Via Greg Sargent comes news of a memo being issued this morning to Congressional Democrats that spells out pretty clearly that Americans want a public option included in the final health care reform bill that emerges (hopefully) from Congress. Included in the memo is a summary of various polling surveys assessing the publics desire for a government sponsored insurance plan.
Note to Congressional Democrats: Is this not clear enough? Just grow a spine and get it done please.
Though this, from FiveThirtyEight, is troubling: Poll: Most Don't Know What "Public Option" Is -- Including Pollsters. Excerpt:A new survey by Penn, Schoen and Berland Associates for the AARP reveals widespread uncertainty about the nature of the "public option" -- a government-run health insurance policy that would be offered along with private policies in the newly-created health insurance exchanges. Just 37 percent of the poll's respondents correctly identified the public option from a list of three choices provided to them.
ReplyDeleteRuss,
ReplyDeleteI saw that as well. This whole health care debate has exposed an ugly truth about the process; it's full of craven ideologues who could give a shit about truth and facts and a depressingly large group of numbskull citizens who will believe whatever they're told.
I guess that leaves two more groups; those that know the issues and can argue facts (whatever their ideology) and the rest who think the "public option" is somehow related to unisex restrooms.
I have seen this copy/paste spam message before. Like those who clamor for the defeat of H.R.3200 and it's still-unborn offspring, the arguments here are misleading.
ReplyDeleteThe history of the Blues is less dramatic and far less sinister. Blue Cross, introduced in the Thirties, was the first group insurance of any consequence and it was an employer-sponsored plan with two objects: offer employees a group insurance benefit for hospital bills (only) and to attract good employees from other companies that didn't have such a benefit.
When it was proposed the AMA was dead-set against it, fearing too much power would then reside in hospitals. The political remedy was that in return for allowing Blue Cross to come into being, ALL hospitals were required to be non-profit. (It worked. The first for-profit hospitals did not come about until the Sixties, but that's another tale.)
A few years later, Blue Shield came along, similar to Blue Cross, but this time the insurance was to cover not hospitals, but medical services. Again the AMA didn't want it, fearing price controls on their fees. This was not altogether crazy, since a few years earlier price controls had been in place during the Depression. Again there was a political remedy. This time group medical insurance for professional services (physicians) was allowed with the understanding that doctors and clinics could set whatever charges they wanted and there would be no interference from either government or the new group insurance.
Much has changed since the Thirties, but the biggest change of all was the creation of Medicare in 1964. It is no accident that Medicare is split in two parts. Part A (hospital charges) is modeled after the original Blue Cross, and Part B (services) after Blue Shield. And just like the Blues, Medicare has little or no leverage over what hospital and physicians charge for their services.
Over time a "reimbursement rate" has evolved, but it was and continues to be a pork item under the control of Congress. Rates are based partly on regional or geographic variations, but no one has figured a way to rectify the incredible variations in the system from one locality to another.
Dr. Gawande's Article in the June issue of the New Yorker outlines the madness of what has occurred over the years and a small part of what H.R.3200 is laying the groundwork to rectify is that very inequity.
During the Bush years an advisory group called MedPac was formed to look into this problem but it was neither adequately funded or given any authority. It has and continues to be an "advisory" group.
I think this (Republican, btw) invention may be the basis for what has come to be known as the "death panel". As I understand it, the proposed legislation builds on that very group, giving it wider scope of operation and authority to incentivise both hospitals and physician group to improve best practices in the direction of better outcomes AND lower costs at the same time.
Explaining the complexities of the legislation cannot be done in short sentences for adults with short attention spans. Understanding even the basics requires that the listener is able to grasp entire paragraphs and retain their meanings longer than a minute or two.
Unfortunately opponents have succeeded in gripping much of the population with a panic-threshold level of fear. Many otherwise intelligent people are now as terrified as children at Halloween, even though their fears are based on nothing more than smoke and spook-house mirrors.