public option

Things are looking up for Americans. The recession is over. And finally, meaningful healthcare reform is looking possible.

The Senate is on board with the public option, giving insurance companies a reason to offer consumers competitive rates. Today, House Speaker Nancy Pelosi revealed the details of the package that would provide insurance to up to 36 million people by expanding Medicaid, the combined state and federal insurance program for the poor, and by offering subsidies to middle-income Americans to either buy insurance from private carriers or from the new government-run providers.

David Herzenhorn, blogging in the New York Times, reports the cost would be $894 billion, and would reduce future federal deficits by about $30 billion over the next 10 years.

Meanwhile, Sen. Harry Reid of Nevada says the bill he will send to the Senate floor next month also will include a public option.

This is the same public option that was derided for weeks during the summer months, right up there along with “death camps.”

"While the public option is not a silver bullet, I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said.

Reid is no doubt emboldened by polls that show growing public support for the public option.

Here’s an interesting development – a new poll shows that that support for the public option in health care reform has surged from its summertime lows and now is favored by a clear majority of 57 percent of the public. If the program is run by the states and available only to those who lack affordable private options, it draws 76 percent, the Washington Post- ABC News poll shows.

The poll finds that two key groups have shifted in support of the public option -- seniors and independent voters. And in additon to backing the public option, they are supporting another key provision of health care reform - a measure that requires all Americans to carry health care insurance.

The public option would put in place a government-run health plan to compete with private insurers.

"Overall, 45 percent of Americans favor the broad outlines of the proposals now moving in Congress, while 48 percent are opposed, about the same division that existed in August, at the height of angry town hall meetings over health-care reform. Seven in 10 Democrats back the plan, while almost nine in 10 Republicans oppose it. Independents divide 52 percent against, 42 percent in favor of the legislation.

There are also deep splits in the new poll over whether the proposed changes would go too far or not far enough in expanding coverage and controlling costs.

So word is that health care reform looks financially healthy itself, although Republicans are whispering there's a 'stealth bill' out there somewhere with hidden costs.

But the much anticipated cost analysis from the nonpartisan Congressional Budget Office shows that the plan will insure more people at less cost than the current system, which flushes a lot of money down an inefficient, bureaucratic middle, and not on patients and care providers. The bill, written by Sen. Max Baucus, D-Mont, would cost $829 billion by 2019.

But because that tab would be offset by spending cuts elsewhere and by new revenue, the bill actually would lower the deficit by $81 billion over the next decade -- and potentially even more in later years -- the budget office concluded, the Los Angeles Times reports. At the same time, the bill would expand the percentage of Americans with health insurance from 83% to 94%, according to the estimate.

House Speaker Nancy Pelosi is saying there will be a public option before the thing is done. And Sen. Maria Cantwell, D-Wash., is pointing to her own state is an example of how to offer private insurance for low-income patients. Often known as Medicaid-managed care plans, these plans exist in several states and typically offer a choice among several insurance carriers. In Washington state, it's called the Basic Health Plan, and while it's run into some tough times lately, moving to push 40,000 people from its rolls due to the state's budget woes.

Indian Country & Health Care Reform

By Mark Trahant

          Seattle-based Amazon.com, the world's largest online retailer, will move into its new headquarters near Lake Union next year. Then Amazon will leave an old Art Deco building, once known as the U.S. Marine Hospital.

          What if we took this empty building and turned it into a hospital? What if we staffed it with federal employees? What kind of health care would that look like?

          The answers are in our history. Congress passed a law in 1789 that provided for health care for sick and injured merchant seamen. But the thinking, even then, was broader. Philadelphia faced an extraordinary Yellow Fever outbreak in 1783 that killed more than 4,000 people (out of a population of 37,000). And therefore the primary mission of the new health service was to intercept diseases brought home by sailors returning from sea.

          The Public Health Service and the marine hospital network eventually expanded across the country. This was the first "public option" because this government plan was funded by a monthly deduction from the seaman's wages. The scope of medical activities grew as well, ranging from the treatment of epidemic diseases to industrial hygiene.

          The PHS could have become the basis for a national, federal health care delivery system. By the 1970s marine hospitals and clinics served American Indians, the urban poor, as well the agency's traditional clients of merchant marines and some federal retirees.

          "These hospitals have a record of service to this nation, and especially to its merchant seamen, which is long and distinguished," President Richard Nixon wrote in a veto message to Congress over the funding of public health.

The Democrats are on the offensive, and they're trying it out in Phoenix. A pro-health care reform campaign rally, sponsored by the Democratic National Committee, drew hundreds of supporters to the first of a campaign that Democrats promise will include more than a thousand pro-reform events across the country, Dan Nowicki of  the Arizona Republic reports.

The event opened with a moment of silence for Sen. Edward Kennedy, whose death may galvanize the pro-reform movement, pundits across the nation are theorizing. Take your pick -- the New York Times or the LA Times. The Daily Kos says name the so-called 'public option' part of the plan after Kennedy and be done with it.

The Arizona Republic says emotions ran high at the rally.

Outside the union hall, supporters of Obama's health-care-reform overhaul and critics of the Democratic plans squared off along both sides of North Seventh Street.

Reform backers expressed support for a government-run "public option" and carried signs with slogans such as "Health care can't wait," "Insurance profits are bad for my health" and "Opponents only have scare tactics."

Sen.

An Internet poll shows that nearly 8 in 10 Americans support a federal health insurance plan for those who can't afford or can't get private insurance, and 86 percent say insurance should be available to everyone regardless of health history.

Wow. You wouldn't know that from the folks shouting and yelling at town hall meetings, or holding up signs with pictures of Obama with Hitler mustaches, or from those trading freely in loaded Nazi terminology when criticizing attempts to reform the ailing health care system in this country. That would be the health care system that ties health care so closely to employment, and that denies health care coverage to the sick or those with pre-existing conditions, that is responsible for a huge proportion of medical bankruptcies , that is is expensive that even many of those who are working can't afford it. That one.

The pollster says the term "public option" has been "swift boated," so large is the misunderstanding that has grown up around what it means, Allison Sherry reports in the  Denver Post. In fact, only 37 percent of respondents define it correctly. The poll was released at an AARP Forum in Denver in conjunction with Charlie Cook of the Cook Political Report.

One-fourth of those polled believe the "public option" is a national health care system, similar to the one in Great Britain.

"These two words have become radioactive, they have been swift-boated," said William Mann, senior vice president of Penn, Schoen & Berland Associates, the firm that conducted the poll.

As it becomes more clear the Republicans don't really want health care reform, and more possible progressive Democrats might insist on real reform, it sets up some interesting dynamics. The August recess has provided time for both sides to take a breath and see what they really have. And perhaps for the country to see what both sides really want. Take away the public option, and yes, it really is a windfall for the insurance companies, kind of like the bailout was for the banking industry ....  And remember what a big hurry lawmakers were in to make that one happen? Had to happen right now, right away, or the entire American economic system was going to disappear forever? Yep. Nearly a year later, we're seeing the record bonuses and banking profits roll in.

Now, as Bob Herbert pointed out in a  New York Times blog this week, health care reform minus the public option mostly means herding the young and well into forced health insurance pools. Who benefits from that? Uh, insurance companies..... Because these are folks who traditionally put off insuring themselves because they don't need it, for the most part. The Washington Post reports today  that the Obama administration was unprepared for the intra-party rift that developed over the public health insurance program. Or, one might say, they were surprised when some Dems stood up for themselves and refused to bargain away the basics of reform.

So the progressives are saying we're not going to go for that. They might just stand firm.