’s not a comeback like Robert Downey Jr. after rehab or the Cleveland Cavaliers after game 4 of the finals. More like Corey Feldman as a dancer-singer, or Speed 2 the sequel.
A group of Democratic Senators including Bernie Sanders introduced a Senate Resolution for a public option on September 15. It’s not legislation and contains no details, but rather a symbolic statement of support for the concept. The resolution is backed by a group of online organizations and petitions, but is not part of any grassroots campaign. The proposal comes, somewhat suspiciously, after Bernie Sanders nearly staged a coup within the Democratic Party running on a platform of single-payer reform, but subsequently agreed to support Clinton and her call for a public option during the general elections.
While there’s no bad time to champion a good idea, the public option is limited as a solution to the problems that ail the Affordable Care Act, and even more problematic as a vehicle for building a social movement over the next 2 years when, in all likelihood, neither Democrats nor Republicans will be able to advance major legislation through Congress. A strong public option would generate a similar level of political opposition as pushing improved Medicare for All, but without the benefit of solving the healthcare crisis. In the current political context, it offers neither vision nor political pragmatism.
The public option is an appealing policy for Democrats during an election year, since it’s a public plan that fits with free market ideology and polls well. It promises to drive down private insurance costs through competition, and there are very few of us who wouldn’t give anything for relief from healthcare costs and the promise of a more humane insurance plan.
Unfortunately, competition does not work for health insurance, since the “cost” of insurance plans – what we’ll pay in premiums, co-payments, deductibles, and uncovered care – is almost impossible for even intelligent people to determine. Study after study has shown that very few people select the plan that’s cheapest for them. One experiment found that only Columbia MBA students chose insurance plans better than randomly picking a plan out of a hat.
Insurers win customers in the marketplace not by selling the “cheapest” plans, but by pushing plans that are appealing when you buy them but a nightmare when you have to use them: this means lower upfront costs (premiums) with much higher uncertain costs at the point of care (deductibles, co-pays, out-of-network care, uncovered benefits, etc).
So in order for the public option plans to “compete,” they will be under pressure to establish narrow networks, limit benefits, and utilize other practices that allow them to sell more insurance while shifting costs onto patients.
This is exactly how a very similar policy included in the ACA played out. Obamacare allowed the creation of non-profit cooperative insurance plans designed to compete with commercial insurers. The coops have failed spectacularly over the past two years, with 17 of the 23 coops created in 2014 closing their doors by 2016. The plans did not have the size or bargaining power to negotiate low prices with large hospital chains and physician networks, and offered premiums on the exchanges too low to cover their expenses.
The upsurge of national support for improved Medicare for All generated by the Sanders campaign has created a tremendous opportunity to advance the movement for healthcare justice in the United States, regardless of the posturing that will continue to take place during the general elections. Now is the time to build on that momentum through organizing and outreach: take action today!
THank you. I guess I looked at a public option being medicare for all that someone could choose as an add on to obamacare. I do think based on your input, however, that thats not quite correct. My question is do you have a way of improving obamacare without doing away with it while we are in a transition to medicare for all? This is a terribly important issue and it needs to be well understood.
You are correct. This IS “a terribly important issue (that) needs to be well understood.” Unfortunately, the short answer to your question is, “No.” No one has “a way of improving obamacare without doing away with it.” The design of Obamacare makes that impossible. And, much as we all may wish differently, “improving” Obamacare is NOT a transition to Medicare for All. The only “transition” is just to do it in one stroke by passing HR 676. That’s the way original Medicare was started.
I think the public option would be a good idea and an improvement on the present ACA. If a lot of people take it, it would help move the system toward a universal, single payer system. Frank;y, I’m tired of your “all or nothing” position on single payer and what it always has gotten us: NOTHING.
People who have benefited from Obamacare will likely be in favor of a public option, despite its deficiencies. Until we have a Congress and President who will help move single payer forward, people with few options will appreciate any help they can get. I was completely without insurance for 2 years, beginning at the age of 62, because I could no longer afford private insurance. I was able to get basic coverage through Obamacare for a decent premium, which was 30% of the cost of my employer’s insurance for part-time workers, with similar coverage. I would have greatly preferred the public option.
SINGLE PAYER–MEDICARE FOR ALL IS OUR ONLY OPTION, FOR AFFORDABLE HEALTHCARE FOR ALL. I KNOW IN GERMANY A TAX IS LEVIED UPON EACH INDIVIDUAL, BUT ALL ARE COVERED BY THE SAME HEALTH CARE, WHICH IS QUITE GOOD. WE COULD DO THE SAME WITH MEDICARE HERE, AND IT WOULD PAY FOR ITSELF. INSURANCE COMPANIES ARE BLEEDING THE HEALTHCARE SYSTEM, BY SKIMMING THEIR PROFIT FIRST, AND TELL ME WHAT DOES AN INSURANCE COMPANY DO TO CONTRIBUTE TO ANYONES HEALTH—NOTHING, BUT THEY SUCK THE INDIVIDUAL WHO IS SICK DRY OF ALL THEY CAN. I AM FOR SINGLE PAYER.
I agree that we should go directly for Medicare for All.
I agree that we should go directly for Medicare for All. Single payer makes sense. Nothing else does. +1
Medicare for all. It could be done in incremental steps over several years but this the way to go.
I agree Single Payer/Medicare for All is the best choice but it will take forever and many will suffer, go bankrupt or die before the GOP agrees to it ,they never wanted Social Security and Medicare to this day. The Public Option should Never have been Removed from ACA due to the Demands of the GOP. I believe those that were against the PO were working to support the For Profit Health Insurance Industry that funds their Campaign Coffers and Not for the Welfare of the American People.
If Competition amongst the Insurance Companies doesn’t work,perhaps,Fear Will,afterall,would these For Profit Health Insurers want to loose their Desparate Paying Customers $$$$$ to a Non-Profit Gov’t Run Public Option that would provide better Value with lower more affordable premiums,co-pays,deductibles maybe even negotiate Bulk Pricing for Medications,putting Big Pharma on their toes!
Yes,The Public Option, being put back into ACA,is the best option and we can still continue to fight for Single Payer Healthcare for all meanwhile!
Medicare already costs about $16,000 per year per person. How much are you willing to pay? Or do you want someone else to pay your bills?
Improved Medicare for all would save our country one trillion dollars each year. Anaything less makes no sense. Anything less is pandering to the insurance companies. There is no reason to aim for anything less.
Exactly right, whether you use a back-of-the-napkin calculation, comparing our 18% of GDP spent on healthcare to the 12% spent by the second most expensive tier of countries and applying the difference to our GDP, or you take the detailed long-term savings in Dr. Gerald Friedman’s funding study of HR 676. (Why non-healthcare-sector businesses aren’t clamoring to dip their snouts into this potential bonanza of increased consumer demand is beyond me. Maybe a lot of their executives and directors are personally invested in the for-profit healthcare protection racket and this is a failure of corporate democracy. Or maybe they enjoy wielding the power of life, death, and health over their employees, plantation-style. But seriously, that they are not fighting for national single-payer is deeply, deeply stupid.)
As for the public option, well… The overriding goal of the Affordable Care Act was to keep the trillion-dollar-a-year skim going for as long as possible. Now that the ACA is collapsing, the Public Option is being introduced to keep it running for a few years more. When that fails, I can’t wait to see what cock-and-bull Rube Goldberg scheme Big Health and their congressional lackeys propose to keep it going for yet another few years. They can buy all the think tanks, PR mills, academics, politicians, and media outlets they need to formulate and sell their plan, so I’m sure it will be different from anything used anywhere else in the world, compelling in its theoretical underpinnings, and a total crock of BS … a crock of BS that will keep the trillion-dollar-a-year skim going for another X years.
National single-payer health insurance is the only solution. Anyone with a background in healthcare economics who tells you otherwise is on the take.
Easy for someone with other options to say.
Medicare for all:
cheaper
easier to understand
eliminates the profiteers
make me happier
It makes no sense for single-payer supporters to rally behind the public option. The weaknesses of this approach have been analyzed repeatedly, so it isn’t necessary to enumerate them here. But we must clearly emphasize that this is NOT a case of supporting “the lesser of two evils” (public option vs. the status quo); it means continuing to support the private health insurance industry over patients and healthcare providers!
The Obama administration crafted a “compromise” that left insurance companies firmly in control of our healthcare. The result has been a shambles, and it’s unraveling by the day. The public option, and similar gimmicks, will produce the same result. We must hold out for the gold standard: Medicare for All / Single Payer — No compromises, no gimmicks, no political maneuvers.
Well stated Ms. Cowen. Get the for profit businesses out of healthcare. The only problem is that the insurance industry is bigger than our government.
Read the excellent The Healing of America,by T.R. Reid, written in 2009 during the 2009 “debate” about the new healthcare system. Every wealthy democracy in the world has a single payer plan. And yes, prices are rising among them too. But guess what, people are healthier in those countries. They have better survival rates for newborns than in the USA.
Socialism is a good thing. It is what Christianity supports. Early Christians pooled their goods and lived communally. It is our media that sends out messages of disgust at the idea,.
Thank you for stating it so well, Suzanne. As long as we leave the same profit-driven entities running loose with our health care there is no change. I hope a huge public education program is institued by
organizations that stand for single payer universal health care is done. The majority of people are in a state of confusion from trying to manage health care coverage for a long time –and really I think the boon-doggle has worn them out.Since ACA arrived I think there are many who are paying attention to the conversation. They must have a good education about what single payer is and how it works, or it is just “more health care talk”. That the politicions will now wave public option now, will not be met with great enthusiasm if the same people are educated to its fallacies. The current atmosphere of dislike of politicians won’t hurt either.
The public option is a distraction and not a solution and will only strengthen the hand of private insurance companies. The public needs to learn “affordable” health insurance is a mirage and it is not the same as affordable and universal health CARE. As many analysts have shown, the only way to achieve affordable health care is improved Medicare for all.
Thank you. I am so glad you are promoting “Improved Medicare for All”. Ever since Senator Bacchus refused to have this conversation years ago healthcare legislation has been a nightmare.Healthcare for all is a human right, as it is in the more civilized societies. Senator Sanders was correct for using this in his platform and I am sorry that it seems to have been watered down. Please keep up the promotion of this sensible and more economical form of healthcare.
Rights are free – like the right to free speech. Medical care is not free. You do not have the right to force others to pay your expenses.
Health care is a human right. At least that is the belief of every other industrialized [civil] nation. National chauvinism causes us to pretend we’re world leaders in everything. Not so. In health care we lag behind many other countries. The US was one of only eight nations that saw an increase in birth-related deaths last year. Liz, if that was your daughter in delivery and she did not have the wherewithal to pay for care, what should happen?
The public option is pure distraction from getting us to a way to pay for health care that works, just serving the status quo. So, what is the next step? Here in Colorado we have a citizens’ initiative on the ballot to create a universal health care system in our fair state. Every resident will be covered and we’ll spend $4.5 billion less a year. This isn’t just an argument, but a way of showing our country that this is what works. To learn more, donate, volunteer: ColoradoCare.org.
Single payer makes sense.Nothing else does.
Democrat Senators, including Sanders, are doing nothing but grandstanding. Medicare for All, Everybody-In, Nobody-Out, paid for with money the U.S. federal government can easily and legally CREATE for that specific purpose right now, is the only way to go.
It’s called social infrastructure, and along with free public education through college, it’s a job-creating engine of prosperity!
I agree, Medicare for All was and still is the only way to reduce healthcare costs. The public option turned out to be another way for the insurance companies to keep raking in the profits.
The public option would be a major step in the right direction. If you want to make the progress that we need we must be pragmatic. Stop being negative and suspicious about progress. Make sure you do everything that you can to defeat Trump and the Republicans or you will never see single payer in your life time and any progress that we’ve made will be gone. Get out and vote for Hillary.
You are absolutely right about defeating Trump and the need to vote for Hillary. Unfortunately, the public option would NOT be a step (major or even minor) in the right direction. It’s just a fig leaf. It provides an illusion of progress, but will accomplish almost nothing. Most of the comments here clearly explain some of the reasons that is true. Look at the fate of ACA’s own insurance coops as discussed above. The public option and other tinkering around the edges of the ACA are not my idea of true pragmatism.
I support HealthCare-Now and all others who work towards Medicare for All.
All of the in-between measures proffered, including the so-called Public Option, still keep the health insurance business in business, while prices of premiums and medical costs for everything go higher.
Keep in mind that 1/3 of every health care dollar goes to pay for some aspect of the health insurance business….paper shuffling, case reviewing, marketing of insurance “instruments”, advertising. It is gigantic puffery and a devastating misuse of people’s hard-earned incomes, regardless of whether you have insurance through an employer or not. Medicare for the elderly is a great program! It should be expanded and extended to everyone.
I couldn’t disagree more. A Public Option is the ONLY long term solution to our health care needs. So long as insurance companies are allowed to stand between patient and doctor our system will fail to meet the needs of our citizens. Insurance companies and the profit motive are a cancer on the whole system.
I agree that we should go directly for Medicare for All. Single payer makes sense. Nothing else does.
I am a strong supporter of the Expanded & Improved Medicare For All Act, H.R.676, introduced in February of 2013 by John Conyers (D-MI)
I believe the so-called public option is a distraction, and a mirage. It’s a ping-pong ball that will forever be in the air.
The current health system has demonstrated itself to be unsustainable, unaffordable, and unhelpful to most Americans. The ACPPA is a band-aid on a broken system, helping insurance companies continue their profiteering, moreso than Americans who need quality, affordable healthcare.
We must unify and push universal healthcare through our gov’t. and join the rest of the civilized world!
The public option seems to me to be more hand fed crumbs to somehow make us happy. It does not address the core problems within the system. I believe Colorado has its priorities correct when it comes to the future of Healthcare. I would like to see us all support Colorado and get it passed. It will serve as a great example for all to follow and ofcourse lead the way for the rest of the states. I would also like to ad. When the public option was brought up as part of the Affordable Care Act, it was Congress that refused to pass it. Many of positions in Congress are up for re-election and voting them out is extremely important to the future of Single Payer or the Public option.
The biggest problem that I have encountered with Affordable Health Care is that it does not help anyone who makes less then $24k per year. I tired to setup AFC for my nephew and since he made only $12k per year, his basic rate for the cheapest health care was more than $900 a month. If he made $34k per year, the deduction kick in and it drops to $190 per month. He could not make enough for the savings. Try health care should cover everyone, especially the very poor. Universal healthcare is the answer.
My concerns with a “public option” or Medicare for all are the following: If we can work a form of one of these going forward to cover all Americans from birth until death, then great. We have to be very leery of anything like the British National Health because citizens there can wait a very long time ( 6 months minimum from friends there) to see a doctor, whether routine or something far more serious. Also the Canadian national system isn’t great either. We don’t want those. France and Scandinavian countries have better systems, but they pay higher taxes. I have a relative who lives in Paris and is now on their system. One just goes to a doctor. If a procedure is needed, then one goes to the local pharmacy to purchase the dressings etc recommended by the physician. If we are to avoid the British and or Canadian problems with their national systems, we still may need some sort of private. If we get stuck with a continuing GOP House and Senate, nothing will happen. We need to closely evaluate what is best and make sure that any system we develop as an improvement over what we have now, has prescription coverage in place so that Medicare for all, etc do negotiate with the pharmaceutical companies and no “pharma-bro’s” dictate what we pay. The executives of remaining private health insurance companies must become federal employees on federally dictated pay scale with bonuses determined by Congress or committees, so that there are no excessive demands.
Personally, I am just about eligible to go on Medicare, and my husband has been on it almost 2 years. It is a help, but without supplements, it isn’t as low cost as one would assume.
I have worked in healthcare financing for over 30 years. And I firmly believe that the only thing that will truly work is Medicare for all. Period.
If we incrementally continue with a public option I am afraid that it would set a precedent of “buying Medicare.” And once you have that set, it could be the first step the Republicans need to make all of Medicare a voucher system.
No, we need Medicare for all. And the current actions of Humana and Aetna underscore the futility of working with for profit insurers. They are all for profit and not for the insured.
I have worked in this field, and with insurers long enough to know taht.
Single payer is the solution. Getting there requires changing public attitudes about the role of government, which will most likely happen in stages, as it did with gay marriage. Generating discussion about the idea of a public option while promoting single payer will help move the conversation in the right direction. It would appear that Senator Sanders believes this as well.
The idea does have grassroots support – check out Presente.org – a Latino advocacy group, which sent out their action alert a few days ago.
Medicare For All! The time has come!
We should be aiming for a system like Germany, France, or Canada has. Some things just don’t work in capitalism and this is one of them.
I suspect there are many “option” advocates out there like Mike Pollock who don’t want to provide any details about why they’re in favor of “option” legislation. (I will put “option” in quotes until I see the details of a “public option” proposal that give me reason to think “option” programs will survive on the exchanges or in any other market. If I don’t put that word in quotes, I’m contributing indirectly to hype about what is currently an extremely vague — irresponsibly vague — concept. I suspect that the “option” will turn into another co-op program, which is to say, a program that won’t survive to provide an “option” to Aetna et al.)
It appears to me Mike just wants to stereotype anyone who won’t support the “option.” He wants to characterize us as naïve idealists who are probably too dumb even to vote for Hillary. (I will vote for Hillary, and I have contributed to her campaign. But I don’t trust the woman. I will vote for her primarily because Trump is such a horrendous candidate.)
Mike’s response is not helpful. We want a discussion with “option” proponents about why they think supporting “option” legislation is a good idea. We don’t need a lecture on “political feasibility.”
To maximize the probability of a good discussion, I suggest that HealthCare-Now and other single-payer groups challenge “option” advocates to provide details of the legislation they have in mind. In my view, that’s the most fundamental problem with the “option” as proponents have talked about it since the summer of 2009 when congressional Democrats first unveiled legislation containing “option” provisions. Since 2009, the “option” has had all the specificity of swamp gas. We have been told ad nauseam that the “option” is “like Medicare.” But why should we believe the “option” will be like Medicare as opposed, to say, like United Healthcare? Or one of the failed co-ops? Or swamp gas?
How will the “option” resemble Medicare? Will it start out insuring an entire age group as Medicare did? Will it function as the sole payer for that age group? Will it restrict access to doctors as HMOs and PPOs do? What will the subsidies for people who sign up with the “option” be? Will those subsidies be enough to make the “option” affordable?
If “option” proponents would answer these question, we could then steer the discussion away from the oh-so boring question of whether “option” advocates know more about politics than single-payer advocates do. For example, once we know how “option” proponents plan to make the policies sold by the “option” insurer affordable, we could then have a good discussion about whether it’s reasonable to expect the insurance industry will raise less hell about the “option” then they will about a single-payer bill. This claim that the “option” is “pragmatic” (it will fool the insurance industry into letting down its guard) and single-payer is not is, of course, the fundamental premise of “option” advocates.
In short, the details of the “option” proposal matter. “Option” proponents don’t get to lecture single-payer advocates that the “option” is more politically feasible than single-payer unless and until they give us details about the “option.” Once we have those details, we can then discuss whether the “option” will accomplish a damn thing. If it will accomplish a damn thing, we can then have a fact-based discussion about whether the “option” really is all that “realistic” or “pragmatic,” that is, whether the insurance industry will resist an “option” bill with less ferocity than they will a single-payer bill.
Kip Sullivan
I will continue to fight for the MN Health Plan, single payer. Minnesotans are feed up with the cost of insurance. Was not aware of what Clinton’s Public option was — Fee for Service or Medicare for All, if not, I am not too keen on the idea.
HealthCare-Now should publish the mechanism of the public option that was discussed during the initial ACA negotiations.
Don’t expect your members to research the actual plan prior to responding to your message. Many of the responses refer to increased use of private insurance companies which is counter to the idea of a Public Option; this is why the insurance companies objected vigorously, succeeding in having this option deleted from the ACA proposal.
We would all agree that Medicare for All is much preferable to a public option within the present system, but the question remains if it would improve coverage/cost for a significant number of people.
That is the question which needs to be addressed.
Only then can we evaluate if a public option would delay eventual adoption a single payer system and whether the potential delay outweighs improvements (if any)of a public option.
Obviously Bernie Sanders and other single payer advocates expect the advantages of a Public Option to outweigh the disadvantages.
Some of us remember that opponents of the public option objected that it would lead to a single payer system!!
I will continue to fight for the MN Health Plan, one payer.
Was not sure what Clinton’s Public Option was. If is is not fee-for-service or Medicare for All, I am not too keen on the Public Option.
Like many Americans, I considered ‘the public option’ a device to keep insurance companies honest. That was a foolish notion; as there is nothing to cure their ravenous appetite for profits. We must demand Medicare for All, in the United States – as the health insurance industry is incapable of offering ethical and affordable plans for our struggling population.
We should remove the profit motive pervading this aspect of society. The surgeon general has declared lack of access to affordable health care – can be deadly.
While I would have been happy with a public option back in Obama’s first term, once it was taken off the table even before negotiating began, I realized that the only REAL option was to have universal single-payer healthcare for all. That opinion has been reinforced steadily every day since. We need Medicare for All, single-payer for all. Nothing else is acceptable because nothing else will work.
$150 BILLION of our tax dollars to Iran not to build Nukes but we all know what is really going to happen yet, we don’t have enough money to provide health care to our citizens? I’m tired of all the smoke and mirrors played on us. Medicare for all is the smart and right thing for our elected officials to pass. Enough of giving our hard earned tax dollars to foreign countries and then telling our public social security is running out of money, medicare is running out of money. None of our tax dollars used to provide adequate health insurance to our citizens but TRILLIONS of dollars given away to foreign countries. Enough already!! Treat us with dignity and pride that our tax money is supposed to be used for. Cut all the elected officials pay and HUGE insurance and retirement perks and see how they would feel to live like the rest of us, being ripped off at every angle to appease the rich! We are all just pawns in a rich mans game!!!!
We must push for Medicare for all!!
The only way that we catch up with the rest of the advanced world in the area of healthcare is to eliminate/reign in what I call the detrimental profit centers — namely, the economically extractive health insurance industry and the monopolistic pharmaceutical industry.
The emphasis needs to be placed on healthCARE for all, not on health INSURANCE.
The emphasis needs to be placed on making (and keeping) people well, not on keeping people under treatment.
The emphasis needs to be placed on meeting people’s medicinal needs, not on making a select privileged few insanely wealthy at the expense of the lives of many.
What is wrong with us?
Medicare is the ONLY sensible cost effective option
Lost my home in Huntington Beach, California. Lost my $75,000 401k. Lost remaining assets (truck, motorcycle, expensive furniture I worked hard & paid taxes for since 15 yrs old til broken back at 37 yrs old) thanks to multi-billion dollar Kroger-owned grocery company, Ralphs who decided to fight paying $50,000 for spinal surgery. So instead of paying taxes and working again, I suffered permanent damage due to delay despite California neurosurgeon’s report stating “he needs immediate surgery or face permanent neurological compromise”. While my attorney fought greedy Kroger company, I flew to ITALY in a wheelchair (deteriorated from walking to crawling to cane to wheelchair in 6 months while Kroger ignored medical reports) Kroger paid $60,000 in physical therapy…yes, more than surgery would have cost, by the time my attorney said go get help quickly for FREE spinal surgery before I end up in a wheelchair permanently. (Mom’s side of family lives in Italy). Italy saved me. My own country, America, fucked me. I can walk. BUT, I have permanent nerve damage (my country and employer waited too long) and now am on permanent Social Security Disability, pay no taxes, am in poverty, and lost the following: my ability to work, my health, my dignity, my hard-earned assets, my mental health (insomnia, stress, panic & anxiety disorders common with losing financial, physical and mental health all within 12 months). I got my dual citizenship and received spinal surgery within 90 days in Italy. Their Constitution states “healthcare is a right of all citizens.” Healthcare is a privilege in the U.S., not a right. I was embarrassed that they KNEW I was a normal case and had to explain why the wealthiest country in the world allows their citizens to lose their homes and health, and even die. They heard and know we are horrible as a nation to our citizens. We neglect our successful, our poor, our elderly, our veterans, everybody. That is why the U.S. is # 37 in health care. Italy is # 2, behind # 1 France. Both have universal health care. WAKE UP PEOPLE. If you do not think it will happen to you or we are exceptional, you have NOT tested our health care system! Go walk in traffic and get back to me. I’m done! Healthcare is not meant to be a for-profit business!! Capitalism does NOT work with health care. I KNOW.
Improved Medicare for all is what we need.
The public option makes no sense at this point. Had it been included in the original ACA it would have helped, but only in inevitably advancing the medicare for all, which is what we need. We will get there but only if we start kicking out the pols that are so deep in the insurance comp. pockets.
As always, the devil is in the details. If people are allowed to “opt in” to Medicare as is prior to age 65, it might be a good bridge to a longer term goal of medical for all. If a different public option offered is not comprehensive, affordable, and limits access to both providors and prescription medications like the more crappy exchange insurance offerings then it is clear it is just being used to try and discredit ANY public option by setting it up to fail just like they did the exchanges.
The public option is a great idea if you want to keep control of healthcare in the hands of the insurance industry. The public option is a government run insurance plan and will eventually fall into he same pit as the private insurance companys. I have no faith in our congress to not water down the best aspects of a public option to benefit the insurance industry. That is the history. Good ideas get watered down because private insurance will have to pay in order for costs to go down. They will not do that easily or ever. That is what happened to the ACA and that is what would happen to any public option program. The problem is the insurance industry needing to make a profit. How is that going to change by adding another layer of insurance based premiums. I am also concerned with any public option being billed as a road to single payer or being equated with it. When that happens and the public option fails the failure will be falsely described as a failure of single payer. Single payer is not insurance based. It is tax based and cannot be moved toward incrementally. It is an entirely different system.
A public option, if it were enacted, would most likely be limited in scope, and would certainly not have a large, guaranteed subscriber base. It will have the same fate as the “co-op” plans you described, and will fail for lack of bargaining power with hospitals and doctor groups. It will also fail because the insurance companies are quite clever, and will entice the healthier people with lower premiums, leaving the older, sicker population for the public option.
If this form of (weak) public option were to pass and fail, it would set back the movement for single payer — the real solution. People confuse the public option proposals with actual Medicare for All. So if it’s enacted and fails, and the rest of us clamor for universal single payer expanded and improved medicare for all, the answer will be — oh, we tried that. Didn’t work.
I am 8 days away from Medicare. I’ve cancelled my Exchange silver HSA plan effective 10/1. Yessss. And just in the nick of time. Today, as anticipated, I got the letter from Premera informing me they are pulling out of offering Exchange plans in my county for 2017. Of course, their employer plans and Medicare coverage will continue. If I were still relying on the Exchange, I’d be “shopping” again come November — and no way to find out what my choices are until then. I also hear that 2017 Exchange premium hikes will be shocking (although my Exchange subsidy has protected me these last three years — at least my premiums remained stable while my $3,000 annual deductible spared the insurer from paying for anything except a flu shot). MEDICARE FOR ALL. Everybody in, nobody out, across state lines, across ages, across incomes, across genders — health care for human beings!
I agree basically with Healthcare-NOW’s analysis, and most of the comments that the Public Option is a fraud and a smokescreen, which “sounds reasonable” but every serious analysis of it shows it is not a path to single payer and will fail because of adverse selection. If people, probably the sickest, were allowed to buy into Medicare at age 55 it would end up with Medicare premiums going up to meet the demand for the costs of the sickest patients. Margaret Flowers calls it the “Profiteers Option” since the private insurance companies would welcome the public option as a way of getting rid of all those damn expensive, sick, people who are messing with their profits.
It is also disappointing that Bernie is selling out by supporting the “public option”.
I’m 100% behind Colorado Care, Medicare for All, and any state single payer plan that helps to build the movement for Universal Health Care. I think we are still experimenting with what is the current best approach, HR 676 vs state based plans. Of course a national plan is clearly the best, but it has zero chance of success in the current political climate.
It’s time for congress to stop trying to please the big donors by giving the people the run around options instead of what every other civilized country gives their citizens. Medicare for all. no options, no copays, no premiums, no networks, no fines. Just give us Medicare for all. My son’s premiums have sky rocketed, but the deductibles went from per family to per person so they can’t see the doctor because the deductibles are so high. It’s garbage unless you have a life altering disease. Give us what every other decent country provides. Yes taxes will go up but it will cost must less than the premiums for con job we are living with now.
The public option was recognized as being the least effective wisp of a slim hope of reining in insurance and drug companies during the Obamacare debate. The US needs to make the move to single payer Medicare for all, no more of these flimsy excuses for more corporate profit that causes US citizens to live in a sick society.
I used to live in Canada. I immigrated there in the seventies. I paid $1.75 a month for doctors, hospital,medication, etc. I believe improved medicare for all is the best option.
I just signed a petition supporting the public option as a temporary bridge for those of us who have extremely limited options through the ACA. Blue Shield offered only an HMO in our Texas county this year, which meant that getting sick in anything other than our hometown would not have been covered. We live in our RV and travel throughout the US, so it meant that we couldn’t actually use our coverage. And since we lost our subsidies, the plan was over $1K per month for my husband and I. So we became uninsured for the first time in our lives.
Yes, Medicare for All would be the best solution, but for those of us with an immediate need for coverage that we can actually use and maybe afford, the public option would be helpful while we wait for our ‘leaders’ to actually address the issue.
Can we save money? Single Payer – Save money. Get care for all. It is simple. Let’s do it NOW.
Please do not call a single-payer system “Medicare for All”! Medicare has, unfortunately, been mostly privatized. Medigap, Medicare, Part C, aka, Medicare Advantage and Medicare, Part D, Prescription Drug Coverage, are all provided by private, mostly for-profit insurance companies. This is not what we want in a single-payer system. In fact, we need to get the greedy, for-profit insurance companies out of Medicare!
Couldn’t agree more… What we want is a SINGLE-PAYER health care system!
Good information and argument.
I’m going for Medicare for All.
Thank you!
While the public option may be better than nothing, I tire of better than nothing. What they don’t tell you is that most people won’t even be given the option of switching to a public option. It won’t be available to those of us with employer-based insurance so even if we want better than nothing, nothing is all we’ll get. Further, once the insurance industry and big pharma get through with it, a public option will be little better than nothing.
The only solution to healthcare in America is to finally get the insurance companies and big pharma out of the discussion and out of the decisions.
I agree. As long as insurers control healthcare and line the pockets of policy makers, the middle and lower class will only have a dysfunctional healthcare system. The lack of control over drug prices is equally devastating. The public option is a weak step toward single payer. The ACA has miserably failed millions of Americans. Now the larger health insurance companies are dropping out of the ACA because they can’t afford to take care of SICK PEOPLE, pay their CEOs and satisfy their stockholders. HR 676, (Rep Conyer’s Bill),titled “Expanded and Improved Medicare for All” is the system we need to put in place. Policy makers don’t seem to care
Many Americans are health care illiterate. They do not know that the current health care system is devastating the economy as well as failing to serve citizens. Our dysfunctional system is has a devastating influence over the other socio-economic systems.