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Health Care & Environment
02.14 Exposure to Glyphosate-Based Herbicides and Risk for Non-Hodgkin Lymphoma: A Meta-Analysis and Supporting Evidence [If its killing us, make it illegal]
02.14 To avoid environmental catastrophe, everything must change [Consider why this headline is laughable or confusing to many, if not most, Americans...]02.13 Study Shows Toxic Pesticide Levels in Families Dropped by 60% After One-Week Organic Diet [2:10 video; Produce and canned vegetables laced with toxic chemicals—from fertilizers and herbicides, too—must be quickly phased out to use safe organic alternatives]
02.11 'People Shouldn't Be Going Bankrupt and Dying': Nationwide Week of Action Aims to Build Mass Movement Behind Medicare for All [Corporate control of government and media must be limited to allow efficient programs for the public good]
02.09 The potato solution: how the Guardian switched to biodegradable packaging [Non-recyclable products should be illegal]
News Media Matters
02.15 Samantha Bee: Fox News 'soiling themselves over the Green New Deal' [video clips from Samantha Bee, Seth Meyers and Stephen Colbert]
US Politics, Policy & 'Culture'
02.15 Jayapal Says Medicare for All Bill Coming in Two Weeks as Expert Calls Plan 'Astonishingly Strong' [Corporate control of government and media must be limited to allow efficient programs for the public good]
02.14 Pentagon Fears Climate Crisis, w/ Billions in Damage to US Bases & Societal Upheaval [In maniacally twisted capitalist countries inconvenient truths are ignored or harshly ridiculed, and Trump's stupid Wall obsession dominates the news instead.]
02.13 'We Will Be That Lantern on the Shore': Ocasio-Cortez, Pressley Rally With TPS Holders Outside Trump White House [Empathy and fairness are scarce when your President is a psychopath]
Economics & Corrupting-Capitalism
02.13 The Green New Deal offers radical environmental and economic change [For the survival of life on earth, capitalism must be effectively regulated or banned]
02.12 Climate and economic risks 'threaten 2008-style systemic collapse' [Willfull ignorance of Trump, Republicans, corporate-media and corporate-Democrats is steadfast, if not worsening]
02.11 Trump offers socialism for the rich, capitalism for everyone else [and the poor will die out like the insects]
International & Futurism
02.15 Who Is Really A Socialist? [Who is really a Republican, etc.?]
02.14 House passes bill to end US support for Saudi war in Yemen [Congress does something good again!]
02.14 Millions Flowed From Venezuelan Oil Firm to Small Bulgarian Bank [Transactions like Manafort performed for Trump. Which Venezuelan political leader is likely behind this—Maduro or Trump-supported Guaidó?]
The Incredible Shrinking Public Option
Originally published in ConsortiumNews.com yesterday, 2 November 2009
When the U.S. health care debate began last spring, the insurance industry and its congressional defenders fretted over the prospect that 119 million Americans might defect from private insurance to a public option, thus devastating the business model of wealthy insurance companies.
Since then, however, the industry has won so many concessions that the threat from the surviving public option has shrunk to about five percent of its feared effect. In assessing the House leadership’s health reform bill, the Congressional Budget Office projects that only six million Americans could or would sign up for the bill’s version of the public option.
And, to make the picture even prettier for the insurance industry, many of those six million would be the chronically ill, customers that the private insurers don’t want anyway.
Because of unified Republican resistance to any health-care overhaul and the objections of conservative and rural Democrats, House Speaker Nancy Pelosi scrapped her goal of a “robust” public option, one whose payments would be linked to Medicare rates and thus could have saved substantial money for the insured and the government, about $110 billion over the next 10 years, the CBO estimated.
Instead, Pelosi accepted a version of the public option which would require the government to negotiate rates with health providers just as private insurers do. That means the pressure to hold down medical costs would be much less and the potential savings would largely disappear.
Indeed, the CBO projects that the public option would have to charge premiums higher than private insurers because people with illnesses would turn to the public option as a more reliable way to get their medical treatment than what they could expect from profit-making companies, which would still look for ways of minimizing payouts.
The CBO study said the projection of six million public option enrollees “reflects CBO’s assessment that a public plan paying negotiated rates ... would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges [because] the public plan ... would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees.”
In other words, CBO is saying that despite proposed restrictions on private insurers eliminating their exclusion of “preexisting conditions” and banning purges of sick people from their client lists, the insurance industry would seek ways around some of those rules.
Thus, the sick would gravitate toward the government plan, which, in turn, would require higher premiums, pushing more healthy people toward cheaper private plans.
This latest win-win for the insurance industry is just its latest victory as the health-reform package has wound its way through Congress.
Corralling the Public Option
The most important concession came when the public option was barred from competing with private insurers for their most lucrative contracts, those with large employers. The public option was confined to insurance “exchanges,” which would start in 2013 only for uninsured individuals and small businesses.
That concession slashed the prospect of defecting clients from the 119 million – predicted in an industry-backed study by the Lewin Group – to about 10 million to 12 million Americans who, the CBO said, would choose the lower-cost “robust” public option on the exchanges.
The death of that “robust” version in the House leadership’s bill trimmed the likely clientele for the public option to about half that number, to around six million, according to the CBO.
In another favor to the insurance industry, the surviving House and Senate bills put off competition from any public option until 2013, granting the private insurers another three-plus years of their continued cartel-like control of the health-insurance sector.
During that three-year period, the CBO analysis projects the number of uninsured Americans will rise to 51 million, meaning that people who are facing bankruptcy over medical costs or early death because they put off needed medical attention will be expected to suck it up for another three-plus years before they can shop on the insurance exchanges for coverage.
Democratic leaders say the three-year delay is needed to properly organize the exchanges. However, Republicans claim that it is really a budget sleight-of-hand to make the 10-year cost of the reforms appear a couple of hundred billion dollars less, keeping the total below $1 trillion.
The current Senate bill, which was cobbled together by Senate Majority Leader Harry Reid, offers another concession regarding the public option, a provision that would let states opt out. Reid included the opt-out clause in hopes of convincing several conservative Democrats to at least vote against a Republican filibuster and let the Senate proceed with the legislation.
But the opt-out clause means that some conservative states may bar their residents from signing up for the public option, thus possibly reducing the number of public option enrollees to less than six million.
Still, it’s hard to see why private insurers would object to inclusion of the weakened public option because the insurance industry already would be in line to get the bulk of the new customers, people compelled to buy insurance or face fines and who also might qualify for government subsidies that would go to insurance companies for policies offered on the insurance exchanges.
CBO estimates that about 30 million Americans would get insurance via the exchanges, with four-fifths buying from private companies. That’s about 24 million new customers. Plus, the public plan’s “adverse selection” – the tendency of sick people to pick the public option – means that private insurers would stand to get the healthiest and thus cheapest part of that pool.
Last summer, during a town hall meeting on health reform, President Barack Obama raised the ire of some liberals by referring to the public option as “just a sliver” of the health-reform package. Given the many concessions that have been made to the insurance industry, Obama’s description now appears to be more accurate than he probably understood at the time.
Robert Parry broke many of the Iran-Contra stories in the 1980s for the Associated Press and Newsweek. His latest book, Neck Deep: The Disastrous Presidency of George W. Bush, was written with two of his sons, Sam and Nat, and can be ordered at neckdeepbook.com. His two previous books, Secrecy & Privilege: The Rise of the Bush Dynasty from Watergate to Iraq and Lost History: Contras, Cocaine, the Press & 'Project Truth' are also available there. Or go to Amazon.com.
This article is republished in the Baltimore Chronicle with permission of the author.
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This story was published on November 3, 2009.