Oh, brother….

May 5, 2009 at 11:31 AM (Uncategorized) (, , , , )

From the NYT:

Well we knew HMO’s/PPO’s would continue the minute the private health insurers voices were invited as stakeholders into the health care debate.

The so-called public option still exists.  But it’s fairly toothless.  Senator Schumer’s compromise points (presumably to satisfy private insurers that they could still rake in $$$ and ‘compete.”)

The public plan must be self-sustaining. It should pay claims with money raised from premiums and co-payments. It should not receive tax revenue or appropriations from the government.

The public plan should pay doctors and hospitals more than what Medicare pays. Medicare rates, set by law and regulation, are often lower than what private insurers pay.

The government should not compel doctors and hospitals to participate in a public plan just because they participate in Medicare.

To prevent the government from serving as both “player and umpire,” the officials who manage a public plan should be different from those who regulate the insurance market.

The plan should also establish a reserve fund.

Not, Quite, Right.

If we *must* continue with private insurers as part of the plan let’s requote the text and shift it a bit shall we? And FYI I used to work in the Illlness Exploitation Industry, so I know a bit whereof I speak.

The public plan must be goverment funded for at least a percentage, the percentage to be determined in committee and be no less than 30 and no more than 50 percent with option to revise that downward should expenses be met. It should pay most of its claims with money raised from premiums and co-payments.

The public plan’s rates and Medicare’s rates should match, and Medicare’s rates should be increased to be more in line with present private insurance rates. Specifically, take the highest private reimbursement for a covered benefit and the lowest private reimbursement in a given area and *split the difference* !.

The government should compel doctors and hospitals to participate in a public plan. However, doctors can limit the *number* of appointments per week they take from recipients, should they choose to and hospitals can also decide not to take it for anything elective. (I don’t like to cut, but they will expect some, so…)

To prevent the government from serving as both “player and umpire,” the officials who manage a public plan should be former administrators of county hospitals, and other public health entities, not business people who think insurance companies are their own personal bank accounts, and yes these would be different from those who regulate the insurance market.

The plan should also establish a reserve fund. (I’m OK with that)

Private insurers, this public option, Medicare and Medicaid should also establish incentives to care for patients in the home rather than institutionally.

It’s *cheaper!* (Union leaders of groups of nursing home employees and the nursing home lobby, I’m talking to you! Get out of the *** **** way!)

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