One of the most concerned points I’ve heard raised by those against a public option is not that it’s a single-payer system - it isn’t - but that it would inevitably become one, i.e. it would offer health care cheaper than the big companies could match, and gradually drive them out of business. I don’t know enough about how the public option will work to say if this is true or not. But to be fair to the Repubs, if true, it would make the current line of “You get to keep your own insurance” seem a tad disingenuous. What say you?
While I’m asking the question, can I clarify what I assume to be an urban myth: that under the current plans, Americans would be forced to drop their coverage in favor of the government plan? Is there any source for this claim?
EDIT: Search wasn’t working for me, so, sorry if this has been covered elsewhere on the boards. Which I’m sure it has.
So what if it did? What do insurance companies do that makes the Reich wing so determined to carry their water? Medicare provides health coverage with a 4% overhead. Private insurance has about 20% overhead. What do they do that makes it worth that extra 16%?
A public option would force health insurance companies to become efficient or perish. They would have to offer better service and more complete coverage to compete. They, of course, hate this idea and will do anything to stop it.
I could be wrong, but from my understanding, the private insurance in other countries bears no resemblence to ours. Since other countries have UHC, the private policies only cover the gaps that the national plan misses, no?
For example, in Canada, doesn’t a private policy give you access to different doctors, shorter waits, single occupancy hospital rooms and the like? It is nothing your main health care plan.
Thanks for the responses so far. I too don’t see a huge problem with insurance companies being driven out of business, but I’m proceeding from as neutral a position as possible, to placate those who don’t wish to reform our current system.
It’s one thing if the public option were being pitched as a way to gradually get rid of private insurance, but it’s not. It’s being pitched as an alternative that will live side-by-side with the private insurance industry. I want to know if that pitch is misleading.
I’m a fan of the private option, and I’ve worked for Big Health Insurance (United Health Group).
One of the scariest things to me though is that Big Insurance isn’t efficient. (Oh, God, it isn’t efficient. I’ve worked for small companies, large companies, the state government - the inefficiencies of UHG would put them to shame. That flow chart the GOP pulls out to say this is the public health care process - look how complex it is - yeah…I had a binder of those - and there were plenty of other binders in other groups working on other things). And because they aren’t efficient Big Insurance employs hundreds of thousands of Americans. And because they are pretty darn profitable, many of those hundreds of thousands of Americans have pretty good paying jobs.
I still think that the public option is good, and I hope that it would cause the private insurance industry to become less profitable and more efficient - but I think its important that that happens pretty slowly. And hopefully, the private insurance companies won’t do what the American car companies did and take inadequate measures to create themselves a niche in a new world when faced with efficient competition.
No, absolutely not, that is not at all what private insurance does in Canada. Most of what is does is cover prescriptions, and help with some of the other out-of-pocket expenses.
As to the OP, my guess is that private insurance is going to THRIVE under a public option.
Think about it from a car insurance point of view: you already know who the most expensive drivers are: young, new, previous accident, high mileage. So if there was a public option for car insurance, as a private company I’d flat out reject anyone I thought might cost me money. And as soon as they did cost me something I’d drop them. Eventually, the government will be insuring only the worst, high risk, drivers, while the private companies will get rich covering those that never actually need insurance.
Fast forward a few years and you have a public system that is broke trying to pay for the most expensive clients, without the revenue from the cheap clients. Service begins to suffer, people have to wait longer to get repairs, so you get the public option branded as inferior. Anybody that can switch will switch. The private companies will have ALL the good drives, and ONLY good drivers. The public option will have only and all the most dangerous.
Kids will start out with the public option since private won’t touch them. If they don’t have an accident by 25 they’ll instantly switch to private, but be so scared of getting dropped they’ll never have an accident. Those kids that did have accidents cost the public system money, are then stuck with the public system, and have shown they are more likely to have accidents.
If you want another comparison, think about public vs private school, but put in the condition that private schools require high grades to get in and stay in. A kid starts out in public school, gets good grades, and switches to private. All the smart kids go to private, all the dumb kids go to public, and after a few years you have a public system baring the entire burden of the worst kids. Meanwhile the private schools look great, all their metrics are off the charts, and they continue to get more and more funding and all the best teachers and resources. But the public schools can’t “drop” the bad kids, they’re required to bare that burden. And without a public option, those kids would be shit out the bottom.
Which is part of the reason why the url=http://en.wikipedia.org/wiki/Canada_Health_Act]Canada Health Act forbids this sort of public/private system.
Okay, but is my basic point correct? The private insurance in other countries doesn’t serve the same function as private insurance in the U.S.
So if one were to say “A public option didn’t drive private insurance companies out of business elsewhere” then they would be comparing apples and oranges, correct?
Not in my experience. Private insurance means your doctor bills someone else is all. It picks up some procedures where the province leaves off, depending on the plan and the province, and may cover procedures the province does not, like physiotherapy. More likely they’ll do all they can to avoid covering such things.
Anyone who doesn’t need to be in isolation can get a single-occupancy room for a small extra fee. Some private insurers may cover that, I don’t know. But it’s not guaranteed. A hospital isn’t going to offer a privately insured patient anything they don’t offer the huddled masses, and the costs won’t change.
As for shorter waits and different doctors, I’ve never heard of such a thing here. You call your doctor and you make your appointment, or if you go to a walk-in clinic it’s first come first serve unless it’s an obvious emergency. I’ve never heard of special doctors for the privately insured. Seems redundant to me. I can’t imagine special doctors who deal only with non-AHC-insured patients, they’d go broke fast.
This is my experience. It’s my impression from living here. I’ve never looked deeply into the details because I would not even consider trading in $42 premiums for $300 premiums. And I have never, ever seen someone in a waiting room receive special treatment because of the insurance they have. What kind of triage is that?
I’ve been trying to hold back my opinion until a true plan is formulated. There are, I believe, at least 2 competing plans from the Dems (the one that seems to get the most attention, I believe, is the bill from the House), and what, 3 from the Repubs. According to wikipedia, though, there are 3 main bills. Until we know which one is leading, I’ve been reserving my comments. Even discussion on the Dope is all over the place.
However, to answer your question, it is very possible that a public option will force insurance out of business (maybe not entirely, but definitely reduce the size of the industry, and/or create something of a two tier system (which is something I feel that most Americans, including myself, would find distasteful).
The first issue, forcing or severely reducing the size of the insurance industry is possible because, there is no mandate from the government that such an organization need be profitable. As another poster stated in another thread, the government and its departments are effectively immortal. It can effectively be non-profitable for an insanely long time, longer than any company.
Secondly, if some insurance companies do survive, they are under increased pressure from their stock holders to find additional sources of revenue. Some of the ways that private insurance can be more attractive to public consumers is to guarantee shorter waiting times, easier access to medical health professionals, and better overall coverage (like paying for experimental treatments, prescriptions drugs not on the government list, etc.) This will effectively create a two-tier system. I predict that a large segment of the populous will see that as unfair, particularly when some seemingly simple procedure or drug or medical access is made available to the insurance holder and not to the public option person. In that same vein, class division will undoubtedly arise.
While I do believe in some sort of health care reform, I have other problems with single-payer and/or public option. Since that’s not what you asked for and since we don’t know what the proposed plan is, I’ll continue to withhold my comments.
More or less. You can get private insurance as a replacement for provincial insurance as opposed to a supplementary insurance, but it’s rarely used as such. Very few people drop out of the provincial system.
That is my whole point. It is inaccurate for posters to keep repeating the meme that private insurance does just fine in other countries with public insurance. The private insurance in other countries does not do the same thing as the private insurance here.
Its about “rescission’s”, the lovely habit of health insurance “providers” to take away your umbrella as soon as it starts to rain. I can’t read these stories too much, because it inflames my conscience and riles up the blood. I want to seize somebody by their neck and stuff a spreadsheet down their throat, and set it on fire. Goddamn! this pisses me off!
Note:
No one knows how often this happens. Which leads me to the question I’ve been harping on for some time now: can the insurance companies do business without pulling this kind of crap? If they can, why don’t they? And if they can’t, what fucking good are they?
Sorry to get so upset, but I give a shit. Which is a damn sight more than I can say for these white-collar slime-balls.
If they can do the job within the bounds of decency, but don’t because of greed, then they are criminals, distinct from murder for profit by reason of abstraction, they don’t actually pull the trigger, they don’t kill you, they just let you die…if they can do it, but won’t, then to hell with them.
If they can’t do it, if it isn’t possible, then thank you very much for the effort, here’s your Participation Ribbon, adios, motherfucker…
Whose people are these, if not ours? What country are they citizens of, if not ours?
Mad as hell, chewing a handful of carpet tacks and washing it down with kerosene, spitting mad, hopping mad…
And you’re not? You, you there, reading this, this doesn’t infuriate you, murder by spreadsheet? Well, then, I reckon one of us is crazy.
So? They’re private, they’re insurance companies, and they do just fine. Sure, the system is structured a little differently, but the efficient, dynamic, capitalistic free enterprise system ensures ours could adapt, right?
It CAN’T be that the government is just so much more efficient that private firms don’t stand a chance against it, can it?