The dangers of a fake public health insurance option (updated)

Updated from yesterday's version. Note: if you support the public option, please sign the petition at StandWithDrDean.com, send an e-mail to your senators, and support Blue America's planned tv ad campaign.

The White House and key Democratic senators, including Iowa's Tom Harkin, appear to be walking into a trap for the sake of bipartisan agreement on health care in the Senate.

There is growing support for a fake "public option," as opposed to a government health insurance plan that would compete directly with private insurance companies.

If Congress passes this kind of deal and President Barack Obama signs it, we will get a enormously expensive non-solution to an enormous problem, and Democrats will pay the political price.

After the jump I'll explain why political hacks as well as policy wonks should refuse the latest efforts to derail the public option.

UPDATE: Check out the numbers from a brand-new New York Times/CBS nationwide poll: Asked, "Would you favor or oppose the government's offering everyone a government administered health insurance plan like Medicare that would compete with private insurance plans?" 72 percent of respondents said "favor," including 87 percent of Democrats, 73 percent of independents, and 50 percent of Republicans.

Earlier this month, President Obama wrote this in a letter to key senators:

I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.

The public option is anathema to Republicans and corporate Democrats, because it would give consumers more choices. In most parts of the country, one or two companies dominate the health insurance market.

Also, a government-run plan would have lower overhead costs than private insurers, especially for-profit insurers that need to reward shareholders. Experts predict that tens of millions of Americans would choose the public option. Private insurance companies would have to change their business practices in order to compete.

With the president committed to a public option, the battle in Congress is now over what kind of program can be labeled a public option. When Dr. Howard Dean spoke at a health care forum in Des Moines on May 28, he warned about two leading "fake public option" proposals: the so-called "trigger" and something modeled on the health insurance benefit for federal employees, who can choose among a range of private health plans. Dean explained that the parameters for the "trigger" could easily be set so that the government-run plan would never be implemented. As for creating a new large pool for Americans to choose among private plans, he likened that to "throwing a trillion and a half dollars out the window," because government funds would be subsidizing purchases of private plans with nothing to bring down costs or create efficiencies.

Many members of Congress who are big recipients of campaign contributions from the insurance industry are now pushing a third fake public option: cooperatives. According to Thursday's Des Moines Register, this model has strong potential in the Senate:

[Senator Tom] Harkin said the cooperative alternative could be the compromise that brings a critical number of Democrats and Republicans together.

"We're looking at it to see how it would work," said Harkin, a top Democrat on the Health, Education, Labor and Pensions Committee. "There may be a few problems with it, but it just might work. I'm looking at it quite positively."

Besides [Democratic Senator Kent] Conrad, Finance Committee Democrats Charles Schumer of New York and Chairman Max Baucus of Montana, and Republican Susan Collins of Maine have said they are favorable to the idea.

Harkin, who has said he supports including a government insurance program, said he would need to know whether the size of cooperatives would be enough to drive down costs. Policies should also be portable as people move from one region to another, he said.

But Harkin remained open to supporting cooperatives.

"They are member-owned. They have to elect their own boards and can set parameters. They can't advertise, market or run up expenses," he said. "It might work. There are a lot of people crunching numbers."

I'm all for Congress allowing people to form health insurance cooperatives if some people believe in that model. If they work well, they will grow in popularity. However, cooperatives should compete alongside (not instead of) a real public option. Citizens need the option of buying into a nationwide plan like Medicare on day one, not years after discovering that the local cooperative is a raw deal.

Also, I can't see how a policy from a state-level member-owned cooperative could be portable for policy-holders who move across the country. And if cooperative boards can set their own rules, where does that leave Americans who are currently uninsurable because of pre-existing conditions?

If the president truly believes in a public option, he should make clear immediately that cooperatives cannot be a substitute for a government-run plan.

Unfortunately, the White House is sending the opposite signal, as in this interview Health and Human Services Secretary Kathleen Sebelius gave the Associated Press:

"I think there is a lot of understanding that the private market has really failed to provide affordable coverage to Americans," Sebelius said. The industry has had "a lot of opportunities" to get rid of coverage restrictions and other unpopular policies, Sebelius said, and really "hasn't served Americans very well."

However, Sebelius stressed that Obama is open to compromise on the shape of the public plan, which doesn't have to be run by the government. She spoke positively of a compromise idea that envisions consumer-owned nonprofit cooperatives, like rural electricity or agriculture co-ops. They would get started with seed money from taxpayers but then compete without government control. The plan by Sen. Kent Conrad, D-N.D., may end up in a health overhaul bill to be unveiled by the Senate Finance Committee this week.

Nor have I heard the White House smack down the "compromise" plan backed by former Senate Majority Leaders Tom Daschle and Bob Dole. Daschle was Obama's first choice to run the Department of Health and Human Services. Here he is alongside the leader of Republican efforts to kill President Clinton's health care reform, proposing a plan with no public option--just a "'federal fall back' if the insurance companies didn't or couldn't implement cost-cutting and efficiency measures on their own." (Yes, I saw that Daschle says he still supports a public option, but if that's the case, why was he holding hands with Dole on a compromise with a "trigger"?)

The White House and many Senate Democrats would rather have a bipartisan plan that could overcome a Republican filibuster than pass health care reform through the budget reconciliation process, which would require only 51 votes. David Broder reported earlier this month,

The president has told visitors that he would rather have 70 votes in the Senate for a bill that gives him 85 percent of what he wants rather than a 100 percent satisfactory bill that passes 52 to 48.

As I understand it, using reconciliation would force Congress to revisit the issue in a few years, when the political climate might be less favorable for health care reform.

I see a lot more downside to weakening the plan in order to get Republican votes. On May 27, I spoke with Dean by telephone and asked him about efforts by Senator Ron Wyden and others to create a health care plan without a public option, with the goal of getting 70 to 80 votes in the Senate. Dean said "there's no great grace in getting 70 votes" for a bill that doesn't do anything. "All that's going to do is bankrupt the federal treasury."

If Washington Democrats lack the political will to support a public option for the right reasons (a Medicare-style plan would be more efficient, give consumers more choices and keep private insurers honest), maybe crass political calculations can bring them around to supporting a public option.

A recent NBC/Wall Street Journal poll found that

There was also support for the Democratic push to let people sign up for a public health-care plan that would compete with private companies, one of the toughest issues in the health-care debate. Three in four people said a public plan is extremely or quite important.

The same poll found high levels of concern about the budget deficit.

Obama and Senate Democrats need to ask themselves how Americans will like health care "reform" that costs over $1 trillion and fails to provide an affordable and accessible alternative to private insurance.

Maybe they think Democrats won't get blamed for a costly failure to deal with a big problem. After all, Chris Bowers is right:

Bipartisanship has nothing to do with reducing the costs of health care or increasing access to health care. However, bipartisanship has a lot do with providing politicians political cover in the event that a piece of legislation fails to deliver on its ostensible purpose. [...]

The purpose of bipartisanship is so that, in the event that you pass legislation that is unpopular and / or does not end up working, then it is impossible to take all of the blame for it.

The Chuck Grassleys of the world know better. They understand that a $1 trillion failure to solve our health care crisis will "prove" that Republicans were right all along: Democrats are incompetent, and "big government" is the problem, not the solution.

Democrats control the legislative and executive branches, and if we get health care reform right, we could achieve political realignment in our favor. If we screw up this chance, voters will hold us accountable. No one will remember how many Senate Republicans voted for the bill.

Accepting a fake public option in the name of bipartisanship reminds me of some French guy's comment from 200 years ago: "It was worse than a crime; it was a mistake."

I'll be listening carefully when Obama goes on ABC this Wednesday to talk about health care reform. Will he insist on a real public option, as in the House Democrats' draft bill?

Tags: Barack Obama, Bob Dole, Congress, health care reform, Howard Dean, Kathleen Sebelius, Public Option, Ron Wyden, Senate, Tom Daschle, Tom Harkin, white house (all tags)

Comments

93 Comments

Re: Timely for

care, early for concern, downright premature for outrage.

I, too, will be listening carefully when Obama goes on ABC this Wednesday to talk about health care reform. Really listening, then I'll come here to find out why what he said really sucked.

by QTG 2009-06-20 10:22AM | 0 recs
Re: Timely for

" Really listening" requires you to have an understanding of the substantive issues involved in healthcare debate. If you do not understand the substantive issues involved with policy, President Obama may as well be speaking Russian when you only understand English. This is true because you will lack the ability to appreciate whether his arguments are valid other than simply trusting that he is right.

by bruh3 2009-06-20 10:35AM | 0 recs
Re: Timely for

Exaclty.  Everyone but you is stupid.  Thank heavens you're here to, you know, help us understand.

by fogiv 2009-06-20 04:51PM | 0 recs
Re: Timely for

Stunningly condescending, as usual.

by lojasmo 2009-06-20 04:56PM | 0 recs
not sure that I follow you

Where did I say in this diary that what Obama said sucked? I am not encouraged by what looks like growing momentum for a fake public option in the Senate, while the White House signals via Sebelius that they might accept this compromise.

And I don't consider it "early" to be concerned when bills are being marked up already.

by desmoinesdem 2009-06-20 12:07PM | 0 recs
Re: not sure that I follow you

By defining a standard for the public option, you are setting up a standard by which we can determine whether not only Baucus or the House, but also President Obama is producing a good reform bill. I think the jury is out, but I am mildly hopeful that we will produce the right kind of bill if there is enough pressure on all parties. Some do not want pressure on Obama or see the point of such pressure. If you look through out this, and other threads, that's the consistent theme. They have no problem with you pressuring Congress- just not Obama.

by bruh3 2009-06-20 12:19PM | 0 recs
Re: This is false

As Steve M says of you when discussing the DOMA issue:

"Ok then, let me be more clear... all these comments I have seen about how it would be an impeachable offense for Obama to fail to defend the law, about how "Obama would lose my support if he politicized the DOJ like that," blah blah blah... I don't believe a single one of them."

The problem here is you make shit up and will say anything. You don't post in good faith. You are doing so right now about me, but that's sort of the point. You are playing the divide and conquer game along this thread despite the fact that what I am saying in no way differs from other. What you choose to do is to attack my motives as unpure because thats all you got. You will say anything to change the subject.

I have very personal family reasons why I am interested healthcare outcomes that I discussed with others over the last few years on these sites, well before I knew who President Obama was. So to read you make that statement, just reinforces my point that you will say anything.

As I discussed a month ago here:

http://www.dailykos.com/story/2009/5/19/ 733263/-Whats-Your-Private-Health-Insura nce-Horror-Story

"My mother was diagnosed with cancer. She lost her insurance a month before because she was a low income worker. They tried radiation that seemed to work, but because she did not have insurance, we lost 2 months of treatment time. Will never know what that time would have meant for saving her life."

That's why I care about this. That's my motives. I have made multiple phone calls to both the WH and Congress. That's my actions. So, you can continue to play your Junior Rove b.s., but I am going to coninue to discuss these issues because I have a personal family stake in this.

by bruh3 2009-06-20 01:19PM | 0 recs
and this is the problem with you

Steve M was wrong and he also says he doesn't "believe" the point, not that the point isn't true...and here you are presenting it as a fact and anyone else who thinks different is "making shit up." What kind of person uses opinions as facts? One who doesn't have his own facts.

You have long been the worse divide and conquerer here...since the days of bruh1 and you accuse other people of doing what you are doing.

Your overinflated ego has gotten you in more flame wars than perhaps anyone else, you have long developed a reputation or your self-rightousness and the nasty way you treat other people.

I have had numerous conversations with critics of the President who I haven't gotten nasty at...you are one of the few I have and that doesn't have anything to do with your opinion of the President, but the fact that you only appear to want to discuss topics negative to him, and strangely disappear when he does something worth celebrating.

One of things I'm most looking for with this healthcare victory is the fact that you'll disappear for a while, because Lord knows you won't want to give the President any credit.

by DTOzone 2009-06-20 02:04PM | 0 recs
Re: and this is the problem with you

People can look up what was said and not said here in which I defend Adam B, a front page blogger at Daily Kos, a person who disagreed with me over the DOMA brief  because he did so with arguments versus your regular spewing. So you can continue to lie as much as you want, but the record does not agree with your tactics or lies.

Here was again Steve M's response to your bile:

http://www.mydd.com/story/2009/6/17/1125 12/131

"The difference is that Adam did not go on and on making ridiculous claims like "it would have been an impeachable defense for Obama to do anything different."  In other words, the sort of rhetoric the defend-at-all-costs faction seems to have talked themselves into."

or here:

This is exactly the type of hyperbole I am talking about.  If the President decides to take a position on the constitutionality of a statute, that represents "politicizing the Justice Department" - no different, really, than Bush hiring a bunch of Regent grads or firing US Attorneys who refuse to prosecute Democrats.

Of course the Justice Department needs to be independent in terms of carrying out its prosecutorial function.  That hardly means it needs to be independent in terms of setting policy priorities or taking a position on the interpretation and constitutionality of statutes - those things are of course for the President to determine.  Like I said, it's just amazing the over-the-top stuff some of you will talk yourselves into, just to avoid confronting the reality that this issue could have been handled better."

Defend at all cost is exactly what you are doing now in this diary.  It's what you do in every diary. As I said,  you both are bad faith actors. The problem is that in every attempt to have a conversation you enter using the same tactics. There is no way to address your behavior because it's not coming intot he conversation with any amount of attempt at communication. If I were what you claim in your lying, there is no way that I would praise someone with whom I disagree for doing so with arguments rather than spewing vile.

I fully expect you next commment to be "but you spill vile." That's what you two do in every diary. You attack without any sense of reality at all. This is simply not healthy to a debate about healthcare.

by bruh3 2009-06-20 02:34PM | 0 recs
Re: Been waiting a long time

As I keep saying- you are a bad faith actor. So you can continue to these sorts of comments as much as you like. Tarheel gets it right that you can not back up anything you claim. It's all attack, attack, attack. Like a good rabid dog defending his master.

by bruh3 2009-06-20 04:08PM | 0 recs
the whole point of this diary

is that while Obama voices support for a public option, various senators are trying to pass off a load of crap as a "public option."

If and when the White House makes clear that the president will veto a bill containing a fake public option, I will feel more confident about lining up the votes in the Senate.

by desmoinesdem 2009-06-20 05:59PM | 0 recs
the veto threat

is a basic tool of negotiations between the White House and Congress. George W. Bush showed this many times by threatening to veto the prescription drug benefit or the energy bill or whatever if it contained X, or didn't contain Y, and of course such a threat did not "doom" the chances for passing a bill.

It showed Congress that he was serious about getting what he wanted.

Obama's administration has also shown that it can twist arms in Congress when the president wants to twist arms--like getting the war supplemental funding bill passed and getting Steve Israel to drop his plans to primary Kirsten Gillibrand.

I would like to see the same kind of tough negotiating posture on behalf of the real public option, instead of sending Sebelius out to say that Obama is flexible, and maybe regional co-ops would be acceptable as a kind of public option.

by desmoinesdem 2009-06-21 05:07AM | 0 recs
how do you explain this, then?

http://online.wsj.com/article/SB12454581 6309433079.html

excerpt

The co-op idea is now the main option in play in the Senate Finance Committee, whose health-care overhaul is the leading initiative under consideration in Washington. In remarks this week, Mr. Obama said he would consider the idea if it helped reduce coverage costs for individuals and small businesses.

In order words what I feared most is most likely going to happen, in the name of bipartisanship. I will lose my excellent risk pool insurance for a shitty HMO!

by suzieg 2009-06-21 01:47PM | 0 recs
Re: and btw

You are a liar. But, thats not unexpected from bad faith actors.

by bruh3 2009-06-20 08:26PM | 0 recs
You are once again lying

by bruh3 2009-06-20 08:27PM | 0 recs
weird comment

My recollection is that bruh was an Edwards supporter before Edwards dropped out, and wasn't thrilled with either Clinton or Obama, so criticized them both at various times.

Your interpretation of that is that he "bashed everyone"?

What kind of criticism of a candidate or elected official is acceptable to you? Or is it all "bashing"?

by desmoinesdem 2009-06-21 05:10AM | 0 recs
Re: weird comment

Actually this is what they want:

But hijacking diaries that they do not like with complete nonsense is what they do.

by tarheel74 2009-06-21 06:51AM | 0 recs
Re: weird comment

I just want to chime in despite my promise to myself to not do so. Thank you for the accurate reflection of my history. the thing this person, nrafter530, and other commentors- what you are seeing regarding their constant lying and say anything to hijact a diary approach is exactly why it is pointless to talk to them. Their one and only goal is to protect Obama at all cost.

Not one of his statements here is geniunely about anything other than that. This is why is a diary on gay rights he can say that gay groups have done nothing to help their own cause despite what happened in Iowa. Why did he say that? Because he wanted to change the subject from discussing Obama's accountability regarding gay rights issues.

So, my advice as I am about to take is to ignore them. They are not here to discuss the issue. They are here to hijack your diary.

Like I said, there is a subset of posters who see that as their function here and other blogs. I have seen these exact same hijacking techniques in several diaries now doing the exact same thing to other posters. It does not matter who the poster is so long as they can get them to react defensively to their outlandish and unsubstantiated lies.

For example, nrafter530, claimed the other day that I was  hypocrite. Why? Because he claimed that I demonized single payer because I said I supported the public option, but did not agree with Obama's approach in which Obama demonized the single payer approach. He claimed that I "bashed" single payer relentlessly.

When I linked to a diary from a month before saying that I supported the single payers being a the table.nrafter530 response? He repeated his talking point of calling me a hypocrite. They are bad faith actors here to push talking points.

Steve M also had to correct him regardin another outlandish claim in which he claimed I called Obama names. My point? This is not a good faith debate. This poster and the posters like him will say and do anything to derail the discussion you are trying to have. When you have a dedicated subgroup focused on derailing any diary by hijacking it through nonsense , it's hard to fight it without doing what Chris Bowers does. That'swhy I say below I am sympathetic, because these posters here are making shit up, and no matter how much you point that out, link to information correcting their statement, they will continue to try to hijack your diary. The sole point is the avoidance of accountability for Obama. Not a discussion.

by bruh3 2009-06-21 01:25PM | 0 recs
Re: weird comment

Forget them man. They are just a bunch of kids trolling around. I think we who are serious about policies and politics should be able to debate like adults without getting into flame wars.

by tarheel74 2009-06-21 01:49PM | 0 recs
Re: weird comment

I intend to ingore them from now on. I wanted her to realize that these people making shit up, and, its important to not let them hijack diaries.

by bruh3 2009-06-21 01:54PM | 0 recs
Re: Whatever bruh

As I said- bad faith actor.

by bruh3 2009-06-20 02:22PM | 0 recs
Re: Whatever bruh

once again:  bullshit.

by fogiv 2009-06-20 04:54PM | 0 recs
Re: not sure that I follow you

How the hell to propose to "pressure Obama"?  Nattering away ceaselessly in a leftie forum certainly won't do the trick.  My best way to Obama's ear is through Tim and Amy (and soon, Al)

by lojasmo 2009-06-20 04:58PM | 0 recs
Re: not sure that I follow you

if you think we have no ablity to affect anything either by commenting here or as I also do by calling the WH and my representatives, then why does what anyone says here need to be responded to?

by bruh3 2009-06-20 05:19PM | 0 recs
Sucessful hijacking

You have sucesffully did your job of hijacking the diary, and avoindg any discussion fo whether we should place pressure on the WH.

by bruh3 2009-06-20 08:29PM | 0 recs
Re: fake public health insurance

People argue that President Obama needs to say he will veto any bill without a robust public option plan like that of the House for the reasons you describe. It is about the fact that the plan that is coming out of the Senate (the Baucus plan) would place us in the worse of all possible worlds. This would be damaging to the party, but more importantly, to the American people to not have the choice of a real rather than fake public option. The whole point of the option is to drive down costs by using market forces to create competition for the private insurance companies. Of course, they do not want that competition. I have yet to see one person explain to me why substantively private insurance companies should not face real competition versus what we have right now- which is none at all.

by bruh3 2009-06-20 10:30AM | 0 recs
the Baucus bill

would be worse than doing nothing. I agree totally with Digby on this--we would be forcing individuals to buy overpriced insurance, with for-profit companies getting all the benefits and no serious cost controls.

At that point we would need to lobby a block of progressive Senate or House Democrats to vote the bill down. I do not think Obama would veto a Baucus-type bill if it passed with a good majority in the Senate.

by desmoinesdem 2009-06-20 12:05PM | 0 recs
Re: the Baucus bill

I agree 100 percent. Hence, why I favor keeping up the pressure on all parties. One idea suggested before was that Obama needs to make it plain that he will veto any bill that does not include a robust public option like the bill being advocated by the House. This threat would reshape the Senate debate because right now the battle seems to be between the HELP Committee and Finance about what version will come out of the Senate. This is why President Obama placing skin in the game by such a threat may be important at this jucture while they are doing mark ups.

by bruh3 2009-06-20 12:23PM | 0 recs
Re: the Baucus bill

Unfortunately all bills mandate individual coverage:

http://wonkroom.thinkprogress.org/2009/0 6/19/tri-committee-bill/

But by sheer scope I like the house bill, now how much of it translates to the real legislation is anyone's guess. We have seen how a strong stimulus bill was diluted in the Senate and we now have to go back for another stimulus according to all prevailing indicators. Plus there is the thorny issue of raising funds to pay for the bills, I am both for mandated coverage (I know it is not popular among progressives) in the absence of a strong public option, or a VAT to pay for a public option (together with repealing the upper bracket tax cut), but that too will not be popular among the majority. So that leaves us with the unspeakable, taxing healthcare benefits which is being given serious consideration in the senate. But over all a side by side comparison shows that the Senate bill is the weakest, it might have the veneer of bipartisanship but in reality it is a bill that belongs to the McCain campaign.

by tarheel74 2009-06-20 01:34PM | 0 recs
I'm for a mandate

IF there is a strong Medicare-type public option.

The Senate bill is absolutely a Republican bill. Any health care reform bill Grassley could support is certain to be horrible.

by desmoinesdem 2009-06-20 02:35PM | 0 recs
Re: I'm for a mandate

Thank you. At least someone here feels like me. I have followed the policies and the legislations and as it now stands anything that aspires to be bipartisan gaining 60-70 votes is a sham, it will not do anything to cover the uninsured but spend trillion dollars for nothing. The Senate bill should be DOA but unfortunately that is one that's making the most buzz because it is "bipartisan".

by tarheel74 2009-06-20 02:41PM | 0 recs
Re: the Baucus bill

Another stimulus? Why, the first one was full of pork and completely unnecessary. We didnt and shouldnt have bailed out banks nor the auto companies.....all wasted money.....and to boot, no one is saying exactly how the money has been spent.

As for healthcare, I am against any bill that creates a tax on health coverage, mandatates or a VAT. How bout we simply cut out all the pork and wasted money, and we will find what we need. A new tax on workers such as one on healthcare is a political disaster. Americans are not going to support new taxes to pay for healthcare...

by BuckeyeBlogger 2009-06-20 02:59PM | 0 recs
Re: the Baucus bill

We have to raise money if we want a strong public option and there are many ways for doing that but the most discussed are:

1) Repeal tax cuts for the rich: Yes, but not enough

2) Impose a VAT: I like the idea, because it is in use in Europe but I doubt many people here will buy even a paltry 5% VAT

3) Mandate coverage: This is very unpopular among progressives but right now all bills on health care has some form of individual mandate to prevent cost shifting. For the record I have always been for a mandate if it guarantees universal coverage.

4) Tax health benefits by setting an arbitrary cap: I am dead against it. I was against it when McCain proposed it and I am against it when Baucus proposes it.

5) Reduce federal assistance to the lower income group: Again this will leave approximately 30 million uninsured.

6) Scrap the public option and go with a co-ops as Conrad plans: Unfortunately the public option is supposed to negotiate and bring down cost of drugs and administrative costs due to its sheer size. The co-op is useless at reducing costs because it will not be anywhere near that size and since we have a large shifting population people who change states will have to enroll in a new local co-op and that brings a new level of problems with it.

As of right now the Senate bill is the weakest because it proposes 1, 3, 4, 5, 6. The house bill covers 1, 2 and 3 with added taxes on alcohol, cigarettes, sodas, junk food etc. to recoup some of the costs. I like their option but that's just me. Although I am skeptical of its chances in the senate.

by tarheel74 2009-06-20 03:13PM | 0 recs
Re: the Baucus bill

mandates dont work, been proven time and time again.

by BuckeyeBlogger 2009-06-20 04:13PM | 0 recs
Canada also has a VAT close to 14% on

everything you buy including homes and service you use such as getting a haircut, plumbing, etc. depending on the province you live in. Here's an idea of how  the health co-ops would work:

http://online.wsj.com/article/SB12454581 6309433079.html

excerpt:

The health co-op isn't a new concept. Seattle-based Group Health Cooperative, whose chief executive met with Mr. Conrad last week, is a survivor of a movement that began after the Great Depression to provide affordable coverage, particularly in rural areas. But most co-ops remained small, and folded after the federal government stopped subsidizing them in the late 1940s.

With 600,000 members in Washington and Idaho, Group Health today operates much like an integrated health-maintenance organization. It employs many of its own doctors, runs its own clinics and spends more of the premiums it collects on medical care than most private insurers do.

How much its co-operative approach contributes to lower insurance costs is unclear, however. Many of Group Health's efficiencies come from the organization's integrated model of using its own providers. In recent years, the co-op has introduced high-deductible policies and plans not tied to its providers to stay competitive with private insurers, and its premiums are in line with others'. Health-care costs in the Pacific Northwest tend to be lower than the country's average, but the prevalence of HMOs and the supply of doctors and their practice patterns are big factors

by suzieg 2009-06-21 02:01PM | 0 recs
Re: Canada also has a VAT close to 14% on

IMO co-ops by their very nature are local entities helped out by local entrepreneurs, physicians, clinics, hospitals etc. We cannot have a national co-op, well that becomes a public option then, because you need a big enough entity to administer it and that's where the govt steps in. There is talk of privately administered co-ops at the national level, we have those too, they are called insurance companies. So by simple logic co-ops are ok at local level but they are just not big enough or can be widespread enough to cover the health care needs of the entire nation. In effect it is a sham.

by tarheel74 2009-06-21 02:08PM | 0 recs
Re: What exactly`

When we are funding research for example to study why some men dont use condoms....thats waste. There are thousands of other programs just like it being funded by the federal government.

by BuckeyeBlogger 2009-06-20 04:12PM | 0 recs
Re: What exactly`

No it isn't.  Reliable condom use by men is important.

by lojasmo 2009-06-20 05:00PM | 0 recs
Re: What exactly`

I will presume your joking,...

by BuckeyeBlogger 2009-06-20 05:58PM | 0 recs
Re: Actually, that's very important

Are you kidding me? You actually think thats a good use of taxpayer money?

by BuckeyeBlogger 2009-06-20 05:59PM | 0 recs
Re: uh, yeah

Please its w waste. The purpose of the study is merely to determine why men dont like to use condoms during sex (feel etc). At a time when our government is broke, spendign nearly a million dollars on this is crap. And there are roughly another 1,000 studies and programs just like it being funded. The government and politicians are possing away our hard earned money. These people are liuars and crooks and dont care about middle and lower class taxpayers. They never have and never will.

by BuckeyeBlogger 2009-06-21 07:32AM | 0 recs
Re: Well then
no just stop voting for the same idiots term after term....
by BuckeyeBlogger 2009-06-21 07:20PM | 0 recs
Re: What exactly`

I dont want anythign that tax more money out of taxpayers pockets. Fact is we should be addressed cost controls first through healthcare IT, tort reform and the like before we implement wholescale changes. Show me the cost control measure first and than I may agree to one of these bills...

by BuckeyeBlogger 2009-06-20 04:15PM | 0 recs
Re: What exactly`

The single biggest cost in the system is that we use private healthcare. This is not theory. It's fact. So, you say on the one hand you don't want tow aste tax payer money, but then ont other you want to waste not 100 bil a year, but to the tune of almost a tril a year on wasted healthcare expenses. You sound a penny wise- and pound foolish here.

Additinal economic information:

""The study found that if a public plan -- open to all workers and people seeking coverage on the individual market -- was to pay health care providers at the same rates as Medicare, it would soon have about 131 million beneficiaries, while enrollment in private plans would drop. Lewin Vice President John Sheils said that under that scenario, "The private industry might just fizzle out altogether." A public plan paying Medicare rates would charge monthly premiums for family coverage of about $761, compared with an average of $970 in private plans, according to the study."

http://www.kaisernetwork.org/daily_repor ts/rep_index.cfm?hint=3&DR_ID=57901

This represents a savings of 2500 per year.

Nor does your argument make much sense on the wage loss front.

""Most economists combine wages and benefits when examining employee compensation and the dynamics of the labor market. Firms that continue to offer health insurance will focus on the total compensation, and when paying higher benefit costs may reduce wages (or wage growth) in an attempt to keep total worker compensation (wages and benefits) the same.[30]  The empirical evidence has tended to show that health care cost increases are indeed offset by either direct wage reductions, increased employee cost sharing, or in instances where wages are fixed (i.e., unionized contracts), by increases in the number of hours worked)."

http://aspe.hhs.gov/health/costgrowth/#e mployees

So, again, penny wise, pound foolish. You are arguing idealogical points. Not how to financially help the middle class.

The cost savings regarding healthcare IT is an industry talking point. This is not the reason why we do not have savings in the US.

Here's another chart to illustrate the issue:

Health Care Spending As a % of GDP, 2003
Country    Total Health Spending    Public Spending    Private Spending
Canada    9.2%    6.5%    2.7%
France    9.5%    6.5%    2.7%
Germany    10.7%    8.0%    2.7%
Italy    8.4%    6.3%    2.1%
Japan    7.6%    6.0%    1.8%
USA    13.9%    6.2%    6.7%

Take into account that for the EU altogher , with a population of over 400, they pay 9 percent (using the highest average) for healthcare.

if you look at the numbers, where we lose out in competing against other countries is the amount we pay in private healthcare spending. Not quality of record keeping or litigation,the other boogieman.  That according to recent reports out of Tx is next to nothing.

I am not even getting into the issue of our quality of care only being the same or lower than other countries.

by bruh3 2009-06-20 04:27PM | 0 recs
Re: What exactly`

The chart above came out a messed up. If you look at the numbers, the column for private healthcare costs tells the tell. The fact is we are paying more for private care than any other part of the world. If you think about it, this is especially screwed up because the government has typically been dealing iwth older patients such as those with medicare and medicaid.

by bruh3 2009-06-20 04:30PM | 0 recs
Re: the Baucus bill

A VAT tax like you propose would help the balance of trade as well because it would fall heaviest on imports, which is allowed by our trade agreements. The Europeans do it all the time. They don't have anything near the trade deficit that we had. The VAT tax could kill two birds with one stone.

by antiHyde 2009-06-20 07:58PM | 0 recs
Re: How come no one is discussing

What would you like to discuss about it?

by bruh3 2009-06-20 10:37AM | 0 recs
Re: Maybe if we got our energy behind

Pressure is being applied across the board. No element is being ignored. You making false statements.

by bruh3 2009-06-20 12:02PM | 0 recs
Because it's a good bill

that if we got behind, may actually pass, and if we promoted, may actually end up being the final bill, and will be a massive success...and we're too busy being pessimistic and gloomy.

by DTOzone 2009-06-20 10:44AM | 0 recs
Re: Because it's a good bill

This post is not for you. This is for any readers or lurkers who happen to see it.

There are two branches of Congress. One of them has a bill that's good, and other has one that's crap. I will allow Chris Bowers post to succintly define the problem rather than the way your delusional post does:

"As Kent Conrad has declared that there are not enough votes for the public option in the Senate, today the Senate Finance committee released a health care "reform" proposal without a public option.

However, House Progressives have drawn a line in the sand on the public option, saying that they won't vote for health care reform without a public option. This has led Speaker Pelosi to declare that there are not enough votes in the House to pass health care reform without a public option, and to strongly reiterate her personal support for a public option."

"So, there you have it. The Senate appears to be unwilling to pass health care reform with a public option, while the House claims it is impossible to pass health care reform without one.

As long as we hold the Progressive Block on health care together in the House, this debate is ultimately going to have to be settled by President Obama himself. "

http://www.openleft.com/diary/13843/obam a-will-have-to-take-sides-on-the-public- option

Your post is also factually incorrect in terms of what people are doing.

Here's just one such activist post at Daily Kos (one of many) on the issue of what's happening. Right now, there is the HELP committe proposal in the Senate,a nd the Finance Commmittee. THe later has no public option at all. Is being pushed by Baucus. And yes, people are pressuring Baucus still:

http://www.dailykos.com/storyonly/2009/6 /19/83848/5696

Note one of the updates, as a result of the progressive you are shitting on is this:

"UPDATE #3: Senator Jeff Bingaman just answered all FOUR of the questions brought up by Chris Bowers in this diary by TheFatLadySings"

Those four questions were about the public option. As I said of you and your twin, you only seem to be here to demonize anything that looks like disagreement with Obama without any context or facts to back it up at all. This information that I am providing is to provide others who lurk information in case they do not know it.

by bruh3 2009-06-20 11:34AM | 0 recs
Wasn't talking about Chris Bowers or DailyKos

they're better advocates for this than you have ever been

by DTOzone 2009-06-20 11:45AM | 0 recs
Re: Wasn't talking about Chris Bowers or DailyKos

There is no difference between what Bowers and I are saying or the diarist.

by bruh3 2009-06-20 12:07PM | 0 recs
Re: Wasn't talking about Chris Bowers or DailyKos

Bowers doesn't go out of his way to regularly tell everybody they're stupid.  you do.  That's why he's a better spokesperson than you are.

by lojasmo 2009-06-20 05:03PM | 0 recs
Re: Wasn't talking about Chris Bowers or DailyKos

You are making shit up.

by bruh3 2009-06-20 05:17PM | 0 recs
Re: Wasn't talking about Chris Bowers or DailyKos

Is this snark?

seriously

by KLRinLA 2009-06-21 01:05AM | 0 recs
Re: Wasn't talking about Chris Bowers or DailyKos

By the way- Bowers would simply ignore many of you or ban you from his site given your over the top behavior here.

by bruh3 2009-06-20 05:29PM | 0 recs
that is probably true

Bowers is too trigger-happy when it comes to banning users, in my opinion.

by desmoinesdem 2009-06-20 06:00PM | 0 recs
Re: that is probably true

I agree. However, I can understand the sourse of frustration. You want to believe that everyone is discussing things in good faith, but when you repeatedly see the same subset of posters act in bad faith in discussion after discussion saying patently insane things and using hyperbole like "the President should not be pressured," you begin to realize why Bowers and Rosenberg, etc are the way they are.

At some point, you want to get to the place of pushing for policies that you think are right rather than debating others who do not share your vision.

The irony is that I was defending Obama  at Openleft before he came into office and began to enact policy and fought with Paul Rosenberg a lot because I felt he was being unfair. I still think he is unfair at times.

Indeed, when Jerome Armstrong was anti-Obama over his foriegn policy I said that Jerome can not judge Obama by the people he picks, but instead by the policy he enacts.

The sad part is that I was wrong, and Bowers and Rosenberg turned out to be right. I still disagree with Armstrong over the foreign policy issue. From what I can tell, Obama is doing okay in that arena.

I don't agree with Bowers approach, but I understand it if one has a progressive agenda rather than strictly trying to cut through the forrest of b.s. that one often finds from the protect Obama at all cost crowd.  

by bruh3 2009-06-20 08:19PM | 0 recs
One time, at band camp...

...we had a self-congratulatory back-patting and condescension contest, and some of them were very good but, wow, you're in a whole different league.  Shoot for the Olymipics, 'cause Man, you are GOLD!

by fogiv 2009-06-20 08:46PM | 0 recs
Re: One time, at band camp...

Yeap- as I said- hijacking diaries is the point.

by bruh3 2009-06-20 08:55PM | 0 recs
Re: One time, at band camp...

Whatever.  Hijack, Bye Jack.

by fogiv 2009-06-21 08:37AM | 0 recs
Translation

"I'm just as big of a jerk as Chris Bowers...I swear!"

Now you'll tell me how I'm making shit up...or, what's that other thing you say? oh...right "You're not acting in good faith"

by DTOzone 2009-06-20 06:02PM | 0 recs
Re: Translation

Again- why you are a bad faith poster, and why you need to be ignored- here's your own post

"Wasn't talking about Chris Bowers or DailyKos (none / 0)

they're better advocates for this than you have ever been

Keep Yelling, Nobody's Listening -SallyCat
by DTOzone on Sat Jun 20, 2009 at 03:45:56 PM EST "

You will say anything to hijack a diary if it has anything remotely to do with President Obama.

by bruh3 2009-06-20 08:34PM | 0 recs
LOL

This is a Democratic blog, EVERY DIARY has to do with President Obama.

by DTOzone 2009-06-20 08:50PM | 0 recs
hey buddy

when someone comments making fun of your hackneyed phrases, it's probably a good idea to NOT respond with one of them. Makes ya look predictable.

by DTOzone 2009-06-20 09:03PM | 0 recs
That would be your fellow

Protect Obama at all cost buddy or sock puppet.

"Wasn't talking about Chris Bowers or DailyKos (none / 0)

they're better advocates for this than you have ever been

Keep Yelling, Nobody's Listening -SallyCat
by DTOzone on Sat Jun 20, 2009 at 03:45:56 PM EST "

At this point, I am going to bow out because you people are nuts.

by bruh3 2009-06-20 08:33PM | 0 recs
Re: That would be your fellow

promise?

by fogiv 2009-06-20 08:39PM | 0 recs
Someone move the coffee table

I wanna do a cartwheel in celebration

by DTOzone 2009-06-20 08:49PM | 0 recs
in my post yesterday

on the HCAN ads I encouraged people to contact their House representatives as well. StandWithDrDean and HCAN are certainly urging people to contact their representatives in the House.

by desmoinesdem 2009-06-20 02:37PM | 0 recs
Iran is blowing up

the media is going to focused on that little shiny object...now is the time for US to redrive the debate...with commercials, ads, talk show appearances, op-eds, anything else we can do...so that when the media turns around and focuses on this again (I'd say by Wednesday when Obama takes over ABC and the Iranian Revolution tires them), they will find us owning the issue.

by DTOzone 2009-06-20 11:17AM | 0 recs
Real dealings

There is a silver lining in even the bad plan...having a plan that the insurers will suck up to.  And then, in 10 years or so, you put into effect either negotiated costs or else introduce a true public plan.

So many people think that business is in control.  They are not...they think they are, and they sure as hell want YOU to think they are, but in reality they are almost always "riding by the seat of their pants".  I have done a fair share of work in the medical side of things...as a EMT and as a Microbiologist.  My sister is a soon to be surgical tech.  And a college friends couple are a nurse (husband) and family practitioner Doctor (wife).  I was working for the predecessor of Guidant Corp when Bill and Hillary decided to start the health care reform in the '90's...and I witnessed the total freak out panic that the business went through.  I was told that Washington went from 30 health care lobbists to 3000 in 2 months.  And I also noted that health care costs were rising with lobbist increase...they passed the cost of keeping the govt. from doing anything on to the consumer (They got us to put our OWN boot on our OWN throat.)  So they bought time then.

Then came the Medical prescription plan that was passed, classic corporate welfare, BUT now those drug companies are DEPENDANT on the Govt. subsidies...imagine what would happen if they said to their share holders that they were not going to sell to the Govt. plan anymore...their stock would nose-dive.  They HAVE to be a player to stay in the game...and now the Govt. under new leadership is going to start making them COMPETE and NEGOTIATE to stay in the game...and they cannot stop it.  They are too invested to get out.  It is not a done deal yet, by any means, and the system can still be messed with, but they cannot put the genie back in the bottle without destroying themselves.

So now there is the same discussion about health care reform.  This is NOT about what is best for the public, this is about what is a easier transition for business.  If you think otherwise, you have not been paying attention to US history.  If you do not like it, well, this is the way of the culture...might as well convince Italy not to pay attention to soccer.  Or get Russians to give up on Vodka.  

They will create a far-less-than-perfect system for the public, but a fair system for the business side to slowly transition over to a new style of healthcare.  It will be slow.  But people will buy into it, and then they will start to tweak it to make it better for less...it is the American way too.  And slowly the process will get to where we want it.  Like Social Security/Medicare/Medicaid etc...

It is NOT how I want to do it, but I see that as the plan.  The alternative is to destroy the business model we have and sort through the wreckage.  It is what we can do, and in my opinion what we do best, but our current mindset is still too much "me me me" and not enough about "a little pain now for a lot less pain later."

I blame the Baby-boomers for that!  ;)

by Hammer1001 2009-06-20 11:53AM | 0 recs
we can't wait 10 years

The flaws in our health care system are damaging our economy already, as well as being a moral outrage.

We cannot pass a Baucus-type bill and hope that some future president and Congress will be able to fix it.

by desmoinesdem 2009-06-20 12:01PM | 0 recs
Re: we can't wait 10 years

A Baucus type bill - with a mandate for individuals, none for employers, and NO public option, not only will fail to fix the problems with our health care system, it will also guarantee the loss of Congress in the 2010 election.

People will be hopping mad when they find out what this will do to 1. their pocketbooks 2. their access to health care.

by Coral 2009-06-21 01:18PM | 0 recs
the Senate is the choke point

Various good bills get out of the House and die or get watered down in the Senate.

I did mention the House bill in my post yesterday. We are fortunate to have a strong Progressive Caucus, and we may need them to vote down the Senate bill.

by desmoinesdem 2009-06-20 11:59AM | 0 recs
Re: the Senate is the choke point

This is why I agree with Bowers that the fulcrum for this debate will be Obama since right now the Senate and House are headed toward a divided position that will probably be only addressed if the WH pushes in the reconcilliation bill.

by bruh3 2009-06-20 12:08PM | 0 recs
Re: The dangers of a fake public health insurance

I enjoyed reading your perspective, DMD.  As I've said before, any health care reform that intends to reduce costs or improve public health is likely to be an exercise in tire spinning.  Unless the incredible subsidies we have for sweeteners, refined carbs, and animal fats are reduced 85% or more, health care costs will continue to skyrocket and the proportion of unhealthy Americans will not decline.  Ever.

by SuperCameron 2009-06-20 12:37PM | 0 recs
let's tilt at one windmill at a time

I agree with you about ag subsidies, but those aren't changing anytime during this presidency.

A good health care reform bill could fix a lot of problems--allowing people with pre-existing conditions not to be screwed, for instance.

You're right, though, that health care reform won't solve the underlying problems that make Americans unhealthy.

by desmoinesdem 2009-06-20 03:22PM | 0 recs
Re: let's tilt at one windmill at a time

I understand your position and the value of it.  Like you, I see no reason to waste trillions of dollars on a reform that will be ineffective.  I'll leave it at that.

by SuperCameron 2009-06-21 06:56AM | 0 recs
The House bill

is a good one.  We can pass it in the House(however narrowly) and then pass it in the Senate with 50 votes.  

by Kent 2009-06-20 02:42PM | 0 recs
that would be the best outcome

possible in this situation. If Obama comes out strongly against a fake public option, we have a better chance of getting that outcome.

Chuck Grassley is issuing statements several times a week reminding everyone that the president has always talked about being bipartisan, and Grassley hopes he will continue to reach out and help find a bipartisan compromise on health care, etc.

by desmoinesdem 2009-06-20 03:19PM | 0 recs
Re: The dangers of a fake public health insurance

I think the point of the post is that the pols can pass something they call a "public option" and have it be relatively worthless (it's all in the details), and that there is a lot of temptation for them to do that and that we see a lot of waffling. When they get on camera and say there will be no subsidy for the public plan and imply that it won't cost us anything, we know something is very, very wrong. When Dems repeat conservative talking points about health care, we have good reason to think we may get screwed. When key players in Congress have major ties to insurance companies, we have reason to be skeptical. When they tell us single-payer is off the table, or that America can not afford health care for all its citizens, we know something is very wrong with this process. When Obama seems more interested in having consensus among all interested parties than with the end product, we ought to be concerned.

by DeanOR 2009-06-20 02:55PM | 0 recs
Grassley is not shy

about using Obama's bipartisan talk against people who want a real public option.

I am hoping that the way Republicans rebuffed Obama on the stimulus will prompt him to get fully behind the House bill. The fact is, we don't need Republican votes to pass health care reform, and we can't get Republican votes for any bill worth passing.

by desmoinesdem 2009-06-20 03:23PM | 0 recs
Re: Grassley is not shy

Unfortunately its not just Grassley, you can add Baucus, Conrad and Nelson (all Democrats) for good measure.They have immense clout in the senate. Or as Bill Maher said we have two parties now, center-right that accommodates corporations, financiers, etc. etc. (i.e. the Democrats) and the loony-right (i.e. the Republicans).

by tarheel74 2009-06-20 03:28PM | 0 recs
Re: Grassley is not shy

Unfortunately, that's what this is really about. A narrow band of conservative interests who are using various procedural rules to hold up progress because they no longer represent where the country is or where it is going. For example, Blanche Lincoln
amongst others are coming out against the public option, but their rational is nonsensical.

http://arkansasnews.com/2009/06/18/linco ln-prefers-co-op-to-government-run-publi c-option-in-health-care/

"U.S. Sen. Blanche Lincoln, D-Ark., says she prefers private insurance cooperatives to a government-run provider that would compete with the private sector in reforming the nation's health care system.

"We want to keep what works in the private industry and make it better," Lincoln told Arkansas reporters in a conference call today. "There's a lot of discussion about what else we might need that we can't get from the private sector."

Lincoln sits on the Senate Finance Committee, which will have a central role in determining how to pay for a health care overhaul intended to control skyrocketing costs and provide health coverage for 47 million uninsured Americans. More than 500,000 Arkansans have no health insurance, 66,000 of which are children, according to the senator.

"A co-op would be the back up for the private industry," Lincoln said.

The senator left the door open to supporting a government-option, though she acknowledged she has reservations"

These are the type of people who will need pushing. As is Senator Hagan of NC. They are the one's that Obama can have an impact. Rather than worrying about getting the GOP, we need to worry about getting the wayward Democrats. We do not need the GOP. Just a strong 51 Democrats.

by bruh3 2009-06-20 04:01PM | 0 recs
Re: Grassley is not shy

"We do not need the GOP. Just a strong 51 Democrats."

Well, that's shot, then.  We don't have a strong 51 democrats supporting a public option, and we won't at least until 2010, if then.

by lojasmo 2009-06-20 05:06PM | 0 recs
Re: Grassley is not shy

You know this how?

by bruh3 2009-06-20 05:14PM | 0 recs
Re: Grassley is not shy

I was away and didn't get a chance to reply to your snide reply to my retort about 'really listening'. Here it is: "fuck you."

by QTG 2009-06-20 07:15PM | 0 recs
Re: Grassley is not shy

Because I am paying attention.  Subtract Klobuchar, Bayh, and Lieberman. and do the math.  You'll figure it out eventually.

by lojasmo 2009-07-05 03:39PM | 0 recs
We probably do

but they're going to avoid using reconciliation for as long as they possibly can so they don't have to revisit this in five years.

Right now I only could two dead set against a public option; Lieberman, Landrieu. Four who are leaning no; Nelson, Lincoln, Conrad, Hagan...Baucus will almost certainly vote for a public option if it makes it into the final bill, but he'll do what he can to prevent that from happening. Olympia Snowe has said she'd vote for a public option, so there's one Republican.

The desire for a public option is much much stronger in the House than the desire against one in the Senate.

by DTOzone 2009-06-20 06:05PM | 0 recs
We are going to have to use reconciliation

I dont quite understand the process though.  Republicans used the process to pass Welfare Reform in 1996 and we never had to revisit that.  Same with Bush's energy bill.  

by Kent 2009-06-20 09:03PM | 0 recs
Re: The Byrd Rule

Well if Democrats can hold at least one branch of government, it will be nearly impossible for the healthcare program to expire.  

by Kent 2009-06-20 11:01PM | 0 recs
It expires by itself

it would have to be reauthorized, but if we gain our majorities, which is entirely possible should we get a working healthcare system, we could revisit it earlier than 2019 and make it permanent.

That had been the plane with the Bush Tax cuts...unfortunately (or fortunately), Republicans weren't able to do it before they lost Congress in 2006.

by DTOzone 2009-06-20 11:22PM | 0 recs
agreed
I fear that bipartisanship is likely to get in the way of what we truly need in a health care bill. No matter how many Repub votes we get and no matter how much we compromise, it is still a left idea, and the Dems will be blamed if it doesn't work.

p.s.
Did i miss something? What is up with the flame wars? We need to debate like rational adults or step away from the keyboard.
by selfevident 2009-06-21 12:51PM | 0 recs

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