The public option sounds like a step toward universal health care, but it’s really a delay tactic. The latest versions would force public plans to mimic private insurers, while the fight over the arcane details buys the industry another decade or two.
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The difference between a vampire and a bad health care policy idea is that vampires jump out of their coffins and drink blood at sunset. Undead health care proposals emerge from think tank closets and suck the life out of useful ideas when the sun rises on a national health care debate. As public fury at exploding costs and deadly corporate claims denials boils over into historic Democratic election gains, can someone please find a wooden stake for the public option?
Improved and expanded Medicare for All would give everyone full coverage at much lower cost than the combined private premiums, taxes, and out-of-pocket payments that are eating up family income today. But it violates a cardinal rule of federal politics: never do anything that causes corporations or the ultrawealthy any pain.
Instead, corporate Democrats wanting to be seen “doing something” about the imploding US health care system have long peddled a vague public option notion because it sounds like the marriage of a big noncorporate vision (it’s public!) with competition and freedom of choice (it’s an option!). Liberal nongovernmental organizations (NGOs) and pundits revived its rotting corpse in response to pro–Medicare for All candidates’ primary victories and Tuesday night’s stunning results.
It’s a perfect nonsolution to our three-headed crisis of health care cost, access, and quality. Nobody knows what a “public option” is because there’s no common definition and nothing like it has ever been seen in the wild, so it can be anything weaselly politicians want it to be. It needs to be put out of our misery.
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The worst thing about public optionism is enduring smug lectures that Medicare for All is a political fantasy that could never happen from people promoting a vague, unworkable idea now enjoying its twenty-third year of politically viable nonexistence. Yet The American Prospect casually assumes that a series of essential Medicare for All elements against which the industry will fight like rabid dogs can easily be grafted onto a public option.
Health care is a public good. Pretending that having government act like a health insurance corporation will do anything useful is absurd. Let’s kill this putrefying political monster right now.
I think they could and should come up with something better than “Medicare for All”, which is still pretty expensive so it’s not like we would have what all the countries everyone envies have, where you pay almost nothing.
Medicare is very convoluted, there are parts A, B, and D. You need to have a supplemental plan because Medicare on its own only pays 80% after a deductible. You also have to pay for a separate prescription drug plan, and there’s no dental or vision coverage at all. So the Part B for this coming year is $209/mo. for a single person if you make less than $109K/year, and there are no discounts/subsidies if you’re poor. Then the supplemental plans are variable, around $150-$300/mo. or more.
Then the Part D (prescription drug plan) premiums could be from $0- a couple hundred more/mo. and they are all different and cover different sets of drugs (and which drugs can change each year), plus you also have to pay for each prescription–the amount varies wildly and also depends on which pharmacy you go to! It’s insane. It’s so complicated that you need to go to one of those Medicare advisors each year to figure out which Part D plan to switch to, since the older you get the less able you are to deal with the complexity.
So I’m just saying, I hope they can do a hell of a lot better than just switching everyone onto the existing Medicare system.
It’s strategically smarter to push for single payer all you can eat health care because there will always be negotiations. And if you push for the best thing first, you can get talked down to “acceptable.”
Agreed . I suggest we open with Single Payer healthcare, with dental, vision, hearing and veterinary included.
I was navigating public plans and Medicaid in my state. 75% of the fuckery, is that every practice is going to only take a select set of plans. Whether by choice or by complexity, you choose the wrong management plan for your Medicaid and your established practice may or may not take it. And it changes too. It ALL needs to get burned to the ground. ALL of it. Medicare for all. Fuck everything short of that.
- End predatory plans.
- End corporate handcuffs for medical care.
- End the gambling every year on what your coverage need to be.
- End predatory ambulance services.
The list keeps going. It’s so fucked right now.
Don’t allow providers to cherry-pick their customers by refusing to accept some plans.
End the distinction between “in-network” and “out of network” which exists solely to cheat the consumer.
One more bullet to add
- Include dental and vision in Medicare for All
Teeth are not fucking luxury bones.
And eyeballs are not luxury organs!
I’m not qualified to make arcane decisions about my health coverage, any more than I am to determine which food preservatives are safe and which should be kept far away from human consumption. There are some people qualified to make such distinctions, but we generally want them employed at a level where they determine what works, and then ban the preservatives that cause flipper babies, and the coverage plans that will leave you dead or bankrupt or both at once.
Everyone should have the healthcare they need, and nobody outside of a very few particular cases should ever have to think about it.
The difference between a vampire and a bad health care policy idea is that vampires jump out of their coffins and drink blood at sunset. Undead health care proposals emerge from think tank closets and suck the life out of useful ideas when the sun rises on a national health care debate. As public fury at exploding costs and deadly corporate claims denials boils over into historic Democratic election gains, can someone please find a wooden stake for the public option?
Brilliant analogy.
And I can’t help but think of Jeffries’ nothingburger response to Medicare-for-all questions: “We’re going to expand ACA tax credits.”
So in other words, you’re going to make UHC and similar corporate middleman vampires richer? Instead of taxing them properly in order to fund actual universal healthcare? Noted.
Medicare for all Americans now!
End the moderation fetish. No more half measures in public policy. Neoliberalism must die.
MFA should be opt-out by default.
No. It should be mandatory and universal. If you want to pay extra for something else that’s your problem, but taxes on everyone should pay for the healthcare for everyone.
The public option sounds like a step toward universal health care, but it’s really a delay tactic.
Before going further, I’ll note that these two things aren’t mutually-exclusive though. I think Public Option is a stepping-stone to Single-payer, and just like the benefits ACA brought with it over the former failed system, it’s a small step of progress which almost inevitably leads to everyone jumping ship to national insurance anyway in the long-run. Whether we can sell to the electorate going straight to the end-goal of Single-payer is the real question.
Last year, PEW did a survey on where people stand on this and if you assume Mix government / private programs suggests public option then Single-payer is overtaking it by 4 percentage points. Keep pushing until we’re forced to settle.
Forget the meta-talk about, “Should we go for it or not” and do the groundwork of pitching it to people across all states as to why it must be the goal from the outset. Convince the people, and then the representatives will follow.
Convince the people, and then the representatives will follow.
Congress doesn’t give a shit what constituents think. Multiple studies show popular opinion has almost zero impact on legislative action.
“Public opinion can behave like ocean tides,” Kuriwaki said. “When support grows large enough, it can be a very powerful pressure on the institution. Though maybe not as fast as a lot of voters might want.”
While imperfect, especially when sentiment grows so strong that impacts their own electability (e.g., AI data-centers, Iran War, Epstein Files), they can shift. It does have some impact.
No matter how you slice it, either way if public sentiment isn’t there, then it’s definitely not happening.
It does have some impact.
In the same way that negotiating with tapeworms has some impact on anti-parasite treatment outcomes.
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Nobody knows what a “public option” is because there’s no common definition and nothing like it has ever been seen in the wild […]
Americans considering anything outside of the USA challenge any% IMPOSSIBLE
Outside the US, there are a number of existing universal-coverage healthcare approaches. But there’s nothing like the “public option” being proposed in the US, where a state-provided system is meant to compete with private-sector insurers.
There are many countries where state-provided (or state-mandated) systems can be optionally augmented by private services, but in those countries, the state system is a foundation that’s built on, not one option in a marketplace.
Okay but this is really on-the-nose sarcasm and not earnest naïveté
