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Not all public options are created equal


One danger a public plan could face is that it becomes the dumping ground for high-risk patients, suffers higher costs, raises rates, loses members, and basically replicates the process by which non-profit, community-rated Blue Cross/Blue Shield got destroyed by HMOs, transforming the Blues into the for-profit monsters they (mostly?) are today. h/t to Matt Yglesias, who flagged this important article by Paul Starr:

http://www.prospect.org/cs/articles?article=perils_of_the_public_plan

Good reading, and we need to make sure we get what we need, not just any public plan.

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Krugman had a good editorial today as well, arguing that some plans might be better to forgo altogether lest the legislature hangs an albatross around our necks.

Which brings us back to health care. It would be a crushing blow to progressive hopes if Mr. Obama doesn’t succeed in getting some form of universal care through Congress. But even so, reform isn’t worth having if you can only get it on terms so compromised that it’s doomed to fail.
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Ken, not only do you share a name with a good friend, but your posts make for perceptive, strong content.

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At one time it was a given that health care reform included a requirement that all sellers of health care insurance had to sell to anyone who wanted to buy it, no rejections for existing problems, no rejections of unhealthy people, etc. If that is part of the final plan, the public option will not end up as the dumping ground for the unhealthy.

The problem we face is that what we want from a new health care plan is exactly the opposite of what the industry wants. Anything that reduces our costs, makes health care more available to everyone, also reduces industry profits. And, when you stand in the way of a wealthy man seeking more money, you almost always get trampled.

Our only way to get what we want is to demand it, accepting nothing less. Last night I printed up a few pages of a petition to Dianne Feinstein, went to a big free concert in the park, and in an hour I had 52 signatures. I faxed the petitions to Feinstein later last night. This isn't enough to get what we want, but the more things like this we do, the more the Senators get the message that their reelection prospects are only there if we get what we want. And, that is the case, isn't it? If not, we won't get a good health care plan.

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Kenneth Thomas

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