Putting the Vicious Health Insurance Dogs on a Leash

( – promoted by buhdydharma )

Also available in Orange

From one of my comments in buhddydarma’s most excellent diary:

I’d liken it to a vicious dog behind a fence. Given access to the fence, he will worry it and try to dig under it, or hang out by the gate and eventually get out. Like a group of corporation with massive profits locked behind a regulatory wall, who will eventually find a way to get a loophole put into the wall.

Tie the dog up in the yard so he can’t get at the fence, the combination is more effective than either alone.

A robust public option works like the leash tying the dog up. The corporate insurance companies cannot squeeze too much harder than the public choice without losing market share, so it will be much harder for them to organize to break the regulations in the health care exchanges.

Don’t get confused by the “five percenters”. This was President Obama trying to mollify the Republicans and also make the extremists look … like extremists.

But in the preliminary CBO analysis of HR3200, which is where the 5 percent seems to come from, this really is a rhetorical trick designed to make a robust public choice sound less effective than it would be. And if we lose sight of how effective a robust public choice could be, we will not fight hard enough to (1) get it in the bill and (2) kill phony substitutes.

Through to 2019, HR 3200 is scored as adding 11m through Medicaid (since I’m blogging in genteel poverty, I’m one of those), 2m through employer provided insurance, and 30m through the exchanges, with 6m switching (comparing 2019 projection w/out to 2019 projection with) from non-employer provided health care primarily into the exchanges, for a net increase in 37m.

Everyone in the health insurance exchange benefits from the public choice – even those with private insurance. So that is 30m beneficiaries, which is:

  • 100% of those in the public exchanges
  • 80% of the increase in coverage
  • 60% of citizens and documented migrants w/out coverage
  • 50% of all people residing in the US w/out coverage

And, yes, 10% of those projected to have insurance after the reform. But the majority of the gap between the percentages in that list and “10% comes from including those people projected to continue to receive employer-based health insurance.

Their stake in the reform is supposed to be reforms that protect what they already have.

Don’t get lost in CBO projections

Of course, this is all simply CBO projections. Don’t forgot what you know about how our politics and economy really works when wading through the CBO numbers.

And so that brings us right back to the vicious dog model of corporate health insurance. If there are corporate insurance only health exchanges, we all know full well that we will be fighting ongoing battles over corporate health insurance companies trying to open the health insurance exchanges to precisely those people where the public subsidy is more lucrative to their bottom line than employer-provided health insurance.

And if we win some, we will surely lose some.

And so the CBO projection will, of course, fall far short of the entries into the health insurance exchanges and it will be far more than 30m suffering directly because there is no robust public choice in the health insurance exchanges.

Who would a progressive deny this protection to?

Of course, one reason for using percents is that using millions make it seem a bit brutal to say, “a mere 30 million will suffer if we lose the fight on the public option, so lets throw those poor losers to the hounds”.


The candy store paupers lie to the share holders

They’re crossing their fingers they pay the truth makers

The balance sheet is breaking up the sky

So I’m caught at the junction still waiting for medicine

The sweat of my brow keeps on feeding the engine

Hope the crumbs in my pocket can keep me for another night

And if the blue sky mining company won’t come to my rescue

If the sugar refining company won’t save me

Who’s gonna save me?

13 comments

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    • BruceMcF on September 16, 2009 at 01:03
      Author

    … from one of the public option whip count saboteurs on Agent Orange, its nowhere nears as blissful as the Commonwealth Study system.

    OTOH, its not my health insurance that is in the fight right now, its health insurance for those of y’all who are more than 133% of the poverty line. How can I tell my wife I went to the mattresses to fight against a reform that might see me live long enough for her to get back into the US?

    • RUKind on September 16, 2009 at 05:57

    They need it. One by one. Just put them down until the only option left is the public option.

    The doctors are almost all for it. They get screwed as badly as we do.

    Put them down.

  1. Obama noted that “based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up” for the federal plan. The CBO did say that only 11 million to 12 million Americans would join the public plan under the original House bill. But estimates from the Lewin Group, a subsidiary of UnitedHealth Group that says it operates with editorial independence, were higher, at 33.6 million. Lewin’s estimate triples when it looks at what might happen if the federal plan were available to everyone, a possibility the House bill leaves open. The House bill as amended by the Energy and Commerce Committee, however, sets up a “public option” that won’t affect nearly as many people. The CBO estimates that an insignificant number would switch under that plan, and Lewin’s estimate drops to 20.6 million, if the plan were open to all.

    link

    You know something is really screwed up about this whole ‘debate’ when the President is lowballing the number of subscribers to his own program at the same time the Insurance companies are touting how popular the new competition is going to be.

  2. And what will really happen will be even worse.

    When the left if there is still one refused to fight for single payer, this fight was lost.

  3. Like Strategic Communications Laboratories says the perception of “your” peasants can be a most effective weapon.

    http://cryptogon.com/?p=11054

    Diversion for what you might ask.

    http://www.theflucase.com/

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