Hullabaloo

Monday, June 15, 2009

 
Conrad The Genius

by digby

Here is a good explanation of the necessity for a public plan option by Jacob Hacker:

In the fast-moving debate over health care, no idea invites more admiration or ire than the “public health insurance option”--or what I’ve been trying to get people to describe as “public plan choice”. The idea is overwhelmingly popular with Americans, garnering 85 percent support in a new independent poll from the Employee Benefit Research Institute. It’s also compelling and simple: If you don’t have coverage from your employer, you can choose from a menu of health insurance products that includes not just a range of private health plans but also a public insurance plan provided on the same terms nationwide.

The argument for this new public plan is that it would have lower administrative costs; greater leverage to hold down prices; and the transparency, broad patient data, and incentives for long-term investment in health to improve the quality and efficiency of care. Along with new regulations, it would also be the primary check on a private insurance industry that has, for too long, neglected both quality and efficiency, focusing its creative energies instead on new ways to shift costs onto and screen out the sick.

The idea of public plan choice was part of all the leading Democratic candidates’ health plans, Senator Max Baucus’ November 2008 White Paper, and the vision of reform articulated earlier this year by key congressional Democrats. All with little attention outside health policy circles--until conservatives, health insurers, and some provider groups decided the public plan was public enemy number one. And so, the misinformation campaign began: A public plan available alongside private plans only for Americans without workplace insurance was suddenly described as a “government takeover” of medicine, the “road to rationing,” and (that old standby) “socialized medicine.” Republicans drew their lines in the sand, and Democrats started their favorite parlor game: compromising among themselves even before the real debate begins.

Read the whole thing. He goes on to explain just why this supposed "compromise" by Kent Conrad about health co-ops is unworkable and counterproductive to the fundamental purpose of the public plan. It's a good idea unto itself, but it will do nothing to bring down costs and keep the insurance companies honest.

I posted the interview Ezra Klein conducted with Kent Conrad the I failed to highlight something that's quite illuminating:

Where did this idea come from? I've done a fair amount of health care reporting, and this is the first I've heard of it.

I guess it came out of conversations in my office after we were asked to see if we couldn't come up with some way of bridging this chasm. Part of it is that we're so used to cooperative structures in my state. They were begun by progressives, they came out of the progressive era. And they're so successful in our state. So I can't really say we came up with some brand new idea. We just thought about our own experience.

I think he thinks that's very clever, but it's actually quite frightening. This issue, of all issues, requires expertise not uninformed bull sessions in Kent Conrad's office after hours. These ideas have been hashed out and debated for years and the idea that old Kent and his staff can just "solve the problem" one night by applying his own experience in North Dakota is downright insulting.

I saw Conrad on TV over the week-end and he characterized this as a pragmatic necessity because there are at least three Democrats who won't vote for a public plan. That's ridiculous. This is only the beginning of the debate and the "Gang of 8" ar entering the negotiations capitulating to the insurance companies. There is absolutely no reaqson to bargain away the only thing left that will guarantee that the reforms won't make the crisis worse by mandating that the uninsured buy insurance without any cost controls.

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digby 6/15/2009 11:30:00 AM |