Still an Option

Posted Oct. 05, 2009, at 6:16 p.m.

The public option health insurance proposal was voted down in the Senate Finance Committee last week and faces long odds making it into bill before the full Senate. But it could be revived in the Senate floor debate, and it certainly will appear in the House bill. So don’t count it out yet.

The Senate Finance Committee is slated to finish its health care overhaul bill this week. Democrats Ron Wyden of Oregon and Jay Rockefeller of West Virginia have withheld their support, as has Olympia Snowe, who long supported a public option that would be triggered only if insurance companies didn’t meet standards for affordable policies.

With a likely prospect that its fate will be decided in an eventual Senate-House conference and subsequent votes in the two houses, the public option is worth clarification. That means far more than the simple liberal assertions that it will make the insurance companies honest and the overwrought charges by a claque of pundits and talk show hosts and a few lawmakers that it would lead to socialism, government bureaucrats choosing your doctor and national bankruptcy.

Sen. Rockefeller’s amendment to the proposed America’s Healthy Future Act, which he pledges to introduce on the Senate floor, offers a vehicle for this analysis.

His public plan would be developed by the Department of Health and Human Services to be available starting in 2013. It “must offer the same benefits, abide by the same insurance market reforms, and follow provider network requirements and other consumer protections.”

The government option would have to be self-sustaining after a $2 billion initial appropriation to cover administrative costs and early claims. Premiums would be geographically adjusted to handle coverage costs and administration and to recoup the initial $2 billion in the first 10 years of operation.

Geographically adjusted provider payment rates would be based on Medicare rates with a 5 percent add-on adjustable after three years to cover pediatricians and services not covered by Medicare and to keep the public option competitive with private insurance plans. The federal government would have specific authority to negotiate prescription drug prices for the public option.

Payment to providers could be adjusted to “promote better quality and more efficient use of medical care.” The purposes would include reducing cost to enrollees, improving health outcomes and preventing or managing chronic illnesses, as well as promoting “integrated patient-centered care.”

Sen. Rockefeller says private insurance companies’ profits have soared by more than 400 percent since 2001, while premiums for consumers have doubled. To fight back against an industry that “is profit-driven when it should be patient-driven,” he has proposed an America’s Health Insurance Trust, which would rank insurance companies annually on affordability and enrollee treatment, so people would know what they’re getting when they bought health insurance.

These reforms, no matter what they are called, should be part of the discussion if the end result is to be true health care reform that will benefit everyone.

http://bangordailynews.com/2009/10/05/opinion/still-an-option/ printed on July 22, 2014