One big argument against junking the popular public option in favor of co-ops has been the inability of co-ops to effectively bargain down the prices (ever on the rise) of prescription drugs. That's going to affect everyone, from those who have private insurance to those who are on already on public insurance -- like Medicaid and Medicare. In the end, the failure to achieve genuine reform will cost the nation as a whole one helluva lot -- the smug anti-reformers no less than the rest of us. The right will feel as though it has won but that feeling won't last when the bills start coming in.
Jay Rockefeller was clearly worried when asked in an interview the other day about substituting co-ops for a public option.
That’s unacceptable, and I can almost prove it. We’ve been in touch with the folks that represent all the co-ops in the country on all subjects, and they point out that there are probably less than 20 health co-ops in the country. There are only two that really work that well, one in Puget Sound, one in Minnesota. Except for those two, they’re all unlicensed. All present health co-ops are unlicensed, they’re unregulated, nobody knows anything about them, nobody has any control over them. And nobody’s ever, they said, which is a stunning thing to me, no government organization or private organization has ever done a study on what effect they might have in terms of bringing down insurance prices. ...Put $6 billion out on the table in 50 states, and then hope that somebody comes in and picks it up to start it. Look, health insurance is complex, it has a long history. There’s billions and billions of dollars involved. These little tiny entities that will be starting up in states where there have never been any before-remember. There aren’t any in the South, there aren’t any in the Northeast, there aren’t any in the Mid-Atlantic, there aren’t any in the Southwest. They’re only in the upper Midwest and the Northwest. They’re not a good idea. They’re untested. They’re unlicensed. They’re unregulated. They’re unstudied. Why would we even think about putting them in as a control on this massive insurance industry instead of the public option?
Of course what Jay didn't point out is that the smaller and more fragmented the "pools" of insured, the less leverage they have to keep costs down. He may be wondering about the extent to which this failure to achieve reform will come back to haunt and very possibly end the Democratic administration and its majority in Congress.
On the other hand, by 2012, the Republicans will be screaming too as they realize that their failure to back real reform has provided smooth running for a slick, steady rise in health care costs to all. Anyone care to bet on the percentage increase in health costs over the next three years? Just in time for that 2012 election? And precisely whose heads will be on the block?
