Let's face it -- the key practical value of the public option is to prevent the individual mandates from forcing people into crappy and expensive private health insurance. My fear was that the Democratic spirit of [strike]surrender[/strike] compromise would lead to a so-called "health insurance reform bill" that well and truly sucked and everyone but the insurance companies hated.

If I had more faith in Congressional Democrats, I'd say they may be pulling off a rope-a-dope here: The media gets to print its "dirty hippies lose!" headlines they so dearly love to write, the Republicans, Evan Bayh and the insurance industry high-five each other, but then when the dust settles, the Democrats wind up having passed a decent health insurance reform bill that expands later, as Social Security did, into a valuable and popular program that puts another nail in the coffin in the cult that is the modern Republican party.

2011? Really? Glad to see there is some urgency to this. And let's give insurance companies a few years to continue screwing us over. I'm sure by 2011 I'll have no insurance (my small business employer pays a portion of my HC costs, but Wellpoint just went out of small biz coverage and we were picked up by BC/BS, and since one of our five employees has cancer, I'm expecting our new carrier premium to at least double, which means I choose from having a roof over my head and eating, or HC.) Sweet deal, Congress. Thanks for looking out for us regular Americans.

Discouraging to say the least.

This is major fail. It's not clearly better than what people face today. It doesn't appear to have a mechanism that will lower costs and if it has a mandate and we're all forced to buy private insurance my guess is that it will cost the Democratic party dearly. Though at this point I'm pretty sure they want to be the minority party. I'm also pretty sure numerous Democrats will be heading off to insurance company consultant jobs soon after they're out of office.

Observation: The new Republicans

Center-right Dems are the new Republicans. They are what Republicans were before the Republican party went rogue. Which is to say: You can still sit down with them and negotiate. They won't hold their breath until they turn blue. And they aren't interesting in running an Al Qaeda like insurgency.

Isn't that fascinating?
I wonder if the media will pick up on this evolution?

Just how much of a Democrat majority is necessary to pass a public option?

What do we do with all the dying and dead bodies laying on the streets while we wait for clauses to kick in?

What do all the people do that are on the verge of losing their health insurance? Should they bend over and kiss their ass goodbye if they find themselves with something worse than a flu?

Will we remember 2010-2013 as the "Denied Health Care Death Experience of 2010?" for anyone caught unemployed/underemployed or poor without health care?

How are we going to pay for this without a public option?

Talk about death panels, how about congressional death committees.

As a DFH who would be eligible to buy into Medicare in 2011 and get decent coverage instead of waiting until 2014 when anyone would be eligible for the OPM, I'm personally delighted with these changes to the weak-ass public option that was being considered. For those of you under 55, stay off the grass.

Senate Majority Leader Harry Reid (D-Nev.) told reporters the compromise "has something that we think should satisfy everybody."

The "everybody" in that statement obviously refers to the 535 people on the hill, you know the ones that already have el primo public health insurance. I'm guessing the rest of us may not be "satisfied". But who knows for sure without more info? Is the secrecy to give the democratic caucus time to build consensus before Republican hand ringing and couch feinting or just because it sucks that bad? or both?

A PO won't work unless healthy people are allowed to participate and pay premiums into the system.

It looks like a win-win for the insurance industry. The healthiest people, i.e. younger people who have jobs providing HC coverage, are required to pay their premiums to private insurance, whereas older/unemployed people, who are more likely to require costly treatment, get shunted off the expense side of their income statements into these government plans, which are paid by all of us.

Will Medicare ever be expanded to include both all of us? With our rigged political system, I wouldn't count on it.

Oh, and BTW, Steve, I WANT the fucking trigger pulled.

So, the medicare lowering starts 2011, 3 years before the exchange. Insurance cos. can put in a non profit, if not, trigger.

Let's see....2014 for exchanges to start....probably 4-5 years to give insurance cos. ability to put in non profit, if not, trigger happens. I'm placing my bets on no non profits.***

IF the trigger even gets pulled (as I know of no "trigger" legislation to ever be pulled regardless of the merits) probably a year to get it passed congress, then, going by the start date of the current legislation, the public option will not be instituted for another 4 years.

So, we're looking at another decade of crap. Just keep pushing that ball on down the road.....

In all, we lose.

Looks like my calendar just opened up on 11/2/10. What will I do with my new found free time?

***Of course, the other very probable option is that the insurance companies will institute non profits, though make them so horrible no one in their right mind will want it. Then they can go back to congress and say, "We tried." and so no trigger to be pulled.

See? Lipstick on a pig. Isn't it pretty? Let's all give a big round of applause for the magic Congress worked.

"Insurance companies will have the option of creating nationally-based non-profit insurance plans that would be offered on the exchanges in every state."

Does this mean that state regulation of insurance is dead? I wonder how states will feel about that?

What about mandated insurance. Medicare will be expensive, so age 55-64 is going to have a costly problem being forced to buy insurance but with Medicare as the only thing offered to them. Age 55 and under are required to buy insurance, too, but there isn't any for them to buy, so they will just pay the penalty and do without insurance.

Keith Olbermann was ecstatic about this expansion of Medicare, of course, but he's a rich guy with plenty of insurance, so all he has to do is look for magic words and cheer loudly when he finds them. He sees "expand" and "Medicare" in the same sentence so he doesn't have to actually read the whole thing and actually, you know, think about it. The two magic words are there, so cheer away.

Maybe we are just too sick of a society to save itself. Instead of a simple, cost-effective solution similar to what the citizens of most other modern countries enjoy, we end up with a complex, confusing, and convoluted mess that may or may not be marginally better than what we have now, depending on each individual's personal circumstances. They should all be fired.

If Medicare is unsubsidized then eligibles in the 55-64 age group will still find themselves unable to buy health insurance. The group that's been hit hardest economically and has the least time left to recover wealth (what a word) will just do --- what?

Something I didn't see in the article was that the people being covered by a Medicare extension are those who wouldn't be able to get regular insurance anyhow because of age. These are the people not now covered by Medicare who will have the highest medical costs so the insurance industry has no intention of covering them anyhow. If the age limit was dropped to 25, then we might have a deal, but at 55, the American public is just going to have to suck it up the way they always have.

The main function of the public option was to compete with the insurance companies in order to induce them to get their act together. If only people who they don't want to cover get a government program, then there isn't any competition at all so the purpose of the public option is dropped.

Within one day this plan went from a fairly ambitious co-expansion of Medicaid and medicare to a much smaller expansion of Medicare and the promise of some non-profit private insurance plans (which really already exist) in the exchanges. Even I'd have to say if progressives suck this one up, you've basically been had, and cheap. I suspect that the CBO scoring won't turn out so well for the Medicare piece... or there will be some pretty rosy scenario spinning. There's also plenty of questions to be asked about just how this Medicare plan would work, or why it would amount to that much of an improvement for that many people (and since the estimates are roughly 1-3 million... it's not that many people anyway). I also think there's that question no one likes that still hangs out there: at what point does this - worse and worse looking - bill become the thing that shouldn't get passed? I think we passed that point months ago... but for the progressives still clinging to "something's better than nothing" - is this something? still?

"All of this, of course, has been sent to the Congressional Budget Office, which will hopefully produce a score in a few days."

This will be interesting, as the CBO already calculated that a national non-profit co-op would do NOTHING to lower costs or provide competition to the for-profit private-sector health insurance corporations.

The national, non-profit "OPM Plan" would nevertheless be operated by private-sector companies, meaning an additional layer of costs atop what a national non-profit co-op would have, and by default will cost MORE.

The buy-in to Medicare at a lower age MIGHT off-set those costs, but neither will do anything to provide competition to keep premiums from skyrocketing for those under 50-55.

The problem is that the plan doesn't make sense. I couldn't even begin to explain how it works and what options are available to someone who doesn't follow politics. It's a system that's been designed not for its ease of navigation but to reflect the fears of five very petty Senators.

re: subsidies

What are the chances of enacting some sort of tax deduction for those under 65 using Medicare? While technically a subsidy, those purchasing insurance would have to wait until they filed their taxes to receive any recompensation. Even so, I would think that that would increase the numbers substantially of those going for the Medicare buy-in.
The more particpants, the better the CBO scoring...