Wednesday, December 9, 2009

An option by any other name...Senate Democrats reach deal

Ten (maybe) Senate Democrats late Tuesday night came to a consensus on health care reform, with major compromises and deals worked out including the removal of the so-called public option.

The group of ten settled on a proposed deal with several broad components. First, a not-for-profit private exchange would be set up for those without health care (replacing the public option plan), and would be managed and heavily regulated by the Office of Personnel Management (which currently overseas a similar program for federal employees' insurance plans).

Second, those between the ages of 55 to 64 would be able to buy into Medicare coverage, greatly expanding the program for those who represent the age-group most affected by the health care crisis today.

Third, the public option would reportedly remain in the bill but would only go into effect through a trigger -- that is, only if private insurers don't fix things themselves within a set number of years (this might not be the case, however, if conservative Senate Democrats don't sign onto it).

The group of ten who came up with the compromise consisted of five liberal and five conservative Democrats. Not everyone within the group was happy with the final outcome, however; Wisconsin's own Russ Feingold had reservations about the deal.

"I think a public option as an alternative is the best way to go," the Senator said, adding that he had concerns over whether assistance would be provided to those 55 and older buying into Medicare.

Feingold is right to be concerned -- the best option for covering all Americans, after all, would have been providing everyone with single-payer health coverage, essentially a Medicare-for-all program. Following that, a public option -- insurance coverage that Americans could have bought into through the government itself -- would have provided competition to private companies, thereby lowering costs.

This proposal, however, shouldn't necessarily be shunned outright -- if it comes down to it, and if there's no way to get 51 votes on the public option, then this compromise is the next best thing to the next best thing. If it includes the all-important abolition of the practice of discrimination based upon pre-existing conditions, then it would provide essentially the same deal to the American people that a public option would.

The problem with this compromise lies with who gets the money -- private insurance companies. A public plan would have encouraged private companies to be more competitive, to provide more services to its clients in order to beat out the federal plan. This compromise, on the other hand, doesn't provide such an incentive.

But it DOES provide Americans more choices through a not-for-profit exchange. It DOES expand Medicare to those older than 55. And it DOES provide assistance to poor families in need of economic aide. In other words, the compromise being discussed by this gang of ten wouldn't be much different than a public option plan in the eyes of the consumer.

What's needed, then, if this compromise does indeed become law, is more reform and regulation of the industry itself, especially for those who buy into the not-for-profit system. Protections need to be afforded to the people who buy insurance, to ensure that those who buy it get adequate coverage, and don't have to pay an arm and a leg to do so.

It'd be better to have a public option rather than a not-for-profit (but still private) option. However, if it's between the not-for-profit option and nothing else, we're better off taking the compromise that's been discussed. It's not the ideal, but it's much better than what we currently have.

Keep telling your Senators to fight for the public option -- but don't oppose this compromise if it's what we end up with.

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