Why I supported a public option

Well, this (via TPM) is just appalling:

Health and Human Services Secretary Kathleen Sebelius today will release a new report showing more dramatic health insurance premium increases are proposed in Connecticut, Maine, Michigan, Oregon, Rhode Island and Washington.

Keying off the Obama administration's recent probe into a planned 39 percent rate hike from Anthem Blue Cross in California, Sebelius will detail large increases in six other states and say that given record insurer profits, health care reform has never been more urgent.


Among its specific findings:

Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state.

Anthem in Maine had an 18.5-percent premium increase rejected by the state last year as being "excessive and unfairly discriminatory" - but is now requesting a 23-percent increase this year.

In 2009, Blue Cross/Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market.

Regency Blue Cross Blue Shield of Oregon requested a 20-percent premium increase.UnitedHealth, Tufts, and Blue Cross requested 13- to 16-percent rate increases in Rhode Island.

And rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations.

The report finds that "[w]hile rising health care costs is a known problem with our broken health care system, some of the premium increases requested by insurance companies are 5 to 10 times larger than the growth rate in national health expenditures."

So long as there is no competition from a large-scale non-profit alternative, the insurance industry in the United States will continue to squeeze the American people for all they are worth. The big insurers are always and only a business, and their concern has nothing to do with health care access and everything to do with profit.

The failure of the Senate to support a public option remains one of its most appalling and disappointing actions. (Considering the doldrums in which even the lukewarm bill it passed is languishing and slowly sinking, it makes me even more upset that they didn't try to pass a better version.) One wonders how insurance executives sleep at night (big piles of money are probably bad for the back), but since their sense of shame and human decency seems to be an imperfect impediment, it will probably take more cojones than our current pusillanimous Democratic Party has to make any difference.


  1. A Public Option, where the Feds run healthcare with full access to your wallet? Sure, what could go wrong? We'd get the noted efficiency of the Post Office and Public Schools[1] combined with the friendly customer service of the TSA, with all the noted simplicity and transparency of the IRS! And Medicare shows just how a well run insurance program can drive down costs! What's not to like?

    [1] Slightly off topic, but can you explain to me why Democrat pols get such joy out of hurting poor children, and especially poor black children, by blocking every attempt to bring accountability and choice to schools? Just curious.

  2. Ah, yes. The Post Office, perennial whipping boy of anti-government types. I actually happen to think the Post Office works pretty damn well, and use it regularly with pleasure. I also went to public schools from kindergarten through medical school, and have no complaints. (For the record, the students in my med. school were held to a much, much higher standard of behavior and professionalism than many of the students got away with at the much more prestigious medical school where I did my residency.) And you have clearly never wrangled with an insurance company if you think Cigna is any improvement over the TSA. Spare me your facile metaphors.

    Plus, if the private option sucks as badly as you say it will, customers will be free to shell out their money for private insurance, just like I am free to ship parcels via UPS if I don't like the Post Office.

    Also, your lament about hurting poor children is silly. The Obama administration, in particular Ed. Sec. Duncan, is actually discussing such things as teacher accountability and merit pay. And if you think a voucher will get an otherwise out-of-luck poor black kid into the Dalton School, I'd like to know what you're smoking.

  3. [In case it's not clear from the comment above, the "much more prestigious medical school yadda yadda yadda" above was a private one.]

  4. The USPS lost $3.8B in 09, $2.8B in 08, and $5B on 07. Oh yeah, the 09 loss was despite skipping a $4B payment on retirement benefits. If that is your definition of "works pretty damn well", I can't wait to see how much money we'll lose under Obamacare and the Public Option.

    And Democrats, Pres. Obama in particular, were delighted to stomp the dreams of DC schoolchildren in order to pay off the Teacher's Union. As far as "discussing" changes, get back to me when Duncan actually does something. Don't worry, I won't hold my breath.

    As far as what benefits poor black children, I'll defer to the parents of those children who seem to have a rather positive view of the whole DC voucher program. Why don't you tell them how silly they are?

  5. The US pays nearly twice as much as every other OECD nation, yet is ranked 38th in the world in outcomes. Here is the ranking by GDP

    1. United States (15.8%)
    2. France (11.0%)
    3. Denmark (10.8%)
    4. Switzerland (10.8%)
    5. Germany (10.6%)
    6. Austria (10.2%)
    7. Canada (10.0%)
    8. Sweden (9.2%)
    9. Spain (8.4%)
    10. Japan (8.1%)

    One of the most important measures of health is life expectancy at birth. According to the CIA World Factbook the United States ranks 50th in life expectancy out of 224 countries. Here is a list of the top 10 countries:

    1. Macau (84.36)
    2. Andorra (82.51)
    3. Japan (82.12)
    4. Singapore (81.98)
    5. San Marino (81.97)
    6. Hong Kong (81.86)
    7. Australia (81.63)
    8. Canada (81.23)
    9. France (80.98)
    10. Sweden (80.86)

    Hawaii Leads US

    Hawaii's residents have a life expectancy of 80 years while the overall life expectancy for the United States is 78 years. One reason Hawaiians live longer might be the state's requirement that employers provide health insurance for all employees that work 20 hours a week or more. As a result nearly 90 percent of Hawaiians have health insurance.

    Read more at Suite101: Where American Health Care Ranks in the World: The Facts About the United States Standing in World Health http://americanaffairs.suite101.com/article.cfm/where_the_us_ranks_in_world_health#ixzz0fw3RnYhj

    When Taiwan recently revamped their health care system (in the 90's), it studied the systems of the whole world, and found it liked one aspect of the US systems so much it adopted it. It is called Medicare, and it is for all Taiwanese (not just citizens, but residents as well, my nephew who is a student has access as well)

    And it has been a great success. If you don't believe me, go there and see for yourself.

    gj's rebuttal will be to bring up a totally irrelevant side issue, what shall it be...Amtrak? Because, you know, it is impossible for Americans to learn anything from anyone else, gj thinks we are far too stupid for that.


  6. I absolutely do not get the opposition to a public option. I think the Dems were moronic not to start with universal coverage and bargain down to public option, but offering people a choice---private for-profit health care or tax-payer paid VA-like health care---would lower costs by increasing competition, preserve choice, and allow a variety of models in which some insurers continue to pay by procedure while the taxpayers pay for health outcomes. I don't see a single logical argument against it. And yes, I've read the illogical arguments. They're ill-informed knee-jerk reactions, postal service metaphors included. Employing civil servants to deliver envelopes is a lot different than paying physicians.

  7. charo, Taiwan's life expectancy is below the US, while Libyans' life expectency is within a year of the US. Has universal care failed in Taiwan? Is Libya's insurance plan really that good? Or is it that life expectancy is a complicated mixture of genetics, diet, lifestyle, in addition to medical care, and so isn't a good way of ranking healthcare? I think the latter is more reasonable.

    NTW, who, exactly, were the Dems bargaining with? Hint: it wasn't the Republicans, who lacked the votes (before Scott Brown) to stop any bill in the House or Senate.

    My argument is simply that government doesn't have a stellar reputation as a high quality, low cost, customer friendly supplier of services. That's it.

    I've said here before, let the Feds wring the 30% waste out of Medicare first to prove their Executive Awesomeness, and then we'll talk about a Public Option. Proof first, though. I've had enough "GITMO will close within the year" and "you won't have to change your current insurance if you like it" broken promises already.

  8. gj, Taiwan only recently built there health care system, in addition a generation ago Taiwan had a much smaller economy, it is not where it stands now, but from where it has come from. 20 years ago you could buy a home in downtown Shanghai for $10,000 now it would cost you $350,000. Was 20 years ago better? Of course not.

    Your solution above by stating it is a mix of yada yada is nothing but evasion, rendering comparisons with other nations impossible (yet that never stops Republicans from talking about England). But your trope is bs since to do otherwise would be to admit defeat. Fundamentally, people are people, health care outcomes and cost are correlated. If we can spend half what we do (like Japan) and get better outcomes, shouldn't we be learning from the Japanese how they do it instead of saying "ooohhnnn nooo, we can't do that because...because....because of DNA yeah, DNA...Japanese people are like supermen."

    How about wringing out the 50% waste inherent in the US private marketplace first and prove to me it is more effective than the 30% waste in the public.

    I see no reason why the US can't do as well as the Japanese using a public system, unless you are an American hater, you should think the same too.