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No public option, no problem

Published on Monday, Oct 5, 2009 at 12:12 am | Last updated on Monday, Oct 5, 2009 at 12:12 am 36 Comments

The success (or failure) of national health care reform does not balance on the fate of a "public option" for health insurance. If the votes for its existence do not exist in Congress — by all accounts, they don't — hanging onto its inclusion could sink other, important changes.

Popular support for a public option is based, in part, on populist resentment of insurance company profits and premiums. While there are good reasons to be angry at insurance companies, it must be considered that achieving universal coverage is more possible with them, than without them.

The cases in point are the two tacks taken by Maine and Massachusetts in addressing the uninsured within their borders. Maine developed its own public option program, Dirigo Health. Massachusetts went for regulation, compelling residents to purchase insurance (with subsidies available for lower incomes).

As the national debate on health care has unfolded, it has not been Maine's decision that has been lauded, even though a federal public option has been touted as the most crucial aspect of reform. Instead, Massachusetts' success in covering its uninsured has earned the laurels.

Why? The easiest of answers: results. Massachusetts has delivered coverage, leaving it to boast the nation's lowest rate of uninsured, by far: 4.1 percent, according to figures released in September by the Census Bureau. Maine, by comparison, had an uninsured rate of 10.9 percent, which is little different than pre-Dirigo Health.

It boils down to one question: What is the goal of reform? Is it to break the insurance companies, or provide coverage to all Americans? The answer should be the latter, yet the insistence that a public option is the make-or-break facet of any policy seems to insinuate the former.

If Massachusetts can provide near-universal coverage without engaging in the possibly costly experiment of a public option, there's little reason to lament the votes of the Senate Finance Committee, which rejected the inclusion of a public option in reform legislation twice last week.

At best, the public option would have reduced insurance premiums by shaking up the insurance market; in fact, we've said the option has merit as a market-based solution. Yet, at worst, the public option could have become a political time bomb inside health reform, just waiting to blow progress to smithereens.

It should be rejected. Massachusetts' example proves that universal coverage is possible without it, as long as policymakers exert their influence. Sen. Olympia Snowe, speaking of influence, has voiced concerns about fining people for lacking health insurance, a point on which she should be flexible.

Some penalty will be needed if the goal is universal coverage. Massachusetts imposes a fee of less than $100 per month, for example, depending on calculations of income and affordability.

No public option is no problem. In the long-term, putting the option aside could become viewed as what makes health reform, as a whole, possible.

editorialboard@sunjournal.com

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Displaying comments, from newest to oldest

Gary C's picture

Healthcare reform is taking

Healthcare reform is taking a bad turn, causing many to take their eyes off of the ball. US healthcare is the best in the world. Rich people from all over the world come to the US when they need something complex taken care of. People come from around the world come to the US to learn how to be a doctor, too. The quality of our healthcare is leading the way for the world to follow.
The problem is that you have to be rich to get that care. Healthcare costs too much, and many people find it cheaper to get sick, stay sick, and die than to go to the doctor when they need to go, and/or to take their medicines as prescribed. Being insured is a start, but even with crappy insurance, people have to make unhealthy financial decisions. 100% of our population insured will not solve the problem. If we can lower costs, and still get people what they need to be healthy, we will have achieved a very lofty goal.
I only wish I knew how to do it, and I can only hope that someone much smarter and more informed than me is working on it right now.
Putting the Feds in charge of everybody's healthcare is not a good idea. I have seen VA facilities and how the govt. has done there--plus Medicare and its programs are reeking with waste, confusion and corruption. In general, American free market systems work better than Federal systems, as long as someone is watching the crooks in the private sector. A one payor system is the worst of all ideas. Fix Medicare before anything else, then address costs, then fix private insurance.

DR's picture

Dirigo fails because it's a

Dirigo fails because it's a lousy expensive program. A really bad example of a "public option".

jalbrecht1's picture
verified

Sirmel, You can't argue for

Sirmel,

You can't argue for tort reform like Texas which restricts competition and then agrue for competition to cut costs. As we now see Health care reform means many different things to different people and interests. Well so does tort reform. Doctors who perform according to standards should be protected. Facilities that apply management techniques that reduce errors should be protected. But 98,000 people die because of medical errors each year. One control that provides an incentive to reduce that number is lawsuits. In this state we have a peer review board. That's a good step. We need more.
Its not state laws that have eliminated competition. The insurance companies have colluded to cut up the insurance markets into monopolies where they can control prices independent of costs. This year Anthem has increased premiums by 80%, 52%, 42% respectively in three states. In the middle of the Great Recession. Competition can only be restore by a government run program where regulated and regulator have no contact.
Jon Albrecht Dixfield

jebbie47's picture

Sir; The number that you

Sir; The number that you have given is purely an estimate, some estimate are as high as 200000! No one has really taken this issue seriously enough to really ck it. To what method or methodology did you do to come with a estimate number of 98000?

Didn't you got it off the web and they themselves don't even know again purely estimated.

For your perusal: http://www.downeast.com/Articles-2007/Maines-Insurance-Mess/

Remember I said tort reform: http://www.atra.org/wrap/files.cgi/7964_howworks.html

MomOfTwo's picture

Sorry...but I just gotta

Sorry...but I just gotta laugh. Proudliberals profile reads:
First Name
Proud
Last Name
Liberal
Profile
Highly educated, smart, and politically saavy

Highly educated, smart and unable to spell savvy! That's a good one!

Proudliberal's picture

You got your stupid and then

You got your stupid and then you've got momofidiots.......http://tinyurl.com/yeae8cl

veritas's picture
verified

So you're both incapable of

So you're both incapable of following instructions when told to submit your name when registering.

Pot, meet Kettle; Kettle, meet Pot.
------------------------------------------
When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

MomOfTwo's picture

Gee...I don't remember

Gee...I don't remember addressing "veritas" anywhere in my comment. And, if "veritas" could actually comprehend what I said, I was not at all commenting on proudliberals choice to not give his/her name. That's a personal decision and I don't blame anyone for not wanting to put private information on a public forum. My comment was addressing the fact that he/she thinks themselves to be well educated, smart and unable to spell savvy. Get a clue "veritas".

veritas's picture
verified

I've got a clue. You're not

I've got a clue. You're not willing to take personal responsibility for the swill you keyboard here.

------------------------------------------
When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

jalbrecht1's picture
verified

Universal Coverage is not

Universal Coverage is not the sole goal of health care reform. If it were only a single-payer universal health care system supplemented by private insurance would be the answer. The US health care system is rated 37th by the WHO. Others rate it differently but no one rates it better than 15th. Insurance Companies deny care for 20% of treatments order by doctors. That can only worsen care.
If we want to meet all the goals of health care reform then a robust public option that as Rep. Michaud proposes permits negiotiated reimbursements not ones pinned to Medicare is the only means that can work.
Jon Albrecht Dixfield

veritas's picture
verified

In essence, the Sun Journal

In essence, the Sun Journal has opted for a 'Public Option' for the Insurance Companies, their shareholders, overpaid management, and "for profit" administration of health care payments.

Way to go, Dingleberry-Heads!!!

------------------------------------------
When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

jebbie47's picture

One of the big problems for

One of the big problems for health care cost is created by state laws. Laws that prohibits competition. Also state laws that will not take on tort reforms. When states take these 2 up and have the laws in placed those states has a savings. You can do your own homework here. Look at Texas and Now Mississippi.

Look at your own state here for the problems, its not the fault of the Feds for these 2 issues but certainly the feds can help if they wanted too.

veritas's picture
verified

Use Texas and Mississippi as

Use Texas and Mississippi as two shining examples of how to do things? My God, Sirmal, do you have one whit of common sense?

Of the fifty States and the District of Columbia, Texas, and Mississippi rank 50th and 51st (in that order) of the people, 25 and over, who have completed High School (including GED). You can see how they value education there. Politicians can foist anything off on that group - they get what they deserve........ Reform?? More like saving money on the backs of the victims as you remain in the age of the 'Robber Barons."

http://factfinder.census.gov/servlet/GRTTable?_bm=y&-geo_id=01000US
&-_box_head_nbr=R1401&-ds_name=
ACS_2005_EST_G00_&-format=US-30

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When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

Lil's picture
verified

43.9 Percent of Texas’s

43.9 Percent of Texas’s Non-Elderly Residents Were Uninsured for One Month or More in 2007-2008 http://www.familiesusa.org/resources/newsroom/press-releases/2009-press-...
______________________

"A conservative is a man with two perfectly good legs who, however, has never learned to walk forward."
Franklin D. Roosevelt

jebbie47's picture

Hmm I knew that long before

Hmm I knew that long before you did but I gauge the end results take a look at this poll you will find this even more interesting so much for school they teach harder in miss and Texas :)

http://money.cnn.com/2005/05/27/Autos/test_scores/index.htm

veritas's picture
verified

Sirmar - Teaching??? You

Sirmar - Teaching???

You site you provided referenced "The average scores on a 20-question driver's test administered to more than 5,000 licensed drivers in a survey commissioned by the GMAC Insurance."

And the drivers who responded in Texas and Mississippi scored in the lower 2/5ths. And those are licensed drivers who actually applied for insurance; Sheesh!!!

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When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

crash694's picture

I find it funny, in a way

I find it funny, in a way that our Goverment official think they need to re envent the wheel here on health care. If you take a look at why health care has risen so hi. We fiirst look at insurance and think they are the colprets. If you stop and think about it, no they are not the colprets here. Hospital are. They are the one that charge you hi rates for a list of cost Like x-ray, scan, room, and the list go on and on, So what do Insurance do, they try to, as best as they can have a rational pricing of cost. Yes some of you must think i work for an Insurance or goverment No i do not to both. If you all think for a minute and look at were the cost are.
Insuranse is like a contractor going out to bid for a job and giving a cost est. on work to be preform, Same thing here But to add to the cost Its States that also tell insurance companies on some pre set requirements that need be added to all policies Like in some states, plastic surgery, bo tox, etc. So this is one reason that some pollicies sky rocket do to the cost of thouse proceadures. Aslo with the added States requirement is also a reason policies are not portable from states to state. So if states would elimant the set requirement and regulate the hospital cost. This would also bring down our Insurance cost. And hvae the states reform TOR ( spelling on that one) refom to limit the of how much Dr, can be sued Then that too will also help in the over all cost.
Remember this wheel has beeninvented and been working fine. We do not need Fed gov. punching hole in the wheel. We as Mainers need to reform from with in

veritas's picture
verified

crash694 writes: "I find it

crash694 writes: "I find it funny, in a way that our Goverment official think they need to re envent the wheel here on health care."

The wheel's already been invented there, Skippy.

We're just the last "Industrialized, First World Country" that would give it a spin in the direction of Single Payer Health Care.

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When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

candiceanne's picture

The public does not support

The public does not support socialized medicine/federal health insurance the votes to inflict it are not there Washington, two facts few would dispute. Since the people dont want it and Congress is not going to pass it lets stop spending on countless staffers and meetings and all that has gone along eith the gargantion media and public relations circus. The taxpayers are footing the bill but it is not for better health care.

Lil's picture
verified

The people paying attention

The people paying attention would easily dispute your so called "facts", 77% support for a public option: http://www.surveyusa.com/client/PollReport.aspx?g=5ba17aa2-f1b9-4445-a6b...
______________________

"A conservative is a man with two perfectly good legs who, however, has never learned to walk forward."
Franklin D. Roosevelt

jebbie47's picture

yep facts are only 46% favor

yep facts are only 46% favor public option as of today

http://www.rasmussenreports.com/public_content/politics/current_events/h...

Lil's picture
verified

65% of Americas do favor a

65% of Americas do favor a government administered health care plan like Medicare that would compete with private insurance companies. http://www.nytimes.com/imagepages/2009/09/25/us/politics/25pollgrx.html
______________________

"A conservative is a man with two perfectly good legs who, however, has never learned to walk forward."
Franklin D. Roosevelt

jebbie47's picture

NY times is a super BIAS

NY times is a super BIAS Paper very ultra liberal not Rasmussen so getting it right I diffantely lean toward toward Ras.!

Lil's picture
verified

"Finally, it is clear that

"Finally, it is clear that Mainers overwhelmingly support a government sponsored non-profit health insurance option, 63 to 27 percent." http://www.democracycorps.com/strategy/2009/09/olympia-snowe-the-politic...
______________________

"A conservative is a man with two perfectly good legs who, however, has never learned to walk forward."
Franklin D. Roosevelt

crash694's picture

and i am sure they would

and i am sure they would also follow evey one jumping off the bridge.

fixit001's picture

My rate for insurance has

My rate for insurance has increased by 20% AND MY CO-PAY HAS INCREASED BY AS MUCH ALSO BECAUSE OF SCUM SUCKING BALDACCI AND THE MAINE BUMS WHO WANT TO SIT HOME SMOKE AND WATH TV!!!! NOW this RAG thinks it would be a good thing nationaly Man I wish this editor would just grab a rope and tie it to a 747 and just take - off!!!!

Proudliberal's picture

Typical Sun Journal analysis

Typical Sun Journal analysis of a complex issue. You cannot compare the way a state would try to provide a public option versus the federal government. The scale is so massive on the federal scale that the inefficiencies inherent in states doing it on their own are eliminated. For example both Maine and Masschusetts had to negotiate separately with HMOs to implement their plans and the insurers had plenty of leverage in the negotiations. The federal government would simply say this is what the pay scale is and the insurers would have to deal with it. The public option is not just about breaking the health insurance companies, it is about making sure no one in this supposed greatest country on earth does not lack for health care. As it is now we rank 36th in the world in terms of the health care provided to our citizens.

Here is a an easy to understand solution: use the French model of health care. France for decades has been the the #1 country in terms of caring for it's citizens and you know how they do it? A 7% payroll tax and $120/month - that's what gets your average French person his/her healthcare -- copays, prescriptions, everything. No unexpected bills, no sticker-shock, no wrangling with insurers.

Why we cannot have the same here in the United States, and why the SJ editorial board cannot understand why a public option is so important is deeply troubling.

Dayle Baker's picture

Way to go Proudliberal,

Way to go Proudliberal, stand up for what you believe. Do let these other haters get you down. The French healthcare system is the perfect example of government health care.

USA Today 9/25/03 - PARIS (AP) — The death toll in France from August's blistering heat wave has reached nearly 15,000, according to a government-commissioned report released Thursday, surpassing a prior tally by more than 3,000...The bulk of the victims — many of them elderly — died during the height of the heat wave, which brought suffocating temperatures of up to 104 degrees in a country where air conditioning is rare... The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

veritas's picture
verified

Chicago had a higher death

Chicago had a higher death rate per capita from their heat wave of 1995.

Whatever faults the French had - our system was worse, but glad to hear you revel in such disasters.
------------------------------------------
When I was a young Sailor - I drank like a Sailor, fought like a Sailor, and screwed like a Sailor. Now that I am old and wise - I have a few scars, but many fond memories.

jebbie47's picture

Hmm straighten me out here a

Hmm straighten me out here a bit I'm somewhat confused. You are saying that the states are inefficient and the federal government won't be?? Sir: may I remind you that Medicare is almost broke and according to Obama 300 billion of fraud are within that program, and the last time I can remember is the fraud issue was taken up with Reagen! Now we look at the Social Security will be broke around 2020.

So far you have blasted SJ with no given facts you really need to your Homework you spin just like a Liberal can!!

Jabba's picture
verified

So your solution is a heavy

So your solution is a heavy handed government that requires your employer to involuntarily take money from you and send it to them? They will then take that money and spend it on people who are perfectly capable of working, but choose not too.

I invite you to emigrate to France.

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Proudliberal's picture

This is just the kind of

This is just the kind of idiocy insurance ceos love. The current system is woefully broken and needs to be completely rebuilt. Having the government provide healthcare isn't a bad thing. Just ask anyone over 65, or a veteran, or a person working for the government and they will all tell you they get superior care to what is offered privately. And to boot, it is much less expensive. Medicare's percentage of income devoted to pushing paper is 2/3rds less than any private insurer. Move to France? Not the solution. The solution is to educate people like you who don't know your a$$hole from a hole in the ground.

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