A Public Plan: It Depends On How You Ask the Question

Survey questions that equate the public option approach with the popular, patient-friendly Medicare system tend to get high approval, as do ones that emphasize the prospect of more choices.But when framed with an explicit counterargument blatant fear mongering lie, the idea receives a more tepid response. In the new Post-ABC poll, 62 percent support the general concept, but when respondents were told that meant some insurers would go out of business a right wing talking point that nobody can ever prove and is counterfactual to the “the government can’t run anything” argument they have made for years, support dropped sharply, to 37 percent.

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Fixt, and you’re welcome.

Funny how free marketers had a system that is truly free.

sg: just added a sentence to the post with a link to lewin report (well-respected and non-partisan firm) showing that indeed both arguments could be true. it all depends on how the public plan is structured.

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“21a. (IF SUPPORT) What if having the government create a new health insurance plan made many private health insurers go out of business because they could not compete?”
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Feature, not bug…
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We already have Medicare…why can it not be opened up for all?

“Opponents will raise the prospect of losing what you have. Which meme takes root will very likely determine the outcome.”
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And everyone should be reminded that they are going to eventually lose what they have right now anyway. With costs going up and up its going to happen. If you have insurance through your employer he or she will have to decide if you the employee are going to take on more and more of the costs or determine that it is not cost effective for them to provide it in the first place. The days of finding major employers offering health care as part of your compensation are coming to a end. Just like the traditional retirement plans have mostly ended in favor of the 401K.
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If you get insurance on your own then you have to worry about being cancelled because of pre-conditions at the time you will need your insurance the most. The evidence is there. The insurers have told you so via the recent hearings in Congress. They are going to do it because it saves them money. Period. They make a profit by not paying for your health care when your are sick, but accepting your premiums as long as you are healthy. The first time you are diagnosed with a medical condition that is expensive to treat the insurer will go through you back ground with a fine tooth comb and find a reason to cancel your policy. Even if they are wrong it won’t matter. Do not believe the insurers at your own risk. They have flat out told you they will cancel you it you cost to much to insure.
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Any efforts to lower cost to you will take money out of your for profit insurer pockets who will in turn attempt to make it up by charging you higher and higher premiums, co-pays and eventually they will add fees to the mix that you have to pay in addition to other costs. This is how the system is set up to work right now.
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I’m not trying to scare anyone into supporting a public option, but if you buy the framing that you have the prospect of losing what you have. Well, just wait because you will and there will be nothing for you to fall back on until you are flat broke, in bankruptcy and praying for your already cash strapped state to step in and save you.

The Washington Times, I mean Post I get them confused, commissions a poll with an explicit counterargument (read: what they perceive to be a worst case result) to show push back against recent polls showing support for a public option.
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Frank Luntz is smiling.

KT
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If the polling question contained all the nuance of the Lewin report then it would be a fair question. But being as that instead it comes off as a right wing talking point with no explanation of why those companies would go out of business to me it invalidates the question. Hell we have the post office but we also have fedex and other carriers too. I don’t think many people are complaining that we don’t have any more competition there.

The President asked the right question yesterday. Why would any private insurers fold unless its because they suck and no one wants them?

KT,
Has anyone looked carefully at what percentage of Doctor and Hospital charges are actually inflated hedges against the no-pays and bankrupcies?

To emphasize sgw’s and PD’s point, here’s Nate, with hat tip to Sully:
http://www.fivethirtyeight.com/2009/06/george-f-will-admits-public-option-will.html

Robert Reich’s opinion on the public option.

“Why the Critics of a Public Option for Health Care Are Wrong

By Robert Reich – June 24, 2009, 1:17AM
Without a public option, the other parties that comprise America’s non-system of health care — private insurers, doctors, hospitals, drug companies, and medical suppliers — have little or no incentive to supply high-quality care at a lower cost than they do now.

Which is precisely why the public option has become such a lightening rod. The American Medical Association is dead-set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won’t consider it. No other issue in the current health-care debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course, they don’t want it. A public option would squeeze their profits and force them to undertake major reforms. That’s the whole point.

http://tpmcafe.talkingpointsmemo.com/talk/blogs/robert_reich/2009/06/why-the-critics-of-a-public-op.php#more

“Opponents will raise the prospect of losing what you have. Which meme takes root will very likely determine the outcome.”
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This is a very different statement from “insurance companies may go out of business.” The reason they would go out of business is that people would not choose a more expensive, less comprehensive private plan over a public option. Choosing something better is not the same thing as losing what you have.
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This is what Obama was saying yesterday. He did NOT, as a NYT headline reads this AM, say that “Obama Says Government Health Coverage Plan Would Not Hurt Private Insurers.”
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He used a complex and sophisticated rhetorical tool called “logic.” He said the insurance companies say they provide great care at a fair price, that a government plan would be run by awful bureaucrats and would suck and that it would put them out of business.
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These three propositions are not mutually consistent.
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In fact, insurance companies would reduce their costs of providing coverage (as retailers have lowered their costs in the face of competition from Walmart) or provide higher quality coverage at higher prices (as with luxury retailers who don’t compete with walmart) or go out of business (as have many retailers in the face of competition with walmart).
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This really is not difficult to explain in a news article, just as it was not difficult for Obama to explain yesterday. There is no reason to repeat these ridiculously inconsistent talking points as based in reality just because Frank Luntz writes a memo that all the Republicans read and implement. Will we hear John Boehner response to Obama’s refutation of what he was writing last week?

KT:
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…report showing that indeed both arguments could be true. it all depends on how the public plan is structured.
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What you mean, I believe, is that part of the report that specifies this:

If the public plan is opened to all employers as proposed by former Senators Clinton and Edwards, at Medicare payment levels we estimate that about 131.2 million people would enroll in the public plan. The number of people with private health insurance would decline by 119.1 million people. This would be a two-thirds reduction in the number of people with private coverage (currently 170 million people). Here again, if the higher private payer levels are used, enrollment in private insurance would decline by only 12.5 million people.

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This leads to the reasonable conjecture that a loss of those premiums is an insurmountable financial catastrophe for many of even the largest insurance companies…conjecture that would be reasonable if 119.1 million people suddenly switched insurers literally overnight.
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The report doesn’t actually mention a timeline to this fewer/smaller private insurer eventuality, it only briefly mentions that older individuals are less like to switch no matter what their options.
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What’s fear-mongering and misleading about the claim “many private insurers will go out of business, leaving the public with fewer options”, is that it’s dependent on a report that does NOT tell us when that state of affairs will be reached. It doesn’t say “over the next 20 years”. It doesn’t say “over the next decade”. It doesn’t say anything at all about the time necessary for over one hundred million people to all do something different than what they’re currently doing.
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The report (probably unintentionally) gives one the impression that the public option is some kind of mass extinction event like a tsunami or an asteroid striking the earth, at which point there will be a sudden, drastic change. Of course that’s anxiety-producing for many people –even people dissatisfied with what they currently have!
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But this is only an impression!
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Look, if I told you that in 1929 there was a report establishing the high probability that, given recent advances in consumer refrigeration, if the electrical grid were extended to all rural and urban areas, most ice delivery companies would go out of business, and you immediately sold your stock, wouldn’t you be a fool? Even the most highly predictable and thorough business extinction events don’t happen overnight, they take decades
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What’s may be occurring is that this so just happens to be the exact moment in history that the press is itself fertile ground for concern over business extinction events, and so the claim “they’ll all go out of business!” resonates with reporters in a way that serves the industry’s “catastrophic event” fear-purveyors.
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The report did NOT say some very important things:
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1) that insurance companies would go out of business
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2) that insurance companies would change their rates and benefits to compete over customers (they explicitly assume that private insurers won’t lower rates to a dollar above public plan rates)
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3) that any of these changes would be complete by a probable date
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KT, if you’re really reading this whole report, can you tell me where I’m wrong on any of this?
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Isn’t a fair, completely true statement “Many large private insurance firms who do not lower rates or provide better service will go out of business over the next two decades.“?
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Shouldn’t the question really have been asked this way, KT? –
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“What if having the government create a new health insurance plan made many private health insurers go out of business over the next ten or twenty years because they could not complete?”
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Unless a reasonable time-line is included in the phrasing, isn’t the question putting a sudden catastrophic event into peoples’ minds?
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As far as I can tell, the Lewin Group’s report contains no time-lines on which to base reasonable estimates as to when in the future “many private insurers go out of business”.
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In the interest of accuracy, could you please ask somebody at the Lewin Group specifically (not somebody familiar with the report who may be willing to conjecture, somebody who understands the data) who knows the programmatic models referenced by the authors of the report “What is the time-line for 119.1 million people switching from private to public insurance?”, KT?
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If reporters and pollsters are possibly unintentionally giving the American people the impression that something sudden and drastic may happen, isn’t it their objective duty to make certain that this truly is a likelihood, and not use their own industry’s current woes as the model their reporting assumes?
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Don’t Americans deserve to know the time-line of the possible events in question, KT?

Or, as nate asks “Why is the Washington Post Testing Republican Messages on Health Care?”
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http://www.fivethirtyeight.com/2009/06/why-is-washington-post-testing.html

SZ: I will email john shiels at lewin and ask him, though i assume that is hard to answer until we know the time line for implementing any public plan.

jayack –
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They be not testin’ mate – they be askin’ th’ questions t’ plant th’ idea, believin’ it will be stickin’, an’ no amount o’ logic ‘r reason comin’ down th’ pike later will be able t’ dislodge their initial plant.
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An’ I be believin’ they be ri’.
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We’re losin’ this thing b’fore it even gets started, I’m fearin’, b’cause “news” be already on board, bought an’ paid fer, frame set, narrative adopted, nothin’ else t’ see here, deal done.
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YARR!

PW
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I’ve recently become very aware of just how much health care advertising there is on my teevee….
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Obama is pushing back, though.

my entry into the “explain to karen that its not about “how you frame the question”, its about asking false/misleading questions and presenting them as appropriate (and reporting on them for Time, Inc as if they were not false/misleading” contest….
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Karen, how do you think the responses would have been if those who were opposed to a public option were asked “Would you support a public option whose competition may result in the private insurance industry providing better health care at lower prices?”
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my guess is that you’d find a lot more support, because that question is really push-polling, as is the ABC/Post question.
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The real story here is how the ABC/Post poll contains PUSH POLLING; and a good reporter on the health care beat would be investigating who ordered up a question phrased in this manner…..

jayack -
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I be afeared it be too late.
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Even on th’ NPR this mornin’ th’ line was all about how th’ press corp’ were finally beginnin’ t’ show their “gumption” yesterday, an’ how “testy” th’ President were in ‘is response.
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An’ even ‘ere in KT’s post…were she pointin’ out who sourced th’ poll framin’ th’ question so’s t’ drive th’ PO support numbers down? No, she were not. She be comin’ ve’ near t’ a “they say, they say” presentation.
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Now, don’t be gettin’ inta’ a tizzle, KT – ye be doin’ fine work on th’ all an’ all! Bu’ even ye be havin’ yer limits in this thing, an’ ye be one o’ only a few on th’ front lines facin’ an overwhelmin’ avalanche o’ Bullsh*t t’ wade through. It be able t’ cause a bit o’ numbness even in th’ sharpest o’ minds!
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Arrgh!

An, WE may be knowin’ th’ WAPO be havin’ their finger in th’ pie, bu’ I be slap sure it be goin’ t’ be presented on th’ “news” as objective evidence o’ support slippin’, wi’ no context ‘r background added.
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Arrgh!

Karen you really need to look at Jayackroyd’s link to Nate.
Nate shows a comparison of the Post ABC poll to one the Kaiser Family Foundation did.

PW
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the president was, at least, “testy.” I’d say “contemptuous” and “mocking” are also fair characterizations.

jayack
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I’m thinkin’ “showed an incredible amount of restraint and patience in dealing with a room full of rabid jackasses.”
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Arrgh.

KT:
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I will email john shiels at lewin and ask him, though i assume that is hard to answer until we know the time line for implementing any public plan.
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Thank you so very much for your diligence and concern for accuracy; I’m beyond gratified. Even if there’s no answer forthcoming, this is the kind of interaction and effort from a representative of a publication for which I would gladly show support with my available income (say, if there were a “donate” button to PayPal next to your name, for example).
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BTW: I believe that an implementation date need not be specified for a reasonable estimate to be given, based on their models –unless Lewin’s programmers (inexplicably) just didn’t include any date factors whatsoever.
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If we assume the time-line for implementation of a public plan is a given date, say January 1, 2012, how long before the last of the 119 million people made that switch from private to public? 10 years? 20 years? 30 years? A week?
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(the question still assumes the Lewin Group report’s debatable premise that private insurers would do nothing differently whatsoever in terms of price and service to compete with any public plan, once people began to switch)

KT
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’bout those numbers signin’ Sanders’ petition fer single-payer?
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Arrgh!

I just hope Congressional Dems realize that when they fail to pass health-care reform, they will have doomed the party.

SZ
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Looking at the model used http://www.lewin.com/content/Files/HBSMSummary.pdf
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I don’t think your question about time can be answered. The models ask the question “What would health care systems look like if State A were in place? State B? There is no recognition that the changes would happen over time.
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That’s a problem for this kind of model–it assumes that the relevant elasticities are not dependent on the nature of the system, that people would not alter their preferences in a different system.
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/pedant This is a variation on the Lucas critique, Robert Lucas’ observation that the large macro models that were in vogue in the 70s and 80s assumed that people do not change their responses when circumstances change. One important implication of this point is that inflation only works in a stimulative way if it is both unexpected and accelerating. Otherwise people start building it into contracts. pedant/
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Of course, the assumption that people would move along the price curve rather than shift the price curve is very limiting. One thing we would expect from a robust public option is an efflorescence of small business development, and an increase in freelancing. That kind of effect is not in the models, that I can see skimming through them.
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Nor, as I said, is time.

“Or, as nate asks ‘Why is the Washington Post Testing Republican Messages on Health Care?’”
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Digby:

This is how it’s done. The right wing stages a hissy fit accusing the so-called liberal media of being in the tank for Obama. And the so-called liberal media, which is more afraid of being called the liberal media than being seen as corporate whores, stooges or fools, bends over backwards to ensure that every right wing talking point is aired with the authority of Zeus. They will push, they will prod, they will argue the conservative line vociferously, using their status as advocates for “the people” to make it sound as if they are expressing the doubts of the public at large. They will not mention any liberal concerns because as Atrios pointed out with respect to Froomkin’s firing, anyone who has concerns about the super liberal administration’s plans from the left is, by definition, a crackpot communist nutcase.

Also, KT,
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I be wonderin’ when I mi’ expect t’ be seein’ a full-blown feature in th’ dead tree version – which be reachin’ a far wider audience than this fine tho’ wee blog – titled somethin’ along th’ lines o’:
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“Who’s Behind the Opposition to Health Care Reform, and What They Don’t Want You to Know About a Public Option.”
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A feature clearly layin’ out:
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who be bought an’ paid fer by who in th’ Congress, an’ how tha’ mi’ be affectin’ th’ legislation they be considerin’
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th’ percentage o’ doctors actual represented by th’ AMA, so’s we know whether or no they be a fair representation o’ doctors on th’ whole, ‘r whether they be nothin’ bu’ another special interest group masqueradin’ as somethin’ else
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th’ most widely-spread myths an’ fears regardin losin’ choice, long waits, th’ situation in other countries usin’ th’ single-payer system (I be mixin’ in public option w/single-payer, bu’ th’ opposition be confusin’ th’ two a-purpose, too), an’ whether those myths an’ fears be havin’ any sort o’ foundation in truth an’ facts ‘r no
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whether ‘r no thar be cost savin’s fr’m eliminatin’ th’ profit motive an’ other increased efficiencies
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ye be knowin’ – factual, contextual reportin’ so’s we citizens who be affected by change ‘r no have information we can be usin’ instead o’ th’ sort o’ helpin’ pull th’ wool o’er our eyes tha’ th’ overwhelmin’ majority o’ th’ “news” media be participatin’ in t’day?
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Mi’ I be expectin’ it in time t’ affect th’ course o’ things wi’ th’ upcomin’ legislation, ‘r will this be some hand-wringin’ “if only we’d a known” crocodile tears piece down th’ road after it be too late?
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it’d just be a whale o’ a help if we could be gettin’ th’ true information out fer folks t’ consider, warts an’ all, instead o’ just repeatin’ th’ talkin’ points o’ th’ special interests as if they be th’ God’s honest truth.
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Ag’in, no personal reflection on ye, lassie. Ye be doin’ a fair fine job, bu’ ye needs t’ be steppin’ it up another level ‘r two an’ reachin’ a bigger audience.
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Arrgh!

“A feature clearly layin’ out:
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who be bought an’ paid fer by who in th’ Congress, an’ how tha’ mi’ be affectin’ th’ legislation they be considerin’”
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Aye, ye be spittin’ in the wind there, lassie.

It is a shame that politicians are not debating whether or not to have a health insurance reform. They have already taken that for granted. Instead they are looking at how to affect the system.
That being said…
My gripe is that the government has no place to start businesses in a free market economy. Mr. Obama has said that this system must pay for itself. If it was possible, and was their true intent, to have an UNSUBSIDIZED insurance plan, then why don’t Mr. Obama et al open their own PRIVATE company? They can charge whatever premiums they want, reimburse providers however they see fit, cover what ever they want, and use any criteria to evaluate potential beneficieries. Because it is not possible. The truth is that giving things away gets votes. The promise of giving away healthcare has garnered a lot of votes. The beauty of the free market is that any one of the uninsured Americans (or any of the insured for that matter) could take up this cause. If they think they have a better way or system they can test it in the market. Walmart did this and won.

The government is also considering an insurance mandate, as Connecticut has already done. This is one way to lower premiums, by spreading risk more. However, this violates my right of free will. It is also a handout and does not encourage people to work. Maybe that is why health insurance is so often tied to employment. Those who are employed can afford health insurance.

One worrying fact is that health insurance companies do sometimes deny benefits to those in need. First, this happens a lot less than the media and government would like you to believe. Second, the government could provide a resource that spells out the limits of long insurance contracts in everyday language. Anyone considering insurance could then use this to gauge whether it is a good plan or not. Education is key. However, just like 401K’s and the SEC, most people would probably be too lazy to check this resource.

PS did anyone ever think that prices and premiums may be going up because people are actually using more health care resources? Thus it is becoming more scarce and more expensive? Instead of “this cough will go away” people rush to the GP who then refers to an ENT. Just think about what would happen if 46 million new policies were added. Even if it took 4 years for this, it takes 8 to train a GP, 12 for specialists. Demand for specialists would outstrip supply for at least 8 years.

[...] in Congress, Daily life, Government, Healthcare, Obama administration at 11:00 am by LeisureGuy Karen Tumulty of TIME: As we have noted here before, two recent polls have shown three-quarters of the public support the [...]

Maybe the solution to the problem of public vs. private is to offer a compromise solution that includes both. To get cost containment and universal coverage we would use a single payer plan. To satisfy those who insist that they must have a private plan we could offer a check box on a form. Those people who choose to check the box would be signing up for the ‘Simulated Private Plan‘.
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Simulated Private Plan features would include:
1. Being charged an additional 20% for private plan administrative fees.
2. Being denied access to specialists because they are ‘outside of your network’.
3. The possibly of having health care coverage withdrawn entirely, when you become sick, because you incorrectly described your medical history (remember that vaccination you had in the 2nd grade?).
4. Having medical care denied because the treatment you need is deemed to be for a preexisting condition.
5. Having medical coverage denied because you actually do have a preexisting condition.
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Of course, we would continue to allow people with Simulated Private Plan denial of coverage to show up at emergency rooms. If they show up with cancer, however, they would be would be asked to leave — just like a private plan.

How about asking the question this way:

Would you support being able to keep your existing coverage and have the free tax-payer supported use of top national medical centers like Walter Reed and Bethesda just like every Congress person has right now?

Seems that might elicit a specific response, not so much about health care, but about how Americans view the mis-representation we have in Congress.

http://whatchannelareyouwatching.com/archives/165

One other comment. John Stewart pointed out the startling trend among news media to more and more rely on “unverified” reporting. Here’s a really novel idea: How about the media worry less about their image among different socio-political groups and actually report the facts. An opinion poll run by a legitimate news organization should not be testing a specific political point of view to see if one side has better ammunition than the other side has. That seems to cowardly at best, and subversively destructive at worst.

raykeller –
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I don’t be believin’ any o’ us who want a real public option and/or single-payer be not knowin’ it be our tax dollars tha’ will be payin’ fer (subsidizin, t’ be usin’ yer own parlance) it.
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Th’ reason th’ govt could provide better, cheaper care be mostly b’cause th’ govt be not committed t’ makin’ a profit t’ pass back t’ shareholders…said profit be dependin’ on collectin’ premiums, bu’ denyin’ coverage.
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Th’ problem wi’ only havin’ th’ poorest, sickest in the govt system be th’ risk not be pooled across a wide ‘nough population. So, th’ private corporations would be gettin’ th’ creme o’ th’ crop – which would help ‘em even more in shuttlin’ premiums straight t’ their own shareholdeer in th’ form o’ profit, and leave th’ govt wi’ all th’ expensive conditions tha’ cost money t’ address.
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I’d be absolute smack-happy t’ take th’ premiums I be payin’ now, plus me out o’ pocket expenses I be payin’ now, plus th’ contributions we currently be makin’ t’ our HSA t’ have an extra cushion, an’ be payin’ ‘em in taxes t’ be gainin’ 100%, non-droppable, non-deniable coverage provided by th’ govt.
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I be sincere b’lievin’ th’ market were havin’ plenty o’ time t’ prove they be capable o’ deliverin’ health care access, an’ tha’ they failed miserable so therefore no longer deserve t’ even be a’ th’ table.
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An’ I also be believin’ th’ time fer health care access as a market commodity li’ caviar ‘r champagne there fer those who can afford t’ be buyin’ be over. I be believin’ adequate health care be a human ri’, an’ th’ govt be in th’ best position to deliver it.
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I also don’t be believin’ anyone be havin’ th’ “right” no more to opt out o’ bein’ insured, unless they first be signin’ a waiver statin’ they be understandin’ should they get sick, they be on their own no matter what. Harsh, bu’ there be too many on their high horses regardin’ havin’ t’ pay in, bu’ when they get sick an’ want t’ be takin’ out, the jibe ri’ quick an’ want th’ care.
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Bu’, tha’ just be me own pirate opinion, mate!

raykeller –
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I be fergittin…Me, an absolutely every person I be knowin’ (I be not kiddin’ ‘ere!) been denied benefits a’ some point ‘r other. Some been dropped complete due t’ losin’ their jobs, some be havin’ procedures ‘r medications turned down. Some been irritatin’, some been havin’ serious health consequences. If anythin’, I be believin’ lots MORE folks than we be knowin be bein’ denied benefits.
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Alri’ matey, I b’lieve tha’ covers it .
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Arrgh!

Here is the question: How do we prioritize health care when compared to education, military, and infrastructure?. …………..

http://thefiresidepost.com/2009/06/23/is-ten-percent-too-much-for-health-care/

Jay:
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Thanks so much for the explanation (all of it).

I be wonderin’ if KT abandoned us fer Sanford an’ Sin b’cause she were gettin’ a wee bit taken t’ task?
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Arrgh!

Sanford an’ Sin…
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It does have that train-wreck quality to it. No one wants to look but they do it anyway…..

bobcnl: The only reason public plans such as medicare are cheaper is because they are subsidize by the government (aka your tax dollars.) Guess who administers Medicare? That’s right, private insurance companies! The government contracts with private insurers to act as intermediaries between Medicare and the patient. Another layer. There is also the Medicare Advantage plan in which case the government simply pays an insurance company to cover the person.
And have you checked out Oregon’s (a real state, not a foreign country) Medicaid? They constantly deny care in a government run program. The Brookings Institute states, “Oregon attempted to ration care according to a priority list of services to which more individuals who could not afford private insurance could have access.”

Pirate Wench: We disagree that health care is a human right. I believe that we are all CREATED equal, not the we are (or should be) all equal. Having said that, there is a mechanism for NFPs in a free market. Blue Cross, as well as many other insurers, used to be not-for-profits. Its not the profits that make a difference. I don’t know why they switched, but NFP didn’t work out for them. With your reasoning about removing profit, why doesn’t the government take over Walmart? Then your groceries could be cheaper. Everyone has a right to food. We’ve already seen how things turn out when the government creates new rights. Part of the mortgage meltdown was a belief among politicians that home ownership is an American right. This is how all the -isms develop (fascism, socialism, etc). Where should the government stop taking away the “profit” making? In my opinion Americans have developed the finest medical procedures, drugs, and equipment in the world because the stand to profit from it. The government cannot legislate innovation and creation.
Many people get denied because of unnecessary procedures. Peter Orszag, in testimony to the Senate Committee on Finance, stated that “areas with higher spending do not appear to have better health outcomes on average than those in areas with lower spending.” This report indicates that roughly 25%, one in every four dollars, spent on medical care is unnecessary. As long as you have insurance, someone will decide what treatment you get and which you don’t. See the Oregon’s Medicaid system above.

Could someone tell me how to make a paragraph break? Might it be that I’m using Firefox? I dislike these blocks of text.

raykeller – you have to cheat and use periods between paragraphs. Like so:
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We can recieve constant updates on the plight of people around the world but somehow it’s beyond WordPress’s ability to recognize a paragraph break.

raykeller –
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I be usin’ firefox, laddie – it be th’ piece o’ sh*t software program TIME be usin!
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When ye be wantin’ t’ break a paragraph,
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1. Hit th’ enter key.
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2. Hit th’ period
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3. Hit th’ enter key ag’in an’ proceed!
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Arrgh!

Ray: welcome, and yes, these paragraph breaks are something we deal with by putting periods between them.

Damnation! Accordin’ t’ NPR, Sebelius just be givin’ ‘er impramatur t’ th’ health care “reform” plan currently in Baucus’ conference – ye be knowin’ – th’ one wi’ nary a public option anywhere t’ be found!
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I be swearin’ – I be ready t’ strangle th’ lot o’ ‘em!!!
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YARR!!!

I be filled wi’ rage t’ be witnessin’ th’ screwin’ o’ th’ American people in favor o’ th’ corporate health industry!
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YARR!

ray –
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Be thar a way ye could be reworkin’ yer previous post wi’ th’ new breaks, me hearty? It’d make it a whale o’ a lot easier t’ be readin’!
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Arrgh!

Mayhap we should be callin’ ‘er SeBAILius, since she apparent’ be most committed t’ bailin’ out th’ health care industry interests, an’ she be bailin’ on th’ rest o’ us!
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YARR!

Me, an absolutely every person I be knowin’ (I be not kiddin’ ‘ere!) been denied benefits a’ some point ‘r other.
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That’s pretty scary to me. I haven’t had benefits denied yet, but I’m sure it’s in the works.
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It’s doubly frightening because I was diagnosed with cancer right before I graduated high school. I was on my dad’s insurance at the time, and we didn’t have any problems with the treatments (I should talk to my parents about what the costs were), but I know for damn sure good health is no guarantee.

bobcnl: The only reason public plans such as medicare are cheaper is because they are subsidized by the government (aka your tax dollars.) Guess who administers Medicare? That’s right, private insurance companies! The government contracts with private insurers to act as intermediaries between Medicare and the patient. Another layer. There is also the Medicare Advantage plan in which case the government simply pays an insurance company to cover the person.
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And have you checked out Oregon’s (a real state, not a foreign country) Medicaid? They constantly deny care in a government run program. The Brookings Institute states, “Oregon attempted to ration care according to a priority list of services to which more individuals who could not afford private insurance could have access.”
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Pirate Wench: We disagree that health insurance is a human right. I believe that we are all CREATED equal, not the we are (or should be) all equal.
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Having said that, there is a mechanism for NFPs in a free market. Blue Cross, as well as many other insurers, used to be not-for-profits. Its not the profits that make a difference. I don’t know why they switched, but NFP didn’t work out for them.
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With your reasoning about removing profit, why doesn’t the government take over Walmart? Then your groceries could be cheaper. Everyone has a right to food. We’ve already seen how things turn out when the government creates new rights. Part of the mortgage meltdown was a belief among politicians that home ownership is an American right.This is how all the -isms develop (fascism, socialism, etc). Where should the government stop taking away the “profit” making?
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In my opinion Americans have developed the finest medical procedures, drugs, and equipment in the world because people stand to profit from it. The government cannot legislate innovation and creation.
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Many people get denied because of unnecessary procedures. Peter Orszag, in testimony to the Senate Committee on Finance, stated that “areas with higher spending do not appear to have better health outcomes on average than those in areas with lower spending.” This report indicates that roughly 25%, one in every four dollars, spent on medical care is unnecessary. As long as you have insurance, someone will decide what treatment you get and which you don’t. See the Oregon’s Medicaid system above.

Cliff – As long as you get coverage shortly after leaving your parents plan (I think 2 months) you should not have trouble being re-covered. This is included in Title 1 of HIPAA (Health Insurance Portability and Accessibility Act). It applies to employer based health insurance policies. I’m not sure about individual. If you are covered by your parents until you get your own policy then you can deduct that amount of time from the maximum 12 month exclusion period. You have probably been covered for more than 12 months with your parents, in which case you would have no exclusion period. Hope this helps.

Ray-
Any advice for someone whose coverage under parental health-care expired around 3 years ago and is currently uncovered? No health-care plan provided through employed either…

ray –
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I hates t’ be tellin’ ye this laddie, but th’ US be havin’ far fr’m th’ finest medical system now. Thar be ’round 38 countries wi’ better care, efficiency an’ outcomes, an near all o’ em’ are single-payer systems, not market-based. An thar’ be plenty o’ other countries with “socialized medicine” tha’ be doin’ plenty o’ development an’ innovatin’.
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Th’ takin’ o’er WalMart comment just be siilly, by me lights – I were never sayin’ there were no place fer th’ free market – just tha’ health care access don’t b’long in th’ market. Usin’ yer argument, we shouldn’t be havin’ a military neither – tha’ be not a market-based enterprise. An’ come t’ be thinkin’ ’bout th’ military, thar be plenty o’ profit bein’ made off THAT govt subsidized organization!
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Sorry, yer arguments just don’t be standin’ up fer me.
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I’d be sayin’ “Give me single-pay, or give me death!”, bu’ that be too close a shave t’ true come th’ near future t’ be makin’ light.
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Arrgh!

An’ thank ye fer separatin’ th’ text thar, mate!
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Arrgh!

Pirate Wench, I’m logging off for tonight, but THANK YOU for getting everyone back down here on the insurance thread and off Sanford. Good on ya, matey! (It just never sounds as good from us land-locked Midwesterners LOL)
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‘night all.

I do believe we should have a much smaller military. One that does not prop up an American Empire.
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The World Health Organization’s ranking of the world’s health systems (the only organization to rank as far as I know) last ranking I’m aware of was produced in 2000. To my knowledge the WHO no longer produces such a ranking table, because of the complexity of the task.
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Neorationalist- I hope I can help. Any pre-exising conditions? And you are employed, they just don’t offer healthcare?

Ray-
Other than a bum-knee, no pre-existing conditions. Employed, but no health-plan offered.

G’night joyous, we man th’ decks ag’in a’ th’ morrow!
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I were fr’m th’ midwest original too, me hearty! Ye have t’ be workin’ a’ it t’ become a pirate!
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Ray –
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Now laddie…don’t go a tryin’ t’ obfuscate by changin’ yer tack t’ th’ SIZE o’ th’ military, rather than me point – an’ ye be knowin’ it be me point ‘ tha’ th’ military – never be mindin’ wha’ th’ size may be – be a 100% govt-subsidized organization tha’ not be appropriate t’ turn o’er t’ th’ market. Bad form, me bucko, bad form.
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Thar be other sources o’ health care rankins, an’ I’ll be searchin’ fer some t’morrow. I do be knowin’ th’ figures I be seein’ be much more recent than 2000.
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Neo –
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Ye go ri’ ahead an’ find yerself some insurance, matey – it be out thar. Just don’t be gettin’ serious sick, ‘r yer ass will be out th’ door!
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Arrgh!

raykeller wrote: ‘Neorationalist- I hope I can help. Any pre-exising conditions?’
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Isn’t that a demonstration of the problem? What difference should it make whether someone has pre-existing conditions? In a system that is designed to provide healthcare whether someone has a pre-existing condition would be irrelevant. It would merely mean that that person may need treatment. But we don’t have a system like that.
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Our system is designed to sell health insurance, not provide care. Consequently, we screen out people that actually need medical attention. In our system the words ‘pre-existing condition’ are frequently a death sentence.

“Our system is designed to sell health insurance, not provide care. Consequently, we screen out people that actually need medical attention. In our system the words ‘pre-existing condition’ are frequently a death sentence.”
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And that, my friends, is the salient moral issue. It’s a national shame.
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Otherwise, let’s stick with the data (rather than compelling anecdote) shall we? We’re talking public policy not what happened at the prom. US health care system: highest cost per patient in the industrialized world + worst health care outcomes (on a host of measures) = FAIL. So the only rationale for the current system is that it provides income and jobs for insurance companies. All other outcomes are negative, relative to a government controlled and subsidized system (assuming we can’t do worse than every other industrial nation).

raykeller wrote: ‘Guess who administers Medicare? That’s right, private insurance companies! The government contracts with private insurers to act as intermediaries between Medicare and the patient. Another layer.’
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Yes, some private insurance companies contract with the government to provide services for the Medicare program. Those services DO NOT include providing medical insurance, however. The private contracts are for claims and payment processing, call center services, clinician enrollment, and fraud investigation. The services are an integral part of the Medicare system — not ‘another layer’.

I love how the worst case scenario is that “only” 62% support the public option. Sounds like a majority to me!

It’s really refreshing to see such reasoned, respectful debate here!

Too bad it’s not like this in Congress or town halls…