Is Lieberman Arguing Against Big Bird?

Posted on 27 November 2009

By Anthony Wright
Health Access California

Senator Joe Lieberman's latest argument against the public health insurance option struck me strange:

"This is a radical departure from the way we've responded to the market in America in the past," Lieberman said Sunday on NBC's "Meet The Press." "We rely first on competition in our market economy. When the competition fails, then what do we do? We regulate or we litigate...We have never before said, in a given business, we don't trust the companies in it, so we're going to have the government go into that business."

Ezra Klein of the Washington Post thought that was a wierd comment, too:

"What does he think Social Security is? Or Medicare? Or public fire departments?"

To be fair, his list includes responsibilities that the private industry largely shuns (there's no market for private fire protection), or which the government is the main provider and private industry is a structured alternative (Medicare Advantage) or a supplement (private retirement plans).

The model for the public health insurance option is one where the government isn't the sole provider, but is one among a range of options. One analogy used by Senator Schumer is public universities, UC-Berkeley being an excellent option alongside private colleges like Stanford.

But even there, the public health insurance option is not going to be subsidized like the UC system (although less so, as the protests this week show), nor as dominant in terms of being the real and only option for so many Californians.

Maybe a better analogy for Senator Lieberman is public broadcasting, which he has strongly supported over his years (at least when he was a Democrat). Public radio and television stands alongside traditional private radio and television stations as one of several options.

Yes, public broadcasting gets a small subsidy, but it's tiny compared to its overall budget. It has been structured with different incentives, and thus has been able to respond to market failures: for example, specializing in educational children's television programming and informational documentaries all of which were unique until the explosion of cable channels; even now, it is an important launching pad for programs. In radio, it has focused on in-depth news, and there's nothing like it on the dial.

There's been a lot of online commentary about how the public health insurance option, given all the compromises to come and already made, may not be worth it. We need to still advocate for a public option that has strong negotiating power, that is national in scope, and begins on day one. But even if it is not available to everybody on day one, or doesn't save all the money that a stronger version does, I do think there are other reasons for it.

With a different structure and accountability that the private insurers, it has the real potential to innovate in areas of market failures: Maybe it specializes in really doing the best possible treatment and management of asthma, diabetes, and obesity. Maybe it figures out new ways to provide access to rural populations. Maybe it is just a "safe harbor" for people against continued abuses by private insurers--much like PBS is a safe harbor for parents against TV commercials.

There are many other important issues as well in the health reform debate, from affordability to employer responsibility. But the public health insurance option continues to be a key concept worth fighting for, even with some of the compromises made.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Blog

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"What does he think Social Security is? Or Medicare?"

Submitted by George Hanshaw on Mon, 11/30/2009 - 22:09.

Ponzi schemes, and through their unfunded mandates responsible for much of the increase in the cost of health care above and beyond inflation.

I mentioned this before but for those who missed it.....

Submitted by George Hanshaw on Fri, 11/27/2009 - 19:06.

From California Healthline:
http://www.californiahealthline.org/theweekly.aspx?theweeklydate=11/13/2009

---------------------------------------------------------------
If Congress passes health care reform legislation, states will assume new levels of responsibility for taking care of their residents.

If the final document leans toward the House bill (HR 3962), states will be responsible for expanding Medicaid programs and establishing high-risk insurance pools.

If the final package more resembles the Senate Finance Committee version (S 1796), states would have even more responsibility. The Senate bill, which many experts predict will be closer to the final legislation, expects states to make most major decisions about health care reform implementation.

Either way, California leaders are worried. Medi-Cal, California's Medicaid program, already is pinched because of the state's budget crisis. Reform legislation could add as many as 1.6 million new enrollees to the program.

"Our No. 1 concern is just the fiscal reality that we can't afford our current program," Toby Douglas, California's chief deputy director of health care programs, said this week, adding, "We can't afford expansion."

In addition to expanding Medicaid, states' responsibility for immigrant health coverage could change. Under some plans being considered by Congress, more than one million documented permanent residents and about seven million undocumented immigrants would be excluded from coverage, according to a study by the Migration Policy Institute, a nonpartisan research group in Washington.

All of the proposals on the table would leave California with the largest population of uninsured residents, with as many as 1.4 million documented and undocumented immigrants, according the Center for Health Policy Research at UCLA.

----------------------------------------------------

If Mary Landrieu can get $300 million 'forgiveness' on Louisiana's Medicaid costs, shouldn't our two senators be holding out for federal help to California if they are going to pass this thing? Please remember, we'll be paying taxes on this for at least three years BEFORE we start getting any services.

A public option is just like the US Army...

Submitted by George Hanshaw on Fri, 11/27/2009 - 08:06.

....deciding it wants to park a tank on your lawn.

Who is going to tell it no?

Half the problem we have with rising healthcare prices is cost-shifting to cover inadequate reimbursement by Medicare and Medicaid. Much of the rest could be handled with tort reform.

Do we really want the government to control ANOTHER one-sixth of the economy? Before you answer that, consider this.

The Republicans will eventually get back in power again. Would you want THEM to dictate what healthcare you got? Would you want George Bush in charge of who lives and who dies in this country?

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