My first question is regarding the funding. In the previous post that this stemmed from, Charley’s Q&A says, in regards to the PO:
How is it funded? Just like normal insurance: You pay premiums. It’s not free.
He later says
Is it Medicaid? Is it Medicare? Is it S-CHIP? No, no and no. Those are entitlements — benefits that are extended to people deemed eligible (the poor, old, and kids respectively), paid for by tax dollars. Again, the public option for health insurance would be paid for by premiums; it’s not a “free lunch.”
I’ve heard and read that one of the ways of funding this reform is going to be a $500 Billion cut to medicare (or medicaid? I get them mixed up). So if I pay taxes to medicare, something I may very well take advantage of some day, God willing, and it gets cut from it and goes to this reform, wouldn’t tax dollars be funding it? Granted, I’m aware there’s more to this reform than just the PO, but PO is the whole point of it, so there would no doubt be such action going on.
Let’s work of the assumption that zero tax dollars will initially go into the PO.
This will be a program that by its design and a greater part in its intent will benefit the lower income citizens in our country. It’s no secret (which is why I’m not going to go link hunting) that lower income people are prone to poor diets, more dangerous jobs, and other factors that cause them to have more health problems than the middle and upper classes. Obesity is a huge problem low-income citizens have. Obesity causes a myriad of health problems. Once again, not secrets.
If we have a PO that is funded by their premiums, but these premiums are less than if they are on private insurance, what we have is less insurance premiums pay for the insurance of people who would use more health care dollars than the middle and upper income citizens that pay higher premiums. Since the PO is going to be a function of the Federal Government, when deficits occur, and I have every reason to think they would, do you think that tax dollars wouldn’t be bailing such a function out?
That said, my questions regarding Hawaii stands:
Your Hawaii case is not really comparable, since as the article says, it was paid for with “public funds”, i.e. tax dollars. So that would be more like S-CHIP “crowding out” private insurance — that happens on the margins, but apparently not very much. Again, the “public option” would be paid for by subscriber premiums, not tax $.
And if demand overwhelms the supply offered, vis-a-vis cash 4 clunkers, how long before tax dollars are tossed into it? It’s going to happen.
I know that question works off a lot of generalizations, but I feel like they are sound in their logic.
My second question is more about the philosophy of the PO.
Once again, our esteemed tenor notes
People shifting to the public option from private insurance is indeed a possibility! The question is whether you think that’s ok on principle or not.
First of all, if we are at this level of debate where people are already counting votes to see if this would pass, how has it not been determined who is going to be eligible for this? Charley agrees that this is super duper important.
Why should we focus on this point more?
Look, I’m not a raving lunatic. The Catholic in me knows that we NEED to do something to help people who are unable to help themselves. I don’t think that the federal government is the right way to solve their problem, out of political principle, but it seems more and more like there isn’t much of a recourse. That said, I think that if we have a PO, it needs to be designed to only be at the disposal of people who need it. If we have very laxed merits to determine eligibility into a PO, we run the risk of creating, as the Lewin Group sees it, the largest insurance company in America — the PO. Out of sheer principle, I disagree with this. We elected Obama and Company, but we are still a capitalist Democracy. I don’t think we should establish public alternatives to private entities that will easily overwhelm the private entities.
I’m not really sure how to phrase my question, but you get the jist of my concern.