(A sign of change? Yesterday I had to call United Healthcare about a glitch in their coverage and, yowie!, I've never been treated with as much TLC by any insurance company. Ever. These guys are feeling the pain is my guess.)
"...The end result of AHIP’s blunder may be a better bill than we would otherwise have had," says Paul Krugman. There's an aura of defeat in AHIP-land. Maybe the anti-reformers in the Republican party are suffering, too.
So it’s a different game than it was 16 years ago. And it’s a game that the insurance industry apparently doesn’t know how to play.
In at least one respect, the ridiculed AHIP report was right, though.
The industry worries that some people will game the system, remaining uninsured as long as they’re healthy, then signing up when they get sick.
This is, believe it or not, a valid concern. Many health-care economists believe that a strong individual mandate, requiring that almost everyone sign up, will be needed to make health reform work. And the Finance Committee probably did weaken the mandate too much.But AHIP, apparently unable to help itself, didn’t stop there. Instead, the report threw every anti-reform argument the authors could think of at the wall, hoping that something would stick.
They couldn't resist piling on. In doing so, they may have facilitated the inclusion of a public option.
First, health exchanges — special, regulated markets in which individuals and small businesses can buy insurance — can be made stronger, in effect giving small buyers a better bargaining position. Second, the public option — missing from the Finance Committee’s bill — can be brought back in, giving private insurers some real competition.The insurance industry won’t like these changes, but that matters less than it did a week ago.
Thank you, AHIP!
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In Senate offices the most notable fight is Democrat against Democrat. The issues: the public option, of course, and whether to put some money into Medicare to pay for in increase in payments to doctors who are supporters of the bill. Doctors have been subject to annual cuts in their fees until now -- with an additional cut of 21% scheduled for 2010. Giving them a fair break would add more than $200 billion to the total cost of the legislation.
Bernie Sanders, probably the only senator who's been making sense all along, describes the acrimonious meetings.
Senator Sanders said the debate Thursday “went up a few decibels higher than it usually does in caucus meetings.” He said he had told Mr. Baucus that more than 60 percent of the public and more than 80 percent of Democrats supported creation of a public insurance plan. “It’s difficult to understand why we can’t give the American people what they want,” Mr. Sanders said.
Can't help but think about that $5 billion plus going to Goldman Sachs management in bonuses this year.
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The Washington Post has obtained a copy of a Congressional Budget Office report on a House bill, one version of which meets the White House's cost criteria. "The report from the Congressional Budget Office, a copy of which was obtained by The Washington Post, puts the cost of one plan at $859 billion over the next decade and the other at $905 billion."
The cheaper version would rely heavily on a more dramatic expansion of Medicaid, the government health plan for the poor that is funded partly by the states -- meaning already-strapped governors would have to pick up more of the cost of reform. Compared with the original package, the two new proposals would offer less generous subsidies for people who need help buying insurance and do not have access to affordable employer coverage. Additional savings would come from reducing employer tax credits.
Both packages are based on the original House framework, which proposes to extend coverage to more than 30 million Americans by expanding Medicaid eligibility and subsidizing private insurance for people who lack access to affordable coverage through an employer. Each would expand the ranks of the insured to more than 95 percent of Americans by 2019, and each would create a government-run insurance plan to compete with private insurance companies.
Again, the context of this struggle should include where we seem to be giving a pass on huge profits elsewhere in our economy, profits which were built on government spending.
