Even a milquetoast trial-balloon like a "government-option" is beyond the comprehension of the Corporate Media.

Now, if I ran things, I would offer only this proposal: single payer (Medicare-For-All), take it or leave it. Not only is single payer the economically correct thing to do, it would be worth it just to watch the nation's media heads explode!

Here's a question I'd like to see answered: what's preventing people under any of these circumstances from shopping on their own?

Suppose a company decides it wants to cut costs by dropping its current coverage and trying to enroll its employees in the public plan. If the employees aren't happy, but are still required by law to buy health insurance, why can't they simply buy it on the individual market, or perhaps better yet, from some sort of private plan in the exchange? What's to prevent people from doing this now, where the option exists, as I think it does in a handful of states?

Unless there's some regulation to stop this, which nobody seems to be proposing, the only thing keeping them out would be price. But is that so different from how it is now? And wouldn't prices drop for a large number of people, as they pool their resources in the exchange?

I feel like I am missing something really simple about this, because there doesn't seem to be any problem whatsoever.

BrianJ: Spoken like a person who's never actually done what you just proposed doing.

Why can't individual people go buy health insurance? Because it's NOT AVAILABLE on the market at anything resembling a competitive price. Oops - Rush did, in fact, lie.

What's stopping people from "buying" health insurance? The lack of governmental regulation forcing those health insurance companies to 1) actually reimburse hospitals for services rendered and 2) offer actual coverage to individuals. Cherry-picking people who don't need health care would no longer be an option with #2.

It's not that regulations "stop" people from purchasing health care.. it's that no governmental regulation forces companies that TAKE money for health care to actually PAY when those services are needed.

No, prices would not drop - because 100% of private health care insurance companies are NOT in business to simply arbitrage the care for people -- they're in business to take your money and NOT pay.

Health care insurance could be regulated like a public utility. The reason Republicans are making such a gratuitous fuss about this is because the industry wants to remain one in which the execs can soak the masses for gratuitous profits and keep you ignorant of what they're actually doing.

Brian J--

By the time most people are 30, they've had something that makes the uninsurable (in states where insurance companies aren't forced to offer insurance to all comers) or prohibitively expensive (in states where they are forced to offer it to everyone). If you had childhood asthma, have ever been hospitalized, had a broken bone, had an undiagnosed illness (even if it resolved on its own), you are uninsurable in the private market. Other countries with insurance systems generally require that companies cover everyone at the same price. (Switzerland, for instance, allows for gender and age bands, but nothing else._

Obama's constantly repeated talking point: "I keep on saying this but somehow folks aren't listening: If you like your health-care plan, you keep your health-care plan. Nobody is going to force you to leave your health-care plan."

I think Dean's post is an example of a hyperpartisan double standard, which is to say, if rhetoric similar to Obama's (the quote above) were being employed by the "other side", Dean would be all over it, expressing outrage and/or spewing ridicule for misleading the American public.

I think an objective observer would criticize Obama's use of that rhetoric, let alone his endless repetition of it, despite its misleading nature being publicized (not that he didn't know it before initiating it).

First, although it is true that someone can lose their current employer-sponsored health insurance plan or lose coverage altogether, the policy in question here would cause a very significant amount such disruption, as estimated by CBO, causing millions of people, many of whom "like [their] health-care plan" to be UNABLE to "keep [their] health-care plan". It is indeed appropriate to criticize this misleading rhetoric, and it is unreasonable and unfair for Dean to pretend that there is nothing misleading at all about this rhetoric simply because some disruption occurs under our current system, as if there would be nothing different or special or noteworthy at all about government becoming a huge player within this mostly private insurance segment and causing this disruption (people losing the coverage they currently have) on a large scale.

Second, as the Wapo piece explains, Obama's rhetoric may give people the false impression that there would be much less disruption of coverage -- indeed that it would be eliminated by the legislation and people would be able to feel secure that they would not lose their current coverage if they "liked" it. As WaPo explains:

Obama's promise is not just at odds with legislative proposals -- it is also at odds with reality. Under the current system, employers can drop coverage, alter benefit packages and switch insurers. In addition, as the president has noted, people who lose or leave their jobs can lose their health plans; that is one of the fundamental problems the legislative proposals address and one of the main arguments for reform.

But in the campaign to overhaul health care, Obama's promise may serve to reassure people anxious about change. As he said at a news conference on July 22, people may favor the devil they know over the devil they don't.

Bottom line: Obama is being deliberately misleading, and Dean is being unreasonable and unfair, either due to subconscious bias or insincerity.

"I would offer only this proposal: single payer (Medicare-For-All)"

If I see Medicare equated to single payer one more time I'll scream. MEDICARE IS NOT SINGLE PAYER!!!!

Medicare pays about 80% of most normal "health care" bills for a sliding scale starting at $96.40 a month. You are responsible for the rest. If you are sufficiently poor - and do mean poor - you can be covered overall but otherwise you have to (1) pay the 20% or buy PRIVATE insurance to cover it, and (2) pay for your drugs or cover your drugs through a PRIVATE Medicare Part D plan. Again if you are poor, there is help. Otherwise you pay premiums, deductibles, co-pays and for ALL of your drugs after they cost $2,700 until they cost you $4,350 (the infamous donut hole).

I am a volunteer in Virginia who helps people with Medicare Part D and I have clients paying over $800 a month for drugs only during the donut hole. Plus their Part D premiums.

Medicare is not single-payer and if you happen to be low income but not poor according to the government and have a number of health problems as many folks over 65 do, Medicare is no picnic. Also it has next to nothing for dental and vision.

MEDICARE FOR ALL IS NOT THE ANSWER!

Obama has "negoiated" with the drug companies to halve the donut hole and eventually eliminate it. In return he has promised not to negoiate drug prices overall, thus allowing Big Pharma lots and lots of profits for years. That's why they are now willing to support "health care reform".

Obama is in corporate America's pocket the same as Bush was.

you can keep your plan if it's the one we planned for you to keep, but only at the conscious level

at the subconscious level, you can keep it if we change it, but only after you wake up

at the subconscious bias level, if we change it and you keep it, it's not the one we changed

at the deliberately misleading level, if you keep a plan you did not plan, that's deliberate

at the misleading level not deliberate, if you keep a plan, we can take it back

at the unreasonable and unfair level, if driven by subconscious, then the plan is unintended, or with bias, unintentionally unintended

if driven by insincerity, then the plan is both, unreasonably insincere and unfair, which corrected for bias, is reasonably insincere and unfair

if the plan has any known knowns, known unknowns, unknown knowns, or unknown unknowns, please dial 1-800-NOW-SICK and press 1 really hard and fast for a claims adjuster with a GED education

Martin Weiss has taken on the big insurers in America's fcked-in-the-head health care system, and survived to write about it.

http://www.moneyandmarkets.com/health-care-war-35069

Well, U.S. Medicare IS single payer by definition, it's just not a dollar-one single payer. What it is NOT is a British-style socialized healthcare system or even a Canadian-style dollar-one (no copay, no deductible) single-payer system.

Canada's single-payer "Medicare" system is not perfect either, and wait times are still an issue, though less so than in the '90s.

The difference in Canada is they have an open dialogue about their problems and what needs to be done, rather than one dominated by lies, deception, and fearmongering. Ironically, when fears are raised in the context of healthcare reform in Canada, those fears tend to revolve around changing the system to make it more "American-like".

Our biggest problem is that we currently pay 17% GDP for our healthcare. Canada pays 9.5% GDP. In dollars, the difference is even more pronounced. They pay $3500 per capita, we pay $7500. Bill O'Reilly might consider that per capita differential a great deal, since "we have more people," but I think we're getting massively ripped off.

Our biggest problem is that we currently pay 17% GDP for our healthcare. Canada pays 9.5% GDP. In dollars, the difference is even more pronounced. They pay $3500 per capita, we pay $7500. Bill O'Reilly might consider that per capita differential a great deal, since "we have more people," but I think we're getting massively ripped off.

srla,

Thank you for highlighting this important fact with innumerable policy implications that wretched botched and bungled mainstream hyperpartisan conservatives like brooks are either too ignorant, too selfish and greedy, too dishonest, or just plain too cognitively deficient to understand.

PMA,

Referring to me as a "hyperpartisan conservative" -- for my simply having challenged you to take a rational approach to policy choices, including the radical notion of considering trade-offs -- is perhaps the stupidest thing I've seen you say yet (and that is saying a lot). I guess it's just a reflexive, juvenile "I know you are but what am I" kind of response (I don't know if six year-olds still say that), since I have probably at some point labeled you a hyperpartisan.

I've sought rational, substantive, mutually responsible discussion/debate with you multiple times on this blog and on Hennessey's, but to no avail. Apparently your only response at this point is persistent ad hominem as some emotional defense mechanism.

If you ever wish to engage substantively on any point I've made or question I've posed to you, please do. And good luck with your emotional recovery.

PMA and all,

By the way, it's comical that PMA projects his own hyperpartisanship onto me, something that I get from hyperpartisans on the right as well. And not that I can conclude on my brief encounter with Ben today on another thread that he is a hyperpartisan, but it's amusing that, due to his own confusion (resulting in his false sense that I had contradicted myself), Ben replies to me saying:
You agree with each of my arguments that support the fact that SS is a Ponzi scheme. Yet, somehow you still refuse to acknowldege that SS is in fact a Ponzi scheme. Amazing. SS must be a sacred institution to you. In that case, I don't expect you to out-and-out agree with me. http://www.prospect.org/csnc/blogs/beat_the_press_archive?month=08&year=2009&base_name=ap_a_giant_rightwing_propagand#comment-6286498

To Ben, I am clearly, completely contradicting myself because I am just so committed to opposing any reduction in projected Social Security spending that I either lose all sense of logic or just lie in an absurdly obvious way.

" U.S. Medicare IS single payer by definition"

If in order to keep from being bankrupted by a single medical set-back like cancer or a stroke, the average Joe needs to have not only Medicare but also a MediGap policy (hospital and health services like doctors) and a drug plan, both PRIVATE, then it is disingenuous in extreme to consider it a single-payer system. It can take several "payers" to produce health care in the US that doesn't bankrupt you. We won't even discuss vision and dental.

I firmly believe that we need health care reform and spoke in its favor at a rally in Bristol, VA (same day as Obama but not at Kroger itself) but, believe me, giving everybody Medicare is no solution. Health care reform would probably hurt me because I have outstanding insurance but I'd still support the right kind of health care reform because I know what havoc it is wreaking on some of our most vulnerable citizens.

I am part of a group of people trying to help fund dental care in my area. We had a meeting tonight to help firm up structure, plans, etc. A (medical) doctor who is part of our group and I started discussing the whole health care reform biz. He said at one point something to the effect that the biggest problem isn't the uninsured, it's the insured.

He ain't wrong from my experience.

FWIW I voted for Ralph Nader, not that corporate hack Obama.

It the public option goes into effect and provides health care at a better price than private plans , will corporations be required to switch to the public option as a fiduciary responsibility to their shareholders?That would be a nice problem.

"President Obama made an absolutely true and meaningful statement in claiming that people would be able to keep their current plan, if they like it."

I think the changing market dynamic is a significant issue. It would be more correct to say "if they like it, and if insurers and employers still plan to offer it." Since that would be a legitimate concern.

What I am baffled about, is that you wrote the same thing that the article wrote, and then acted like they didn't write it. Literally the 4th last sentence of the article reads "Under the current system, employers can drop coverage, alter benefit packages and switch insurers."

So it is amazing that you can 'bash' them for ignoring this fact, when in reality, they gave it a prominent place in the article for the reader.

Aditya,
Well said.

Aditya,

the point is that given that fact, there was no point in having the article. I really doubt that was a single person in the country who thought that Obama was promising that his proposal would keep their health insurance plan from ever changing. Since no one, or almost no one, believed that this was the meaning of Obama's assertion, why did the Post have to kill trees to tell them that Obama's plan would not mean that their insurance would not change?

Dean,

The answer/correction to your rhetorical question is upthread http://www.prospect.org/csnc/blogs/beat_the_press_archive?month=08&year=2009&base_name=the_post_uncovers_the_truth_pr#comment-6286454

I guess you somehow missed it (ahem). If you think those arguments are invalid, feel free to say why.

And Dean,

A bit more.

What Obama says:
"I keep on saying this but somehow folks aren't listening: If you like your health-care plan, you keep your health-care plan. Nobody is going to force you to leave your health-care plan."

The Reality:
A great many Americans, probably millions, who like their healthcare plan and would be able to keep it if Obama does NOT achieve his "reform", would indeed be forced to leave their healthcare plan if Obama DOES get his "reform".

Do you really see no difference between those two, and think no reasonable person would see a difference between those two?

Do you really think that just because some people lose their current coverage under our current system, that means that it is legitimate for Obama to say (and say repeatedly and emphatically) that no one will lose their current coverage when he is talking about legislation that causes millions of people to lose their current coverage (and I assume significantly increases the total number of people who lose their current coverage)?

And again (per the second point in my comment upthread and as noted by WaPo), some people may even think Obama's reform would eliminate the disruption of the current system.

...and just to be clear, by "cause", I don't mean that it would be mandated by the legislation, but rather "cause" in the sense of creating conditions that have a particular, predictable and anticipated consequence.

I have Blue Cross Blue Shield coverage. My premiums have doubled in the past seven years. My copay is recently at about 50%. I am retired and 1/3 of my income goes to health care. My age prevents me from being in a position to "shop" for insurance. The taxpayer money that has gone to 'bailouts' or Iraq would more than pay for health care in the US. It's time to try something else. The middle class cannot afford to fight this legislation like the insurance companies can.

And Factcheck.org weighs in http://factcheck.org/2009/08/keep-your-insurance-not-everyone/

The question is what does "keeping your insurance" mean in this situation. Healthcare reform won't force anybody who has good coverage into lesser coverage. The equilibrium of a public option would be a two-tier system that helps everybody. What it will do is decrease the cost of basic coverage, leaving you with more money to purchase private add-ons. Meanwhile, more poor people would be able to afford the basic coverage.

Dean, thanks for responding.

You've got more respect from me since you sometimes respond to the criticisms.

If you don't even see this comment now, I will understand that :)

I recently read that the proposed reform also bans high deductible plans. This is a -real- removal of choice to keep our own plans!

I like high deductible plans -- low deductible plans mean paying the insurance company to manage my financial risk. I don't want to pay them for that! :) I would be fine with a law that only allowed us to have a high deductible plan -if- we have enough money in an 'investable' HSA - where the investments money could be restricted to FDIC insured CDs (or bonds).

As the proposed reform stands now, the insurance companies will get paid to manage my financial risk AND will do what they do for others now -- invest the rainy day funds into more risky investments than I would.

So Obama's statement is not true, and I don't want to pay them for that :)

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