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I think it entirely depends on how comprehensive the private option is. If you look at it, Gold's Gym isn't for the 'rich'. They're more expensive than the YMCA, but they still manage to make do for themselves.

 

Yes, Gold's can diifferentiate themselves based on quality and admittedly the price point isn't that extreme. However, healthcare will probably be a breed of a different animal as the numbers are much higher.

 

You don't have to imagine it, since many of us already have it. I have what is known as a PPO plan, which I have from a private insurance company, through my employer. It is the best coverage my employer offers, so we can put that aside.

Any specialist has to be approved by the insurance company that my regular doctor recommends. For instance, when I injured my back, my general doctor had to recommend only a specialist who was "within network." It was the same for my MRI that my specialist ordered, which had to be done only by a lab that was approved by the insurance company as well. So all this talk about "quality and rationing" is one we can have right now, about private insurance companies, and what employers are willing to offer. There is no "imagining" required.

I apologize if I sound a bit snarky, Snook, but this is the Heat of Battle for reform....

 

Not a problem.

Although, I don't agree with your analogy. While I'm not a big fan of PPO plans, they run that way to try to manage costs as they have negotiated lower payment rates with the doctors in the network and that is the plan your employer picked and you picked your employer. I know that may sound a little harsh, but they are doing exactly what they are being paid to do.

The difference from my scenario is that the doctors in your PPO network, probably also accept other types of insurance and have all sorts of other rules they have to follow. I'm imagining doctor groups that do not accept "public plan" patients at all. Considering Medicare pays less then almost any other insurance plan it is a very safe assumption that the "public plan" will probably pay the same if not worse. I can easily imagine doctors who will not at all be happy with losing their higher paying "private insurance" patients. Then what will happen? Would Congress force doctors to take the "public patients"?

 

I also picked my president.

BTW, my inusrance company, plan, and conditions have CHANGED since I originally picked my employer.

I don't have a problem with that since my insurance company actually called me to tell me what I should be having for dinner (the bastards).

 

Well, a few things here. First of all, if you had watched Obama's speech last night (which I thought was excellent), he said that he did not want taxpayer dollars going directly towards funding a public option (but he does support taxpayer dollars going towards subsidies for people who cannot afford health insurance). As such, the public option would only be able to pay out what it gets paid in premiums. I will concede that the public plan will probably not have the high advertising costs the private plans do, but then private plans are supposed to be so much more efficient that government operations, so I'm sure they'll be able to keep up.

Also, according to the speech last night (did I mention it was great) I don't think there's going to be an issue of hospitals not taking the public plan. One thing that definitely seems to be happening is industry regulation. The Obama plan would place all private insurance industries into a "marketplace" where they would have to abide by certain conditions, like not turning down coverage due to pre-existing conditions, or dropping you from coverage if your bills start getting too high. A public option(s) (if they make it into the final bill) would be in this same marketplace as the private option.

Finally, if you watched the speech last night (I may have already mentioned how fantastic it was) the very first thing that was commented on was if you are happy with your current insurance (be it private insurance, Medicare, Medicaid, or the VA), you can keep it. So if you don't like the public option Snook, there's no need for you to sign up for it.

One more thing regarding personal mandate - Obama is in favor of it, and said as much last night. The thinking is even if you are young and healthy, you should carry some basic level of insurance. While it is unlikely that a healthy 25 year old is going to need extensive medical care, 25 year olds do come down with the flu, they do get into car accidents, and due to their active life-style tend to get more pulled muscles, strains, and even broken bones than you'd think. If they aren't paying for a basic plan, then EVERYONE ELSE is paying for them when they show up to get a bone set in the emergency room.

One more thing (really this is it): Shame on you Joe Wilson!

 

I'm still not convinced that this isn't all smoke and mirrors. I don't see any way that private insurance can co-exist with a public plan. The public plan will be a lower cost plan and if it saves the employers and the employees money that is the plan they will choose. Maybe I'm thinking too far in advance, but my business savy says that this is a no-brainer.

While I'm not quite willing to say that Obama is lying to us (although I'm sure I can find many that would say that) I can't help but think that there is a fair amount of misdirection going on.

 

I thought that you said: "We pick our employer."

I think that could be the writing on the wall, IF insurance companies don't reform. But insurance companies can compete if they offer better services than the basic government option. But if some employers choose something different, than as you commented, not meaning to "sound harsh," but you choose your employer and what he is willing to provide.

 

Honestly, I'm not sure how well this sits with me. The problem here isn't the principle so much as the execution. As it stands, Medicare and Medicaid pay doctors a tiny fraction of what even the best insurance companies pay. Forcing them to take it is like forcing Boeing to sell the Gov't more jets, but at a fraction of the production cost.

I didn't watch it, and so I don't know what's in the Obama plan (is there one now?), but if it's the Senate plan (regulation, no public option), then that's a bald-faced lie. Obama's been saying it for a while now, but no plan I've seen to date lives up to it. At best, they severely limit the plans that can be grandfathered in, and even those will be cut out in time.

 

Do you know what the "tiny fraction" is?

Defense contrators are one of the reasons we pay taxes. It makes sense, that the government should get the best deal when you consider that they are spending your money. I thought you opposed high taxation?

 

Wow, that is a wicked twist of logic. If the public option eliminates private insurance picking your employer will not matter as every employer will offer the same plan.

 

Question -

Is the Public Option going to be a plan that you sign up for via the Government or offered via your employers? Via the employer doesn't make sense, as the unemployed would be left out to dry, which defeats the whole point of making the Public Option, so everyone can have Health Care and afford it as well. Am I missing something here?

 

Yes, very much like how "I don't have the choice" of a government option, atm.

 

For my father (psychologist, not MD, but still treats patients on Medicare and Medicaid), it's about 10% of what the private insurance companies pay. Not 10% less, 10% total. What he bills the gov't, as a PsyD, is what an intern working on a Master's degree could bill without insurance.

I agree they should get a good deal, but they shouldn't force people to take the deal they offer and nothing else. Imagine if, whatever your work is, the Government came to you and demanded that you do it for them, only at about 10% of what you would normally charge. Now imagine it's not a one-time deal, but a regular business arraingement (which you didn't get to agree to or negotiate). Imagine if 80% of your customers decide to go through the gov't to get your service, instead of coming to you directly. Now 80% on this public plan may be an extreme estimate, but then again maybe it isn't. The point remains.

 

NOG, I know I often come back with snarky comments to your posts, but this one is serious. In all the speeches given by Obama, and by all the press conferences and town halls held by Congressmen, they have all said that no legislation would be passed that would force you onto a public plan. In fact, if the Senate version that doesn't have a public option is the one that gets passed, there would be no public option to force you onto. How is it a bald-faced lie to say you can keep what you currently have if you like it, when apparently that is what all versions of the plan include.

All the details have not been ironed out, but my interpretation of the speech was that there would be a "marketplace" of choices for health care, of which the public option would be one choice. So there would not be any requirement to be employed in order to sign up for the public option.

Independent estimates puts the number at around 5%.

 

I hope you are correct, but I have a feeling time will prove that it isn't possible for public and private to co-exist and that this was all a smokescreen to pass a bill.

 

Simple, he didn't say "You won't be forced into a public option." He said "You can keep your current plan." The Senate version means massive regulatory changes which will force every insurance company to completely re-write every plan they have. That bill allows them to grandfather in a few types of plans offered by employers to groups (something like 20% of current plans), but even those will only be permitted for five years, and without any changes. If they even update the drug list (usually done anually), you have to meet the new regulations. That's not keeping your current insurance.

Sounds like some kind of fusion of the House and Senate bill.

Without knowing what the coverage will be, or how much it will cost, or if there will be any requirements for buying it (low income, whatever), it's impossible to make any real estimates. At this point, 80% is just as reasonable as 5%.

 

For instance?

 

For instance limits on how much you can charge, restrictions from any kind of action based on past or present drug abuse, mandated inclusion of certain services. Go read it yourself. I'm sure the links still there in one of my older posts in this thread.

 

Actually, he has made both of those comments. By simple virtue of the fact that there likely will not BE a public option means he can say pretty convincingly you won't be forced onto one - you can be placed on a plan that does not exist.

Industry regulation is happening no matter what gets through. Even Republicans agree on that. That's going to happen regardless of a whether there is a public option or not. And I don't know about you, but my current insurance industry pretty much re-writes my plan every year anyway.

These "new regulations" include things like not dropping people from your plan if they have high medical bills, and not disallowing coverage for people with pre-existing conditions. You're arguing against one of the few points of health care reform where there is bipartizan agreement, and for which there is support from the pharmaceutical company lobbies (which makes sense, as they stand to profit from it).

The estimate was done by the CBO - which is an independent body of, and does not answer to Congress., It looks at the prposed bills and makes estimates on what kind of coverage will be offered, the committees put together estimates for the cost, and the bill itself sets forth requirements for buying it. A lot of work was done by a bunch of competent accountants from both political parties to come up with that number of somewhere between 4% and 5%. So no, I don't think your number of 80% - which you just pulled out of your arse - is as reasonable as the 5% estimate that was reached through detailed research by the CBO. It is shockingly arrogant that you can think this. The CBO has a website - check it out.