Politics or Poppycock A Look From the Left At Politics, Politicians, Policies and Issues of National Concern

Campaign for America’s Future

By Bill Scher

August 18, 2009 – 9:40am ET

The daily Progressive Breakfast serves up what progressive movement members need to know to start their day.

No One Can Say How Co-Ops Would Actually Work

NYT explores the difficulties co-ops would have, including current insurer monopolies BECOMING co-ops: “The history of health insurance in the United States is full of largely unsuccessful efforts to introduce new models of insurance that would lower costs. And the health insurance markets of many states suggest that any new entrant would face many difficulties in getting established … Mr. Conrad’s own state demonstrates the uncertainties surrounding cooperatives. Blue Cross Blue Shield of North Dakota dominates the state’s private insurance market, collecting nearly 90 percent of premiums. As a nonprofit owned by its members, the company would hope to qualify as a co-op under federal legislation, said Paul von Ebers, its incoming president and chief executive.”

W. Post on what co-ops couldn’t do: “co-ops would lack perhaps the main advantage of the public option: reimbursement rates for doctors and hospitals set by federal law, like those paid by Medicare, the program for older Americans. Federally determined reimbursement rates were central to the cost-saving promise of a government-run health plan and a potentially powerful competitive advantage.”

HuffPost’s Sam Stein uncovers government report indicating co-ops won’t cut costs: “The U.S. General Accounting Office produced a report on cooperatives in March 2000 that was mostly sour on the idea. Using five different co-ops as examples, the study concluded that on the key function — lowering the cost of insurance — these non-profit insurance pools came up well short … without a large number of participants, co-ops essentially were subject to the whims of the insurance market, unable to use market influence to get consumers better deals on coverage.”

Ezra Klein discusses the range of co-op possibilities: “The theory of the public option [is[ a robust public insurer can do a better job holding down costs and delivering access to high-quality care than a fractured private insurance system. Obviously, a lot of people don't like these ideas. Among them are insurers, Republicans and, crucially, providers like doctors and hospitals, who fear that a large public insurer will hold down costs, which will in turn hold down incomes ... You could imagine a co-op proposal that actually offered a meaningful alternative to private insurers. Some months ago, Conrad, alongside public plan supporter Chuck Schumer, seemed to be edging in that direction. But I haven't heard anything similarly encouraging since then. The co-op is now a favored alternative for Republicans who don't agree that the profit motive is a problem in health insurance..."

Health care analyst Bob Laszewski: "Co-Ops Are the Single Dumbest Idea I Have Heard in the Health Care Debate in Twenty Years ... on day one how many members does the co-op have? Well it has no members on day one. So, the co-op's provider relations guy goes to the doctor and hospital administrator and demands better prices and protocols. My guess is the provider’s response would go something like this, 'So you are here because your stated objective is to screw my reimbursement down more than it is, you have no members now, and if I give you the rates to take members away from the existing health plans you are going to make life even more difficult for me than those existing health plans have?' My guess is that when the provider stops laughing…"

White House releases Q&A to explain its current position, suggests co-op details determinative: "Q: Is he in favor of a co-op? Would that achieve the goals? A: Senator Conrad and others who are drafting a proposal for a co-op system believe that it would achieve those goals. We have not seen the details of that proposal, so it’s hard to evaluate at this point. Senator Conrad has been very constructive in offering this proposal and we look forward to talking to him further about it."

This is compromise? RNC release lambastes co-ops. TPMDC: "...if at the very least you thought that the Democrats could escape the 'government run health care' canard by, say, dropping their plans to create a government run health insurance system, you were mistaken. As the RNC makes clear, in their eyes, 'Public option by any other name is still government-run health care.'"

Progressives Take Stand For Public Plan

Dems digging in for public option generate headlines. W. Post: "Public Option Called Essential." McClatchy: "Obama's hint that he'd drop public plan provokes ire."

Progressive Caucus not potted plants. Politico: "Along with their sharply worded letter, the three House members sent an attachment listing the '60 Members of Congress who are firm in their position that any legislation that moves forward through both chambers, and into a final proposal for the president's signature, MUST contain a public option.'"

HuffPost's Ryan Grim questions Sen. Conrad's head count assertions: "Conrad, a Democrat from North Dakota (pop. 641,481), is presumably assuming that a bill containing a public option would need 60 votes to overcome a filibuster. But even if that is the case, not a single member of the Democratic caucus -- including Conrad himself -- has actually announced that he or she would support such a filibuster. And a few Republicans -- Susan Collins and Olympia Snowe of Maine -- might not support it either. 'Senator Conrad should leave the vote counting to the leadership,' a peeved Democratic leadership aide told the Huffington Post ... Even Conrad himself is not a definite no. His spokesman said he has yet to take a personal position on the public option."

Pro-Soc. Sec. privatization Blue Dog Rep. tries to scrap entire health care bill. CNN: "When a [town hall] questioner, Ray Evans, said he believed the President wants to do too much at once and asked whether [Rep. Allen] Boyd would ‘be willing to scrap everything’ and start over to do pursue reform more incrementally, the congressman responded: ‘I think that is an excellent idea … we may end up there.’ In a later interview with CNN, he said the idea had been been floated with the congressional leadership. He said that with the strong emotions and heated opposition he is seeing, the idea of doing health reform in a more piecemeal fashion is something he is strongly considering.”

Families USA and Third Way talk down public plan to LA Times: “‘The health reform bills have many critical factors designed to make healthcare more accessible and more affordable,’ [Families USA Ron] Pollack said in an interview. He and others noted that the bills working their way through the House and Senate included provisions that would transform the way Americans get health insurance — even without a government plan. ‘The public plan is not the essential element of reform,’ said Jim Kessler, vice president for policy at Third Way, a centrist Democratic think tank in Washington.”

American Prospect’s Paul Waldman calls bluff of public plan opponents: “I hereby challenge not just any insurance company representative but any conservative officeholder (current or former – I’m looking at you, Sarah and Newt), political professional, activist, pundit, or regular person who complains about the terrifying specter of government-run health care, to take the following pledge: When I become eligible at age 65, I will refuse health coverage under Medicare. After all, Medicare is an awful single-payer, big-government program, and we know they want no part of that. So who’s going to take me up on it? Anyone?”