Public Option is a Debate Very Much Needed
The announcement this week from Senate Majority Leader Harry Reid that he is moving forward to introduce legislation offering a government alternative to compete with private health insurers was welcomed news. Before I go further, let’s review (per a summary from USA Today’s October 28, 2009 edition, p. 6A) all three of the public options being considered by Congress:
Robust-includes the original House health care bill; would be available nationally to people—except for workers of large companies that provide coverage. Doctors and hospitals who accept patients in the plan would be paid at the Medicare rate.
Opt Out-this is the option that Sen. Reid is offering. It would allow individual states to opt out by 2014, meaning residents in those states could not enroll. The program would negotiate how much to pay doctors and hospitals for procedures, just as private insurers do.
Opt In-some moderate Democrats, including Sen. Ben Nelson of Nebraska, have said they prefer a public option that would not take effect unless individual states choose to opt in. The idea has been floated in Congress but is not included in any bill.
Trigger-in this situation, a pubic option would be triggered by a state-by-state basis only if certain conditions are met—such as the cost of premiums not falling by a set date. The idea is backed by Sen. Olympia Snowe of Maine, the only Republican who has voted for a Democratic health care plan.
So here’s my thinking…
What’s needed more than anything else right now is a vigorous debate about this topic occuring outside of Washington. One criticism—and a valid one, I think—often touted by the pro and anti side of health care reform is that much of this health care discussion is an “inside the Beltway” one. By pushing the debate out to the states via this very controversial public option, there can finally be a good and candid debate that will let the chips fall where they may.
Understandably, opponents of health care reform from both sides of the aisle are not warm to this idea. For certain it will force a level of transparency about motives and what is actually being presented that has not been present so far. Also, it is likely that by going the route of encouraging states to debate the issue, other issues can become part of that discussion—such as parity for mental health services, something we in Michigan have been fumbling around with for a number of years.
Yes, let’s let the states decide—and let’s do it quickly.
Robust-includes the original House health care bill; would be available nationally to people—except for workers of large companies that provide coverage. Doctors and hospitals who accept patients in the plan would be paid at the Medicare rate.
Opt Out-this is the option that Sen. Reid is offering. It would allow individual states to opt out by 2014, meaning residents in those states could not enroll. The program would negotiate how much to pay doctors and hospitals for procedures, just as private insurers do.
Opt In-some moderate Democrats, including Sen. Ben Nelson of Nebraska, have said they prefer a public option that would not take effect unless individual states choose to opt in. The idea has been floated in Congress but is not included in any bill.
Trigger-in this situation, a pubic option would be triggered by a state-by-state basis only if certain conditions are met—such as the cost of premiums not falling by a set date. The idea is backed by Sen. Olympia Snowe of Maine, the only Republican who has voted for a Democratic health care plan.
So here’s my thinking…
What’s needed more than anything else right now is a vigorous debate about this topic occuring outside of Washington. One criticism—and a valid one, I think—often touted by the pro and anti side of health care reform is that much of this health care discussion is an “inside the Beltway” one. By pushing the debate out to the states via this very controversial public option, there can finally be a good and candid debate that will let the chips fall where they may.
Understandably, opponents of health care reform from both sides of the aisle are not warm to this idea. For certain it will force a level of transparency about motives and what is actually being presented that has not been present so far. Also, it is likely that by going the route of encouraging states to debate the issue, other issues can become part of that discussion—such as parity for mental health services, something we in Michigan have been fumbling around with for a number of years.
Yes, let’s let the states decide—and let’s do it quickly.
posted by Robert McTyre Sr. at 12:36 PM
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