Archive for June 8th, 2009
For most of you, this is the big one. The inclusion of a strong public insurance option has become, for most observers I know, the single most recognizable marker for victory. If the public plan exists, liberals have won. If it’s eliminated, or neutered, then conservatives have triumphed.
The public plan has a very particular political lineage: The lesson liberals took from the 1994 health reform fight was that you couldn’t threaten the insurance coverage individuals already had. For many policy wonks, the central problem in health care was the existence of private insurance coverage. For most Americans, however, the central problem was that they could lose their private insurance coverage, and be left with something they didn’t like, or nothing at all. This effectively ruled out something like single-payer, or even Bill Clinton’s managed-care-within-managed-competition model. It ruled out anything that began by changing the health care coverage of those who wanted to keep their current policies.
But that political insight didn’t cancel out the policy insight: The private insurance market is a mess. It’s supposed to cover the sick and instead competes to insure the well. It employs platoons of adjusters whose sole job is to get out of paying for needed health care services that members thought were covered.
Moreover, public insurance is simply more efficient. Medicare holds costs down better than private health insurance. The substantially public systems employed by every other industrialized nation cost less and cover more than the American model. So the question became how to marry the policy need for public insurance with the political need to preserve the status quo.
Enter the public insurance option. It doesn’t replace the insurance individuals already rely on. But it provides an alternative. It lets them make the decision. It’s the health care equivalent of being pro-choice. And it thus serves two purposes. The first is to act as a public insurer. To use market share to bargain down the prices of services, much as Medicare does. To lower administrative costs. To operate outside the need for profit, and quarterly results. The Commonwealth Fund estimated that this would result in savings of 20%-30% over traditional private insurance: …
Just found red Fresno peppers at Whole Foods. I bought 1.5 lbs for pepper sauce, along with a handful of habaneros.
Enough, it turns out, for two batches. The first batch was Fresnos, the habaneros, and 4 dried chipotles, along with salt and wine vingegar (and a little apple cider vinegar when I ran out of wine vinegar) and a splash of olive oil.
Second batch was Fresnos, 6 dried chipotles, 6 large strawberries, apple cider vinegar, a good splash of balsamic vinegar, a splash of olive oil, and salt.
I used oil in the recipe because I speculated that some flavor components are oil-soluble rather than water-soluble. The oil does separate at the bottom of the jar, but one should shake the sauce before each use anyway.
Have two grandsons, I found this article quite interesting:
Both boys and girls have issues, but boys seem to be the ones getting the raw deal. According to Judith Kleinfeld, professor of psychology at the University of Alaska Fairbanks in the US, issues affecting boys are more serious than those affecting girls, but they have been neglected by policy makers. Her review (1) of issues characterizing American boyhood, how they compare to those affecting girls, and the lack of initiatives in place to address them has just been published in the June issue of Springer’s journal Gender Issues. Professor Kleinfeld’s paper reviews the different viewpoints surrounding the debated existence of a so-called ‘boy crisis’. She then looks at gender differences in measures of educational achievement including literacy levels, college entrance tests, school grades, engagement in schools, dropout rates, as well as psychological issues affecting young people including mental health, suicide, depression and conduct disorders. Lastly, she shows how boys and girls compare in terms of premature death and injuries and rates of delinquency and arrests.
According to Judith Kleinfeld, boys get the raw deal. Compared with girls, American boys have lower rates of literacy, lower grades and engagement in school, higher drop-out from school, and dramatically higher rates of suicide, premature death, injuries, and arrests. Boys are also placed more often in special education. Girls on the other hand are more likely to have different problems including depression, suicidal thoughts and eating disorders.
Big Meat is less than pleased with the food safety bill currently moving through Congress, summarizes Tom Laskawy. Despite the facts that food safety breaches — and voluntary, useless after-the-fact recalls — are still common, the industry thinks the proposed new fees are too high, and the government shouldn’t have mandatory recall power, and inspecting farms and livestock operations is unnecessary. But what really freaks them out is that a more powerful FDA might get regulatory authority over the industry, versus the currently toothless USDA. (Grist)
Steve Benen of Political Animal has a very good post:
The New York Times had an item over the weekend on the inclusion of a public option in a health care reform. The piece was primarily about the existence of state-based plans in which employees are given a choice "between government-backed insurance options and a menu of commercial policies." Though the comparisons are imprecise, as the New America Foundation’s Len Nichols noted, the state plans are "proof of concept" that governments can maintain fair competition.
But the article also noted the principal criticism of a public option.
[C]ritics argue that with low administrative costs and no need to produce profits, a public plan will start with an unfair pricing advantage. They say that if a public plan is allowed to pay doctors and hospitals at levels comparable to Medicare’s, which are substantially below commercial insurance rates, it could set premiums so low it would quickly consume the market.
Yeah, don’t throw us in that brairpatch.
Josh Marshall added, "As [Jon] Taplin suggests, these ‘problems’ sound remarkably like ‘the point’ of the whole exercise. Most of the argument here is that a big government plan would just provide the insurance ‘service’ much more efficiently and cheaply than private carriers. And that the private carriers wouldn’t be able to make any money off selling the service any more. But this is the argument that single payer advocates routinely make — namely, that a lot of the money that goes into private health insurance goes to paperwork, much of which is tied to finding ways to deny people coverage. That, and the need to earn profits on providing the service."
For a while, it seemed the right tried to argue that a public option would be awful because no one would want to sign up for it. Such a system, they said, would force Americans to accept rationing, long wait times, a labyrinthine government bureaucracy, etc. Except, that never made any sense — Americans who are already in such a system tend to like it (the VA system, for example), and for that matter, there’s no reason to think consumers would voluntarily sign up for an awful system.
So, now the right is arguing that a public option would be too popular. Insurance companies want consumers to think that private coverage is already so inadequate, Americans will flee, if given half a chance, to a public system that’s more efficient and costs less. If there’s a competition, conservatives and the industry expect the public option to win.
In turn, they want government to, above all else, protect the insurance industry’s flawed business model. It’s not exactly a persuasive pitch.