Baucus - orchestrating defeat of the Public Option

I just realized that Baucus has orchestrated his committee's hearings to defeat the public option.

How?

First, he put the two public option amendments up before Conrad's co-op amendment. Now, Conrad's amendment has not a chance in hell of passing. It won't get any Republican votes and not enough Dem. votes to pass - but by bringing it up after the public option amendments, Baucus assures a "no" vote from Conrad on the public option amendments.

Second, by bringing them up near the start of deliberations rather than at the end, the proposers can't point to all of the failings in the Chairman's mark because Baucus can always assert that "amendment such-and-such" will solve that problem.

I sincerely hope that his poll ratings drop like the proverbial lead balloon.

Health Care Reform: The Health Exchange Myth

I've been following the health care debate pretty closely, and the proposal for health care exchanges seems to be a cornerstone for individual choice. But it's really just rearranging the chairs on the Titanic.

Consider the following hypothetical situation: a very healthy single 25-year-old man working a minimum-wage job goes to an exchange. Now, after rent and groceries and phone service, he doesn't have a lot of extra money floating around. The only plan he can afford from the "wealth of choices available" is a $50/month premium with a 10K deductible. He gets it. 6 months later, in spite of a flu shot, he gets the flu which turns into pneumonia. He spends weeks in the hospital. He loses his job. His health bills total $20,000. But he has a 10K deductible. And he doesn't have $10K in a savings account. And he's unemployed because the company he worked for doesn't have anything like sick days off. The fact that he had a "choice" of health plans is irrelevant.

Or take another case: somebody has bought a cadillac plan from an exchange, paid premiums for 5 years, then loses her job. Unemployment benefits run out. She has a choice: pay the rent, buy groceries, pay for utilities or pay for health care premiums. She's healthy so she drops the health care. Then she gets really sick. And she can't get help except from an emergency room because she no longer has health insurance.

The central problem with health care exchanges and this so-called health care reform is that everything depends on a person's being able to buy health insurance, pay the monthly premiums and cover the deductible. It is a system designed to save the private health insurance industry not to guarantee health care for all Americans.

No citizen of any other industrialized country has to depend on being employed, and earning enough to buy health insurance, to get health care. Only in the U.S., even under the proposed plans, is health care still to be a privilege not a right.

Health Reform: "Affordable, Accessible"

I am beginning to hate this phrase, used by both Democrats and Republicans. Do citizens in other major industrialized countries ever ask themselves if health care is "affordable"? No. Of course not. Health care is a right. Yes, they pay for it through their taxes but they don't have to ask what the cost is when they need to see a doctor.

But in this U.S. reform movement, the highest goal is to make health care "affordable".

I'm not sure what is meant by "accessible".

But the Republicans are, at least, honest. They don't argue for health care for all. They talk about "access to health care insurance". Think about that. Access to insurance not to health care.

Health Care Reform: Why Should A Public Plan Cost the Government Money?

I'm baffled by the assumption that a public plan must be paid for by the Federal government.

If private insurance companies are forbidden to "cherry pick" insurees, then a public plan should be able, theoretically at least, to fully fund itself from the fees paid by the people it insures.

In other words, aren't we talking about a non-profit insurance option? Yes, such a plan will probably undercut private insurance companies. It, after all, will have no shareholders to consider, probably won't pay its executives multi-multi-million dollar salaries and won't have an army of employees whose only job is to deny coverage.

But that's a problem for private insurance companies to solve - not a problem for the federal budget.

Obviously, this won't work if private insurance companies are allowed to choose to insure only the young and healthy while all the rest of us flock to the public plan - but if no plan can discriminate against people based on pre-existing conditions (not just in providing insurance but in the cost of that insurance), then a public option should pretty much be able to fund itself with, perhaps, some government backstop for those citizens who simply can't afford health insurance at any price but are not eligible for Medicaid.

Left Missing in Action: Nobody should get between you and your doctor

One of the GOP mantras re health reform (listen to Grassley et. al.) is that Americans don't want government bureaucrats to come between them and their doctors - which is why we should oppose single-payer and a public option and comparative effectiveness.

The most frustrating thing about this mantra is the almost total lack of response by the so-called liberal media and Democrats.

We already have bureaucrats getting between patients and their doctors. They are employed by private health insurance companies. Thousands (tens of thousands? millions?) of them are employed to deny coverage to patients. Some doctors spend 20% of their time arguing with these people.

Now, I agree with the basic premise. Health care decisions should be between patients and their doctors - but if somebody has to get in between the two in order to reduce overall health expenditures, I'd rather it be a civil servant who can't be fired for saying "yes" (and who may rely on comparative effectiveness research rather than cost) than a private insurance company employee whose salary depends on reducing costs and increasing the bottom line.

Please explain to me, somebody please explain, why this very simple and accurate response to this frequently repeated Conservative canard seems to be almost completely lacking from the health care debate.