At the beginning of June, I sent this short note to my US Congressional delegation which consists of Senators Kennedy and Kerry, plus Congresswoman Tsongas.
I have been working since I was 14. Now, for the first time at the age of 43, I am foregoing my employer provide health care plan and purchasing a family plan directly. I strongly favor a PUBLIC OPTION.
To talk politics, I don’t think the public option should be used as the extreme to force conservatives to make substantial concessions towards progressive reforms. If that is the game, use Single Payer to get them to make the quantum leap. Nor do I like the idea of a “trigger.”
At the end of the day, working class families need the drastic paradigm shift that a public option offers. Please be steadfast in this enterprise.
Thank you for all that you do, large and small,
Jack Mitchell
Lowell, MA 01850
So far, I have received replies from Tsongas and Kerry. (I’m cutting Kennedy’s staff some slack. I’m sure they are extra busy) What I’ve received is, how should I say, less than inspiring.
Update: A 10 year trigger?
Kerry Pushes For Public Option Trigger In Closed-Door Meeting
Each response has the standard, we understand the scope of the problem (cite statistics) and this is what we have accomplished (cite legislation). What neither have is a bold statement that the PUBLIC OPTION is vital to reform.:v(
Kerry’s summation statement:
While I strongly believe there are many things that need to be changed within our current health care system, it is equally important to preserve the parts of our system that work. As we move to make health insurance more affordable, those who are satisfied with their current insurance should be able to keep what they have.
As we continue to move forward with health reform I will keep your thoughts and concerns in mind. Thank you again for writing me. Please do not hesitate to contact me about this issue or any other matter of importance to you.
Tsongas’ summation statement:
Thank you again for sharing your views with me on this important issue. As this debate continues, I look forward to working with the new Administration to reform our system of health care at this unique moment in time and I will support the most immediate hope for providing health care to all Americans.
Of the two statements, Tsongas’ disappoints me the most: “I will support the most immediate hope for providing health care to all Americans.” Come again?
I am not asking, nor are most asking, for “immediate” or other synonyms for “politically expeditious.” We are asking you to get it as best as possible. Yes, there is urgency. There is a crisis with a pending catastrophe. Please act immediately, but do not compromise fundamental progressive values in the name of ease.
Here is the message I sent out over the intertubes via DKos, Blue Hampshire, Facebook and, now BMG, to POTUS.
As much as I hate to simplify and put all my eggs in one basket, I’m getting to a point. A point that reminds President Obama that he clearly stated that he would govern first and ensure re-election second.
“I’ve been in office for two months now. The last thing I’m thinking about is re-election,” Mr. Obama said. But, he added: “I’d rather be a good president taking on the tough issues for four years than a mediocre president for eight years.
Sir,
We need this done. Burn every bridge, twist every arm, pimp slap every punk ass inside the beltway. Worry about 2010 after we have real reform. You are damned, if you do and damned, if you don’t.Sir, with all do respect, my family and those that sit at our table and break bread will be DAMNED IF YOU DON’T.
What I, and everyone I talk to about this wants, is to see the Congress sweat blood on this. No bullshit. Staffers should be quitting their jobs because of the workload. Politicians should be seriously considering their bid for re-election. The months leading up to the signing ceremony should leave you all battered, bruised and hating life.
We are not talking about another day in the office. This will be THE legislation of this decade, if not greater.
Robert Reich, in Salon:
All this will be decided within days or weeks. And once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal — Snowe’s “trigger” or any other — the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well.
This is it, folks. The concrete is being mixed and about to be poured. And after it’s poured and hardens, universal healthcare will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers — one that gives the public insurer bargaining leverage over drug companies and that pushes insurers to do what they’ve promised to do. Don’t wait until the concrete hardens and we’ve lost this battle.
Let me be so bold, audacious, if I may, as to tell you how this goes Rep. Tsongas and Sen. Kerry. The President will not, at this point, draw a “line in the sand.”
BUT I WILL!
This is where we, the people of the Commonwealth, stand up and hold your feet to the fire. We will pressure you, badger you, and on occasion say please and thank you. Whichever means we choose, know this, you have one mission on health care reform. Use the office that we have bestowed upon you to give the President the political capital he will need to get us the best reform possible.
If we make, such a noise, then what else could happen?
NOW GO!
Fasten your seat belts!
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p>Autobumping — how dare you break the fourth blog wall! What are you, some kind of community organizer? (Try to hear my Rudy cackle.)
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p>Natives are restless everywhere.
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Forget about a 10 year trigger, ridiculous, simply a way of passing over a public option without really saying so.
Do it, and do it now.
An exchange with a public option, as discussed here, is the best idea (after nonsense chatter > begin view at 1:23).
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p>I do have concerns about the recent talk of taxing health benefits to fund a public option. This would be a tax on the middle class, a bad idea. Although I have also heard sound bites stating that the tax would only be on premiums covered by employers above $15,000 dollars. This should take the burden off of the middle class. I’m basing this on the assumption that the average family plan costs about $1000/mo. (anyone know for sure?)
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p>6/23/09 President Obama Discusses a Public Option at his Press Conference
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It reaffirms the decision of the majority to elect him president.
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p>As for the current discussion on taxing benefits, there is a threshhold above which the tax will be applied. Although not settled, it is in the region of $17K for family, $7K for individual, and thereby only taxes teh “gold standard” plans. But that could change, especially if premiums continue to rise.
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p>The benefits of the public option need to go well beyond lesser administrative costs and profit (will the public plan add a “profit” to its expense, and turn that money into a fund for subsidizing both public and private health care for lower income people?).
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p>So how can the public option drive down all costs by the large amount needed to keep health care from excessively burdening the economy? Building on studies of benefit analysis it could lead to the most effective treatments, including preventative measures. With only health improvement and lower cost as its goals, it would eliminate some other factors that would otherwise drive cost and reduce health, such as market share and profit.
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p>It won’t be easy, but it is necessary.
is something that needs to be dealt with. Health insurance reform alone won’t take care of that.
I’m becoming a big fan of Niki Tsongas, very impressed with legislative record.
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p>Everything I have learned indicates single payer is the best solution to the health care crisis. It is difficult to comprehend the resistance for the obviously best choice in the Congress as the majority of Americans support single payer.
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p>A public option would allow each of us to make our own choice. If us single payers are right, the choice will be obvious.
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p>I have recorded an interview with Dr. Robert McKersie who gives a powerful, concise and informative presentation of the challenges facing our health care system and the benefits of the single payer option. The Insurance interests have already filled the airwaves with misinformation on this subject and I wanted to offer the alternative point of view.
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p>This is available to Local Access Cable TV stations in Massachusetts and can be downloaded at http://www.pegmedia.org. Please contact your local access station and request they air “Local Impact – Crisis in Health Care”
Constituent services are great. She comes around to listen to local issues, i.e. Merrimack flooding.
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p>She has put forth solid ideas to help active duty servicemembers & veterans.
http://pegmedia.org/index.php?…
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p>Sue- I see on the website that you produced the show and that only cable station staff and media producers can access a preview of the show on the Pegmedia website 🙁
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p>Is there any way that you can post the preview segment here on BlueMassGroup? That would be valuable, especially if the post includes a link to contact information for the various local access Cable TV Stations. If you do this, I think BMG readers will be more likely to ask their local station to air the health reform program. Thanks for all you are doing! -AnnEM (Ann E Malone, RN)
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p>P.S. ACTION ALERT: We BayStaters have got to deluge Senator John Kerry with calls 1-866-338-1015 (Capitol Hill Switchboard) telling him that his constituents feel STRONGLY that a Public insurance option based on Medicare is a non-negotiable “Line in the Sand” and that a 10 year trigger is NOT ACCEPTABLE.
If he doesn’t support a strong and robust public option. Period.
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p>I’ve voted for him twice now – as many times as I’ve been eligible – so I’d be very disappointed if he doesn’t stand up for this paramount and widely popular piece of reform.
I mean “look up”.
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p>HuffPo has done a little dance on Kerry’s position on the PO and the
trigger.When I “autobumped” this diary, I had not gone back to the the HuffPo story I cited about Kerry floating a “trigger.”
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p>I have since rechecked and am glad to find a strong statement which is now inserted above as an Update. The HuffPo story has also added this editorial note, which should be acknowledged:
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p>Hey Jodi,
Don’t forget us over here at BMG next time, please. We actually vote for Senator in MA.
Would it be a one-size-fits-all plan, or would there be many sizes for people who wanted different coverages?
I figured there would be rates for single, w/ spouse or family.
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p>What a good question.
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p>I may opt for a public option with lower premiums and a moderate deductible, if I’m single and healthy.
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p>If BCBS can offer a variety, why can’t Uncle Sam?
Right, there might be a variety of deductible/premium options, but also there is the HUGE issue of what procedures are covered. And, the HUGE issue of if it would be the same for every state. Currently, states all make different requirements of what is “minimum credible coverage”, and then beyond that, within each state you will find hundreds or perhaps thousands of different plans that people are on, each one different. Some people will thus find they are covered for such-and-such, and others will find they are not. Are we asking Niki and her colleagues to decide what The Public Option Plan should cover, for every person in every state?
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p>For just one example of how hard this would be, check out this page State Mandated Insurance coverage For Fertility Treatment.
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p>Would the Public Option have to meet New Jersey’s minimum standards?
Or would it be more like New York?
… of what to cover was covered in the combination of the comparative effectiveness study and the new MedPAC provisions.
So it’d be an independent board that decides what’s covered. If I read that right, currently Congress pretty much ignores MedPAC and instead offer their own bills like this one by a Representative from New Jersey (which apparently never got out of committee):
Looks like under that bill, “the Secretary” (of H&HS?) could identify any new ART they may have left out when enacting the law, that’s nice. I remember the dust-up when McCain was asked why he voted against mandatory coverage of birth control, but some plans offer Viagra, does that imply that Democrats would mandate coverage of birth control, not only surely in the “public option” plan, but in all plans?
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p>And, assuming there was a national IVF mandate, how would we even reconcile states like Maryland, Texas, Arkansas, Hawaii, that do mandate IVF coverage but say “the patient’s eggs must be fertilized with her spouse’s sperm”, with states that don’t say that? Is that going to be something that each Administration reverses, like international “family planning” funds?
… is that there will be some quality data on effectiveness for providers and insurers to use. The data isn’t there to set policy, just to inform those who would set policy.
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p>The MedPAC recommendations are for Medicare and aren’t really followed now, mainly because the legislative process is too slow and ill-equipped for the kind of technocratic thing that the recommendations are. The proposed reform is to turn the recommendations, as they come in, into straight legislation that would be given an up or down vote, speeding up the process and greatly enhancing the likelihood that they are implemented rather than turned into political footballs or shelved for lack of effort.
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p>If MedPAC would similarly inform the public option(s) like it does Medicare now, I don’t know what their recommendations regarding IVF would be. I just know it would be studied pretty well (they do a pretty good job as is).
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p>As far as I know, there isn’t a plan to mandate birth control in private plans. The data and recommendations, however, would be available and I’d suspect that self interest would take over in the case of private plans – which is really no different than now, other than being better informed.
that vary from state to state, as well as a variety of plans available in each state. Remember McCain’s proposal was to allow people to purchase plans from other states, so they wouldn’t have to pay for bloated plans mandated by the state their plan was based (which often is not even the state people live in). So my point is that the Public Option should be the bare minimum, and things like IVF, prescription drugs, Viagra, organ transplants, psychotherapy, etc, should not be mandatory and should not be included in the basic Public Option. I don’t even think there should be a higher level public option, those things should be covered by supplemental private insurance if people want them.
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p>What that bare minimal coverage is is going to be where the fight is, or where the fight should be (it seems to be foisted on us under cover of darkness here in Massachusetts). Do we want to keep costs as low as possible for medical care, or do we want to make sure everyone pays for drug research, IVF, birth control, and abortions?
… referring to when you say there are state mandates? The public plan will have things it covers and things it wont. This is not noteworthy at all,… it’s what every insurer does. You have an opinion about some specific things you hope they don’t cover. I certainly hope they don’t cover everything, if for no other reason is that it’s unrealistic.
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p>But it seems that you’re actually asking for something wholly different, you want the public option to be substandard compared to private insurance. Certainly there is a place for ‘basic’ insurance as well as ‘more comprehensive’ insurance. Certainly the premium costs for either would differ. I don’t see why a public option would operate any differently. The costs would be relative to payout and the characteristics of the risk pool. Costs are covered from premiums, so I’m not sure what containment you hope to get by limiting services to ‘basic’. Furthermore, I can see where you wouldn’t want IVF or viagra in ‘basic’ coverage… but perscription drugs? Really? The very thing that people need to keep from getting worse? Are you really considering not covering insulin? In the end that’s actually more expensive… like not covering immunization.
with a mandate for minimum credible coverage, then the question is “what is the minimum credible coverage for the national plan”. I’m asking that question. I would consider a plan that forced me to pay for IVF and HIV and abortion substandard, and a lean plan that encouraged healthy living and prevention optimal.
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p>Premiums are determined by costs. Fewer services covered means lower costs means lower premiums.
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p>Prescription drug coverage is a blank check to Genzyme. It’s a huge part of why we can’t cover everybody. I’ll stick with generics if I need any drugs, and pay out of pocket, or buy a supplemental plan. If you have extra money you want to send Genzyme, be my guest. Actually, no, it would be better if you send it to Rosie’s Place, or paid for someone’s root canal.
… any insurance plan intended to be ‘the affordable alternative’ would include some sort of ‘minimum’. I would expect a low service plan to have correspondingly low premium (unless the risk pool, the other side of the cost calculation, says otherwise…), of course. Certainly drug companies profit when drugs are prescribed.
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p>Now, all that being said, I’d expect a cost conscious plan to use generics where applicable (and studies indicate that they are often more applicable than is currently being prescribed), but I’d rather the decision be based on cost combined with effectiveness, keeping in mind the ‘minimum’. That is, if a non-generic is called for, I’m not hesitant to include it in the plan, especially if comparative effectiveness backs the call with good data.
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p>The other thing I’d say is that I don’t necessarily see the only public option necessarily being a ‘minimum’ option. Certainly a ‘minimum’ plan has its place and certainly one of the public options would be a ‘minimum’ plan. But what’s being discussed here isn’t ‘medicaid for all’. That’d be a horrible idea, in fact.
Anyone want to interpolate for us. I think they are saying that if the cost is 1 trillion +$1, then they need all 50 votes to bust the filibuster.
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That is it. Not sure how anyone from this state can’t tell that this is the plan they are talking about. So that public option, I would bet my house, it’s for those only of a certain lower income threshold. Silo’s between those on the public plan and everyone else in the private insurance market. No competition. What on earth does “robust” mean? Wouldn’t anyone like to know exactly how the Congress defines “robust” before they sign on to this plan? This is an “accessibility” plan not a universal health CARE plan. The government can not control health care costs without controling most of the market, so just as in this state, rates will rise, insurers will still dictate care, so on, and so on. Also, if employers are still responsible for health insurance, why does anyone assume they would just be able to pick the public plan? I guess if you own your own business, otherwise it seems to me, it would be employers choosing in most cases. Let’s just hope they don’t put this thing under ERISA.