Thursday, June 25, 2009

The Public Health Insurance Option [UPDATED]

If PresBO get's his way, and we get a public health insurance plan similar to Medicaid, how will it work?

There are no assurances at this time that a public health insurance option will materialize. Or how it will work. Or most importantly, how it will be funded.

But we do know this much.

If and when it happens, we can probably get a good idea of how we will be affected by looking at how well (or not) current public health insurance plans work (or don't work).

For instance, consider how Medicaid works. According to at least one source, 40% of doctors will not treat Medicaid patients. In some states, like California, it is more like half of all doctors refuse to treat Medicaid patients.

In Georgia, Rep. Alan Powell tried to introduce a bill (HB 89) earlier this year.
so as to require physicians who participate in the state employees' or board of regents' health insurance plan to also participate in the Medicaid program
In other words, if you want to treat state employees you must also treat Medicaid patients.

Bills such as this, requiring doctors to treat Medicaid patients have failed in the past. HB 89 was withdrawn the end of April without coming to a vote.

How is this working for you so far?

U.S. Congressman Phil Gingrey who is also a physician, has these thoughts on a public health insurance plan as reported by U.S. News and World Report.

DNC Chairman Howard Dean, former candidate for president, is a staunch supporter of Obama's push for a public health insurance option. Governor Dean is also married to a physician, Dr. Judith Steinberg.

Dr. Steinberg does not treat Medicaid patients.
As Vermont's governor, Dean aggressively pursued expansions of government-run health insurance—and bragged that doing so "was very cheap to do." Unfortunately for beneficiaries on state-run Medicaid and children's health insurance, that "cheap" coverage often came at a very steep price. Low reimbursement rates mean that few doctors actually participate in the government-run plan, so patients can't see their personal physician—and may not be able to see any physician when they need one.

In Vermont, one of those physicians whom Medicaid beneficiaries couldn't visit was Judith Steinberg—Howard Dean's wife. In 1998, low reimbursement rates—coupled with the impact of additional regulations her husband signed into law—prompted Dr. Steinberg to end participation in the state's largest Medicaid-managed care program. As a result, the residents of Shelburne in Vermont's largest Medicaid plan lost access to the only primary care provider in town who would accept their insurance.

Rep. Gingrey continues:
I don't fault Dr. Steinberg for her decision—it may well have been the only rational business decision for her to make. But for Governor Dean to claim that a government-run plan won't be "inferior" is to ignore his wife's experience, and that of the many beneficiaries who lost access to their physician due to Medicaid bureaucracy and poor coverage.
So health care is a business decision. As in, "for profit".

Supposedly having a government run plan would eliminate the for profit motive.

Apparently not . . .
President Obama promised during his campaign that, "If you like the plan you have, you can keep it." But most individuals don't really have their own health coverage—they get it from their employers. And if the coverage provided in the government-run plan is cheaper than what employers are paying now, logic suggests that employers will drop their current plans and place their workers in the government plan.

Estimates from independent actuaries at the Lewin Group suggest that well over half of all Americans currently with employer-sponsored health coverage—nearly 120 million individuals—would lose their current coverage due to the creation of a government-run health plan. And the change in coverage would not be a "choice"—according to Lewin studies, employers would drop their plan options, dumping employees into the government-run health plan to save money.
Well of course. Free is always better, isn't it?

ADDENDUM [HGS]: Rick Scott, head of Conservatives for Patients Rights, concurs with Bob:


"President Obama's town hall meeting on health care delivered a sickly rating Wednesday evening ...The one-hour ABC News special "Primetime: Questions for the President: Prescription for America" ... had the fewest viewers in the 10 p.m. hour. The special tied some 8 p.m. comedy repeats as the lowest-rated program on a major broadcast network."
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