One more thing about a public option for health care: if we ever have one, insurance companies would probably produce a competing product for which they would make little to no profit. Funny how that would be a bad thing.

I think the official winger logic on this one is that the public option will be subsidized and therefore at the very least some insurers will not be able to compete with it. As these insurers withdraw from the market, the public plan will come to dominate the market. You'll be 'forced' into it in the same way some people are 'forced' to shop at Walmart.

What I understand, different from what I can say for sure, is that there's a start up funding for the public option and from there out it's supposed to fund itself on premiums. The subsidies, where they are needed, would go directly to individuals either through direct subsidy or employer mandates which they could spend as they choose.

One of the things that pisses me off about the insanity of the debate is that there's no room for rational critiques in the public forum. The rational critiques would either drive out problems which could be addressed or command responses which would inform. Neither of these can happen because of the deranged nature of the debates. I think it's Digby who has regularly pointed out that the Republicans benefit from the 'freak show'.

STeve, your idea sounds like Obama Ju-jitsu.

-And reminds me of "Mandrake gestures hypnotically". Let's hope it works!

AW, try to look at it this way: right now insurance companies can charge you a lot of money and yank the coverage out from under you if you get sick. Small businesses that buy policies for their employees have to expend huge amounts of money for grossly imperfect product.

If a public option is done properly, nobody will have to worry about losing everything if they get sick. Medical-disaster bankruptcies would be eliminated.

Those things would be very good for the economy as a whole, you know, as would creating a plan (like a public option) that would force insurance companies to be honest for a change.

There are plenty of examples of public and private forces operating side by side and somehow the private forces still manage to turn a profit.

I'd like to believe at some point that the people who are being duped, time after time, to vote against their best interests will some day realize that they have been duped. I mean, they have been masterfully manipulated via calls to their 'morals' (e.g., Jesus, America is the bestest ever) which often are things that have high face validity. If someone paints the public option as 'against America' well, that's necessarily bad. No further need to look into, see if there's more to it than that. The low-information voter is easily manipulated this way, and has been for quite some time.

One day, perhaps when frail and reflecting on life, I wonder how many of these people recognize what's been done to them, these appeals to motherhood and apple pie as fronts with which to allow those whose interests are everything but to enrich themselves on the backs of the misinformed. Problem is, we don't have time to wait for that reflection. And that's what liars like Armey are counting on--they need to win the battle, not the war. And so far they are, sadly.

Of course, neither Armey nor anyone who listens to him would support it.

Nor should that matter, considering that the Democrats already have the votes.

What I would like is serious proof that Obama himself, beyond lip service, actually supports the pubic option.

Pundits and politicians should put Armey immediately to the test and ask for his support if the government-funded solution is optional.

From what I've seen the anti-reformers (like Betsey Caughey) agree with the spirit of reform to your face, say "see, we can all agree" and then stick the shiv in your back as they call you a tyrranical big government tool.

Did you ever get the feeling you awash in a sea of idiots. I can not even watch the news anymore. Idiocracy, the documentary.

Playing silly word games with the likes of Dick Armey strikes me as a fool's errand - the problem isn't whether a "public plan" is "optional" or not; the problem is how it will, theoretically compete with private insurance. Armey knows that, and so, I think, do progressive advocates, some of whom are, at least, honest enough to admit that they would probably, prefer the private insurance system to collapse anyway. There's dishonesty all around this discussion, and the bigger waste of time is, as far as I can tell, that the public plan has become the Holy Grail of health reform for the left, when a number of other, more significant reforms might well be more worth fighting for (like, I never cease to stress, serious reforms to Medcaid).

One final point: Medicare is a success for precisely the reason Armey's complaining about it: because it forces every odler person to participate, Medicare's best asset is its sheer size, and, as we always note, the economies of scale which derive from it. In essence, by arguing Armey's point - that we agree there shouldn't be the "tyranny" of forcing people into givernment run plans - we're arguing against what, in fact, makes Medicare work. That's why a "public plan" that's designed to be optional - and that wouldn't serve as a Trojan horse to eviscerate private insurers, wouldn't amount to much. If you can't make a public plan the mechanism for eventually achieving single payer... then it's really only a small part of a much bigger solution.

Why would it be such a terrible idea to sanctimoniously declare that Jesus , Hallelujah , had visited and instructed the speaker to act as an agent for his flock ?
Enquiringmindsetcetc ...
This fulcrum has been mirror polished lifting deader weight , more complicated issues and with great success in the very demographic that appears hell bent to sacrifice Gods gift of reason for the devilish satisfactions of appeasing the wealthy .

Another "trick" conservatives use is the claim that liberals would like to see the private insurance industry to collapse. Just as the claim that the government would force everyone into the public plan, that's also nonsense.

Liberals are largely indifferent to the private insurance industry (as it is all private industry, really). Their problem with it only exists to the extent conservatives want to "force" everyone into private insurance.

It's the choice liberals seek, not the outcome to the industry.

Just quit calling it "The Public Option" and do what Teddy did. Just say that anyone could who wants to could buy into Medicare. That is indeed a 'wonderful gift' only an idiot would look at it any other way. An idiot or an insurance executive.

Please forgive me, but I have a dumb question that I need to get clarified.

Will this legislation, if it becomes law, require everyone to purchase some kind of insurance - either private or government-sponsored?

If so, wouldn't that be "forcing" people to buy health insurance -- and since the public option would be cheaper and more likely be picked -- they'd be "forced" to buy government-sponsored healthcare?

I mean, these people twist themselves into pretzels to distort the discourse, so maybe my interpretation is correct, huh?

If you live as a member of a nation which eats corporately dominated industries , the products of salty , fatty , sugary food , are you forced to have diabetes ?

I had a winger tell me at a "Honk and wave" that "the Bill" (HR 3200) says that in 5 years, everyone will have to be in the public plan, like it or not. I asked where in the Bill it said that but he didn't remember. He urged me to read the Bill. I asked if he had and he assured me he had. All 1000 pages of it.

Anybody know what he was talking about?

armey's was the first texas frat boy smirk i noticed when he led the pack of repugnants who refused to stand at a state of the union address by bill clinton back in the 90s.

there he was on camera with that guilty smirk expression -- looking like a foolish little boy taunting the adults in the room with his prankish behavior... i knew then what that man was made of... shit. just like the shrub who slouched toward washington shortly thereafter.

such bravery! such statesmanship!

whatta country!

Dick Armey's a dick! Why waste our time? Oh, but we all know how dicks never rest. Give him some saltpeter! -Kevo

pol

My grasp of the required insurance coverage isn't much better, but as I understand it, the un and under insured would get subsidization to buy any insurance they want, public or private.

Koreyel had a great comment yesterday about this topic. I'll take the liberty to copy and past it here....

Putting the Big O in public Option

We need to make the public option optional for individual States.

States can vote themselves in or vote themselves out. Those States voting themselves in will allow their citizens the option of the public option. Those states voting themselves out will not be able to make the public option available to their citizens.

Arkansas and Alabama and Oklahoma and Tennessee can freely reject it and continue on with their status quo. Other states can choose to participate in the public option and bear its financial burdens and its shared rewards.

Think about it...

The most unhealthy states with the most obese people are the ones that oppose the public option most virulently. These diabetic States will end up burdening the public option and making it more expensive for the healthier States. Indeed if the wingnuts had any sense they would realize that the public option will result in a net cash flow to their hillbilly States. But these States, like Oklahoma, are either too stupid or too angry to realize this.

Fair enough. Give them the option of the Public Option. If they opt out it will make healthcare cheaper for the smarter, saner States that opt in.

I am not my hillbilly brother's keeper.
Nor are you.

Nor should I suffer the burdens of his obese future health care costs. Nor should I suffer the slings and arrows of his anti-government febrile brain.

I say: Give my hillbilly brother his freedom!
And give me my freedom too. Make the public option a state-wide plebiscite with open enrollment every four years...

Posted by: koreyel on August 27, 2009

Anybody know what he was talking about?

Perhaps a misreading of the section on "Grandfathered Health Insurance" on p. 16. Hilzoy took this down back in July.

"In arguing against the Democrats' plan, he says that Medicare is a form of tyranny, and that citizens should be able to choose to enroll in the program."

Am I missing something???

In which universe is enrollment in Medicare mandatory/required?

In the universe that I live in, it is my understanding that nobody is automatically enrolled in Medicare. In the universe that I live in, it is my understanding that you actually have to go through a process that you initiate to enroll in Medicare.

Is not Armey making the dumbocrats point for them! Must mean he is on their side! Thanks - you dick.

This is a hoot! Armey & Michael Steele should go on the road with their Health Insurance Reform Lalapalooza. It's better than Crosby & Hope. They'd get a lot of laughs & teach everyone the wisdom of universal health care by the time they were done.

The Constant Weader at www.RealityChex.com

IIRC, Dick Armey objects to seniors being "forced into" Medicare at age 65. I believe he is suing the Federal Government to allow him to not enroll.

Forcing people into Medicare? I worked for Medicare for ten years. Enrolling is optional! Granted if you don't sign up when your eligible there is a financial penalty for Medicare Part B (physician coverage) to make up for the premiums you didn't pay at the time you became eligible. Regardless, Medicare is not a mandatory option for the elderly. Most sign up because it provides protection against illness.

Oh, no no no. No states option, thank you, I live in Florida, and they're already trying to cobble up some way to make federal health care reform illegal here.

Nobody is forced to be in Medicare. If you don't sign-up and pay the premiums, you have no Medicare coverage. Dickhead Armey is also falsely claims you will lose your Social Security if you don't sign-up for Medicare.

It's the tyranny of the stupid.

Side point: Props to The Economist for calling Armey's attempt at sophistry BS right away.

Ah, real press in action!

Maybe Democrats should introduce two parallel bills, one having a public option that is open to registered Democrats, the other with a public option that is open to registered Republicans. Offer to let the GOP kill the second bill if they're so opposed to giving their own voters the choice, on the condition that they allow the first bill to go through.

Can we be honest? Among ourselves anyway? People who support a strong public option and particularly those like me that hope and believe that the public option will trend towards single-payer over time need to recognize that during that process people will indeed be forced into the public option either by necessity or pure economics.

Advocates of Single-Payer believe that on a level playing field that private companies won't be able to compete on price and so over time will be so squeezed in profits that they will abandon the market. Which is exactly what happened in the last go around when HMOs were supposed to be the magic bullet. Instead the HMOs found that they could not reach economies of scale needed to supply the infrastructure they needed to make an HMO really work. So they walked away from especially rural markets leaving people with little to no fallback.

In areas that are under served now people seeking individual coverage will likely only have one option, to ask whether they are 'forced' into that is just semantic. Similarly people who work for "smallest" or "smaller" employers who either don't offer insurance now or who struggle with premiums are likely to be faced with that same choice as employers decide it is just makes most economic sense to pay the 8% of payroll and call it good. If employees are lucky there will be at least one acceptable private plan in the area Exchange, if not they will just have the one fall back.

True the bills currently in play offer all kinds of theoretic outs from this, but those outs don't work very well if the private companies have abandoned your market.

No one is forced to enroll in Medicare Part B or D and no one is forced to have your Hospital Care billed to the Medicare Part A that you already paid for. But realistically how many people opt out? If we institute some form of Medicare for All and in small towns and rural areas that turns out to be the only game in town over time are those residents being 'forced' into the Public Plan?

Now trying to explain that on this question the real answer is "well no, not mostly, and certainly not everywhere, but sometimes in some places, yeah pretty much" would require a nuanced argument. And since 'nuance' is a French word maybe we shouldn't even try. But I wince every time I see a strong supporter of ultimately going to Single Payer dismissing this as a 'myth', to that degree we are talking out of both sides of our mouths.

"I think Obama should use all the fictional friction points as bargaining chips. You want us to give up the tyranny of compulsory coverage? You win, Dick Armey. Will you support the bill now?"

Here's why that would fail: the media would be full to the gills with wingnuts shrieking about the monumental dishonesty of the Democrats now misrepresenting their own bills.

Remember the First Law of American Politics: Lying is only okay if you are a Republican.

p.s. The Second Law of American Politics is Hypocrisy is only okay if you are a Republican.

I had a winger tell me at a "Honk and wave" that "the Bill" (HR 3200) says that in 5 years, everyone will have to be in the public plan, like it or not. I asked where in the Bill it said that but he didn't remember. He urged me to read the Bill. I asked if he had and he assured me he had. All 1000 pages of it.

Anybody know what he was talking about?

Its a combination of two things. One is a mis-reading of Sec 102 (a) which supposedly bars private insurance outright. (It doesn't).

The other is the requirement that large employers bring their plans up to at least the level of the basic plan that includes the Essential Benefits Package as outlined in Sec 122. The actual requirement is set out in Sec 102 (b) (1) (a) (in the Energy and Commerce version p.17)

Sec 102 (a) says that if you have crappy private insurance you can keep it, your insurance company just can't sell that same crappy insurance to anyone else after Jan 1, 2013.

Sec 102 (b) says that employers currently offering insurance that is not up to the minimum levels established in Sec 122 have five years to get it up to that level or to pay a fee and drop employer coverage. In practice this will mean some medium size to large employers choosing to move to the Exchange, which depending on how many if any private plans are participating may have a lot of employees end up with the public option.

So it is fair to say that after five years employer provided coverage will have to be at least as good as the public option.

I'm sure we'll be seeing all those over-65 GOP members clamoring to leave the "tyranny" of Medicare in ... six... five... four... three... two... one...

Hmmmm... where are all the freedom-lovers???

You guys are such idiots....read the fn bill
- Sect. 102 of HR3200 basically says that your health insurance will get grandfathered in if its in force prior to the first day of Y1.....EXCEPT:

Section 102(a)(1) - Limitation on new enrollement. After the government plan is in effect, private insurance companies cannot enroll any more individuals into their plans. This is a death blow to private insurance companies. So if one quits their job or gets fired and has health insurance from their employer, then they automatically get dumped into the governemnt plan.

Section 102(a)(2) - Limitations on Changes in Terms & Conditions. After the government plan is in effect, insurance companies cannot change anything in the plan including co-pays, benefits and deductibles. Everybody knows that this stuff almost always changes on a yearly basis. If anything in the plan changes then you get dumped into the government plan.

So in the first two pages they have killed private insurance. With no new revenue base & not being able to adjust plans, private insurance will go out of business. Now everybody is forced into the government plan. Welcome to your worst nightmare.

Is tommers correct? Will private insurers not be allowed to take on new individuals?

"If you in fact freely choose to enroll in Medicare that's a wonderful gift, it's a charity,
it's something I applaud. But when they force you in, that's tyranny."
-- Dick Armey, on the tyranny of health care, Link.

So, according to him, some people walk into a hospital and say, "I'm eligible for Medicare but that's
socialism and I want no part of that so please let me write you a check for my stay here."

Tommers, I don't know which Republican webpage you're reading this from, but I just went through the entire 1018 pages of the bill HR 3200 and you're just making stuff up. Quoting section numbers is good for show, but that's not what it says. Go read the REAL bill!