Public Option Health Care May Get Dropped

I think if it gets dropped, then it demonstrates gutless politics by Obama and the Democrats, and fails as true reform. If ever there was an issue and time too fight, this is it.

The Democrats need to grow some Kuhonas and fight to keep a viable public option and one payer system in consideration. Educate the people, fight with information and real data and push it to a vote.

I am now stepping down off my soap box LOL

I understand your frustration rng, but I am also a realist.  We need health care reform, and I want a public option--what I really want is a single payer universal health care.  But I know this is not going to happen; therefore, what are the options and compromise points.  It looks like the public option is going to be a compromise issue. I am not happy about this, but if insurance exchanges are going to be substituted, let's start debating how the exchanges can be managed.  I wrote a piece on another thread about considerations in initiating them. 

Insurance Exchanges 

We can now open the discussion on insurance exchanges.  Exchanges function somewhat like a large employer as purchaser.  They assemble, organize, disseminate information about competing health plans, enact policies that promote risk pooling, design benefit packages, negotiate premiums, limit the number and types of plans marketed, structure the enrollment and plan-selection process.  This is done because consumers are rarely, if ever, equipped to deal with markets offering complex, expensive, hard to understand products.  "Consumers facing complex, high-stakes choices are prone to predictable errors.  They are likely to lack the skill and time to make choices based on a careful assessment of the relative costs and quality of competing health plans, tending instead to choose on the basis of anecdotal information, such as their friends' experience." (NEJM 7-22-09)

How should exchanges be administered.  Exchanges should recognize the realities of behavorial economics.  "Inertia due to numbers" reinforces "status quo bias."  This was discovered in a Swiss health insurance study that revealed when faced with a choice of 30 to 75 health plans that all met mandated coverage standards, there was less competition because people were less likely to change plans thus suppressing competition.  When choices become very large and people are overwhelmed this prevents them from seeking information on alternative plans that are less expensive.  Insurers know this and consider their customers captive customers; therefore, the incentive to competively lower premium costs is mitigated. 

Studies of Medicare recipients suggests when consumers are faced with complex, uncertain choices with consequences they rely on simple rules, many times to their detriment. 

Exchanges need to be structured to encourage consumer choices through consumer-friendly information.  Information and web-based tools to compare plans and their summaries, and to evaluate plans based on individual need and income, but this might not be enough for some to decide. Some federal oversight, counseling and referral would be a practical component for those who need personal help in making a selection.  Also, people should be encouraged to review their plans yearly to evaluate the market and change plans if a better one is available, thus promoting health plan competition.

Safeway Health Plan. It is one of the few plans that has contained costs because it uses a well-thought out and effective wellness  plan. Keeping the costs down benefits the employees by letting them pay less for their coverage and keeps pressure on wages down so Safeway can stay competitive.

Effective wellness plans are based on the idea that the only way we can do the maximum good is to create health rather than manage disease. Or, we could say that the best way to manage disease states was to minimize or prevent their occurrence in the first place.

I totally agree in holistic practices, and this is one of the positive aspects of the health care reform debate that has heretofore gone unaddressed.  Including health plans in the exchange that reward wellness and healthy lifestyles gets my vote. 

:) Great Post.

The public option is an integral part of health care reform proposal. 

It will be very unfortunate, if President Obama and Congress choose to drop the public option from the Health Care reform.