I'm sure I read that the original "public option" being floated was a rival policy offered on the exchanges and open to anyone to buy into?

The PO would only be open to those who had no other options, a group estimated to be from 2% to 5% of the total market.

That, as I've said all along, I think is a good idea.

Now, how is 5% of the market going to consume the other 95% of the market?

It's not, which is precisely why I didn't put that argument forward.

Perhaps if what were being discussed were indeed "open to all" then your feared scenario might even be possible, but it just ain't.

My "feared scenario" was predicated upon an "open to all" option.

Single-payer would be dandy, but ain't going to happen politically any time soon here

And yet Democrats have been on record as saying that the public option is merely a "trojan horse" to bring about single payer:

http://www.youtube.com/watch?v=dT4mV3R7vu4&feature=player_embedded

please explain the use of Blackwater in our wars when they do the same job our military used to do, except at a price tag per soldier that is much much higher?

Two points. Number one, profit. If the government operated to turn a profit at the same rate as Blackwater, the price tag per soldier would be higher. All I said was that the private sector's costs are lower. That it's a more efficient way to operate, and we should tap into that wherever possible.

Secondly, re-read what I wrote:

And yes, that includes spending on the military or other "Republican" areas too, but there isn't really a sensible option for privatisation of those areas.

I've never advocated the use of companies like Blackwater because I do think that the military is one of those areas where public is better than private.

Now you're for a public option?

I've always said I agree with a public option. In fact I outlined a proposal in one of my earlier comments as to how I'd reform US healthcare if it were my responsibility, and my plan did include a basic public option.

The "public option" being discussed isn't remotely anything near "public option open to all" which you're talking about. The PO would only be open to those who had no other options, a group estimated to be from 2% to 5% of the total market. Now, how is 5% of the market going to consume the other 95% of the market? It's like saying "MacOS has brought Microsoft to their knees" -- it doesn't hold up, in simple market economics. Perhaps if what were being discussed were indeed "open to all" then your feared scenario might even be possible, but it just ain't.

Single-payer would be dandy, but ain't going to happen politically any time soon here (unless it happens on a state-by-state basis, which it might).

As for the government always screwing things up, and the private sector always doing things cheaper, please explain the use of Blackwater in our wars when they do the same job our military used to do, except at a price tag per soldier that is much much higher? Oh, and don't forget the "cost plus" in that arrangement.

Michale -

Poll after poll shows Americans would prefer the public option, at a steady 60% to 40% split. So why not add it to the current bills -- which poll much lower, because the public option isn't in them?

nypoet22 -

I agree about the hypocrisy of claiming credit in ribbon-cuttings.

Moderate -

Now you're for a public option? As I said, the PO as it exists in any of these bills, is very limited and most wouldn't even be able to choose it. So isn't that what you're talking about? Limiting access to it? Perhaps you'd limit access differently, but I really don't think it's all that far from what you say you'd support.

Michale -

OK, let's try an experiment. Take a poll of everyone on:

Medicare
Medicaid
VA

and ask them: "Would you prefer keeping the healthcare you have, or buying it on the open market, even if I handed you John McCain's $5,000 voucher per year to do so?"

And then poll people with private insurance, and ask them: "Would you prefer what you have now, or Medicare, at the same price you are now paying?"

I bet the answers would surprise you. If, as you claim, gummint healthcare sucks rocks, then the percentage of people on gummint HC who want the private market would be high, and the percentage of people on private HC who wanted Medicare would be low.

I'd bet 1,000 quatloos the results would be the exact opposite.

-CW

I suspect the Democrats want to be in a scenario where if it works, they can take the credit, but if it goes wrong, they can blame the Republicans and claim the bill was bipartisan. Clever, eh?

Democrats are bringing the same old tired and defeated legislation to Thursday night's summit..

Democrats say that, if the GOP doesn't get on board with CrapCare, then they (Democrats) will simply push it thru using reconciliation...

So, here is where I am cornfused...

Where, exactly, is the "bi-partisanship" that Obama has promised??

"Our Way Or Else" just doesn't seem much like bi-partisan, does it??

Michale.....

Actually, having done further reading, I've discovered several liberals, both in the media and Democrats themselves, who've actually admitted that the whole point of the public option proposed in the healthcare bills is to drive private insurers out of business and thereby use the public option as a "trojan horse" to bring about single-payer.

Making my earlier statement all the more potent:

The whole "if families or individuals like their current coverage" argument is moot, because the public option is the de facto death of the private option.

IHS
Medicaid
Medicare
VA

"Lotta 'usses'"
-Phil, HERCULES

Michale......

I agree with that. Which is precisely why I don't think the public option as it stands is a good idea. My proposal was, I think, very different. My theory was that it's better for people who would otherwise get no treatment to receive an inadequate level of treatment than none at all.

On the other hand, there is PLENTY of empirical and direct evidence that the government can royally screw up a Health Care program.

Exhibit A: The NHS. I would also be careful about believing the statistics you read about the approval rating of public healthcare systems. The Dutch one, for example, is often lauded as being hugely popular. Yet I happen to have a lot of Dutch friends who are incredibly unhappy with their system, and their complaints are largely similar to mine about the NHS (that average taxpayers subsidise the less fortunate, but when they need healthcare they don't get it, and meanwhile the people they subsidise go to the head of the queue).

The "less fortunate" tend to be quite happy with public schemes as they know they're not the ones funding it. Getting something decent for nothing whilst some other schmuck pays for it tends to skew your approval.

There is absolutely ZERO evidence to support the claim that the government can adequately run a Health Care program.

On the other hand, there is PLENTY of empirical and direct evidence that the government can royally screw up a Health Care program.

Why in the entire universe would ANYONE think that a Public Option is a good idea??

Michale.....

this is why i think ideally there needs to be some division within the field of medicine, where public funding can prevent the worst, while leaving to the private sector those newer, fancier procedures that are nicer for the patient but cost more to provide.

That's what I've proposed all along. A public option to act as a safety net to ensure people aren't dying needlessly of things that are easily treated when they simply cannot afford to get the treatment (or where it's for a condition that they got whilst covered under an old employer plan that's considered a pre-existing one under the new one, which is a disgrace).

Even there, however, there is a gray area, because the same type of condition can be a want for one person and a need for another, depending on the severity. And when it's health at stake, who can be an impartial judge of which is which?

There's always rationing. Whether it's insurance companies or bodies like NICE, somebody is always there to put a value on a human life and what is "necessary" treatment and what is merely "desired" treatment. It's a fact of life, whether healthcare is public or private; it will be rationed somehow.

I'm of the opinion that what would be best would be what's being proposed in the US for the public option (a government body to give advice, like NICE) but that it should only apply to the public option, which, as I said, should be available on a means-tested basis. Basically unless you can show that you're unable to afford insurance or that you can't get coverage for a pre-existing condition, the public option shouldn't be open to you.

Rather than "competing" with private insurance (which, as I said before, will probably mean the end of private insurance) the public option acts as a net to protect the worst off under my proposal.

the stimulus went ahead whether the Republicans liked it or not, so they might as well try and acquire some of that money for their constituents. They wouldn't be doing their job otherwise.

You're right about using the stimulus as best one can; it's just a question of wearing two different faces on the issue. I don't begrudge conservatives their use of the funds, but ribbon-cutting ceremonies are for achievements you're proud of, not projects you begrudgingly secured because they were the only option available.

I've always said the private sector is more efficiently run than the public sector, and I still believe that to be true.

I don't agree about this necessarily being the case. government is more stable, and (as you've acknowledged) has the benefit of not requiring a profit. On average, the private sector tends to be more efficient, but it is also much more erratic, with many more booms and busts, soars and crashes, great successes and monumental failures. For most industries, this type of fluctuation may be acceptable. However, successes and failures in medicine have vastly different consequences. The difference between mediocre and great medical care is generally improved comfort and quality of life, while the difference between fair and poor tends to be much more dire.

When it comes to public versus private funding of medical procedures, i think the trouble exists in the gray area between needs and wants. When people are dying, the government must step in to meet their needs. Wants are best addressed through other means, where the risks are tolerable in exchange for a chance at better quality. food stamps and public housing are not great, but they're better than eating out of the trash and living in a cardboard box. the government should not be involved in professional sports, because life could theoretically go on without them.

The trouble with medical care is that in-between cancer treatment and cosmetic surgery, there is a huge gray area where it's not entirely certain which medical care is really necessary to avoid deadly consequences, and which would be nice but is not really needed. this is why i think ideally there needs to be some division within the field of medicine, where public funding can prevent the worst, while leaving to the private sector those newer, fancier procedures that are nicer for the patient but cost more to provide. Even there, however, there is a gray area, because the same type of condition can be a want for one person and a need for another, depending on the severity. And when it's health at stake, who can be an impartial judge of which is which?

DR. BETTES
They haven't done the standard scratch test? Where they make small injections into the skin?

~~As Good As It Gets

It was put to a vote over and over again.

When were were there, the headlines read,
"FOR THE NINTH TIME... NO!!!!"

With CrapCare, poll after poll after poll says that the majority of Americans do NOT want CrapCare.. Even amongst Democrats, the idea of CrapCare is a non-starter...

So, WHY are the Democrats in Congress and Obama STILL pushing CrapCare??

Michale.....

But equally, the stimulus went ahead whether the Republicans liked it or not, so they might as well try and acquire some of that money for their constituents. They wouldn't be doing their job otherwise.

After all, those constituents will be paying their fair share of taxes to pay off the stimulus, won't they? Taxpayers may not like paying the extra taxes (so have a right to complain, and therefore so should their representatives, against it) but they can't do anything about it now. They might as well get something back from the stimulus now that it's passed.

As for the public option, I don't think I need to announce why I think it's, as being presented currently, a bad idea.

A basic means-tested public option is a great idea, for those who either can't afford insurance or who have pre-existing conditions, but a public option open to all would likely lead to a single-payer scenario by virtue of simple competition. The government doesn't need to turn a profit (and, in fact, shouldn't be doing so) and insurance companies can't compete with a non-profit entity on price. They'll struggle to survive (and probably won't).

The whole "if families or individuals like their current coverage" argument is moot, because the public option is the de facto death of the private option. Unless, of course, the public option is limited to those who simply cannot get the coverage they need in the private sector, as this would prevent too much corrosion of the profits (and sustainability) of private insurers.

Why not go single payer?

Single-payer opens the door to insurance becoming a stealth tax and the slow but sure degradation of the high standard (if not availability) that has many people outside the US envious of the American system. Certainly many of those of us in the UK.

I've seen recent improvement in the NHS. All have come from private funds being injected in because the state is bad at spending money efficiently.

Governments waste money. It's in their nature. And yes, that includes spending on the military or other "Republican" areas too, but there isn't really a sensible option for privatisation of those areas. If there were, I'd support it wholeheartedly. I've always said the private sector is more efficiently run than the public sector, and I still believe that to be true.