The progressive 'public/private' health care debate is well represented in this excerpt from a recent 'discussion' that came to SinglePayerCentral.com noting that folks should keep in mind that no one individual speaks for the entire movement (on either side)... at least so far (though some may wish or imagine that not to be true):
SP (Single Public Payer proponent):
"...There should be no "second chances" for the insurance companies. They had 14 years to clean up their act after "Hillary Care" bombed and the Health Insurance Situation has gone from the sublime to the ridiculous. This exercise should be about ONE THING ! Allowing the Insurance Industry to exit gracefully. That is where [generosity should end]..."
P&P (Public & Private Payer proponent):
"...Single payer advocates all agree that a "public option" won't work, for the reasons stated in the PNHP quote below. However, single payer is not on the table, and there is little indication that it will be placed there any time in the foreseeable future. Given that unfortunate fact, we need to consider what is the best strategy to follow in the short run.
If the public option fails, the corporations win--big time! In addition, it will constitute a major defeat for one of the most ambitious aspects of Obama's agenda, and it will deal a serious blow to his administration.
As individuals, we can continue fighting for single payer, but sign petitions and letters to lawmakers supporting the public option as well. The Congressional Progressive Caucus, for example, has come out with a statement that single payer is by far the best option, but lacking that, there must be a public plan that will truly compete with the private insurance industry. .."
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SP:
"... [urges note be taken of this quote from Physicians for a National Health Plan]
Public Plan Option in a Market of Private Plans
By David Himmelstein, M.D. and Steffie Woolhandler, M.D., M.P.H.:
The "public plan option" won't work to fix the health care system for two reasons.
1. It forgoes at least 84 percent of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes, which would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even if 95 percent of Americans who are currently privately insured were to join the public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16 percent of the roughly $400 billion annually achievable through single payer -- not enough to make reform affordable.
2. A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan -- which started as the single payer for seniors and has now become a funding mechanism for HMOs -- and a place to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan.
www.pnhp.org
The PNHP Press Release shows how truly unfeasible it [public option] is. Even in the most rosy of participation scenarios it only provides marginal revenue savings which does not even make a down payment on comprehensive coverage.
The CPC is little more than hand waving. "there must be a public plan that will truly compete with the private insurance industry" Watch the words carefully ! Why can't they replace "must be" with "is" ?
As to signing petitions for the Public Option PNHP has said the Insurance Industry would not tolerate a competitive government plan. And the only way it would it would be competitive is if it retained the confiscatory pricing structure of the private insurance model.
The Public Option is nothing more than an exercise of trying to split the baby. You either have an Insurance Model or you have a Government Financed Single Payer System. There is no in between.
This is why I view eliminating the insurance industry from part of the Health Care Picture as the only form tangible result that is acceptable.
When Medicare was setup in the mid 60s it was intended as a stand alone self financing agency. Since that time the insurance industry has found its way back into the tent through their henchmen in Washington DC. Their battle cry has been "Medicare is going broke and needs to be fixed". And what results is a "fix" that undermines the original intent of the program. First it was Medicare Gap Insurance now it's these Medicare Advantage Programs that allows Seniors to cash in some of their basic medical coverage so they can get Prescription Drug Coverage.
I don't know if you have seen this article from the Washington Post but there appears support for Single Payer come from some very umlikely quarters.
http://www.washingtonpost.com/wp-dyn/content/article/2009/04/08/AR2009040803857.html?hpid=moreheadlines
Here is an interesting excerpt:
'...Rep. John B. Larson (D-Conn.), a member of the House leadership, estimated that more than 60 members of his caucus would prefer nationalized health care resembling the Canadian single-payer system...'
It seems to me there is no reason to lend support in any form to plans competing with Single Payer....I have not lost sight of the fact that we have the Insurance Industry and their Toadies in Congress on the run. Don't let up now !...'
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