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Monday, August 17, 2009

Just fade away

The co-ops envisioned by some backers would be nonprofit, member-owned groups that would assemble networks of health care providers and negotiate payment rates with them. The government would provide up to $6 billion to get them started.
That $6 billion will go straight into the pockets of insurance company executives, and maybe insurance company shareholders, and the co-op policies will be too expensive for anyone to afford.

This may be what Gatsby Wyden wants, but it isn't worth bothering with. If it's the best we can do, let's go work on something else. Like starting to make some long-overdue decisions about the tax code, for example. I'm sure Ron has a nice "centrist" approach to that, too. We should give him a call at the luxury box at Yankee Stadium and see what he thinks.

Comments (10)

Ive heard if the Co-Ops don't get enough enrollee's, they will need further funding from the government and or cause premiums to rise to make up for the shortcoming in revenue vs claims...

Why not have Medicare for all who want to buy into it... or for those 50 an older to begin with, then expand it... its a system that's already in place and has worked well for generations..

Of course there are abuses in any system, but the Medicare program worked well for prior generations..

The Medicare compensations rates to doctors and hospitals would have to be revised as Ive heard they are still based on figures when the program was initiated in the 60s...Some states pay better re-imbursement Medicare rates than others, so a more equitable payment system would need to be part of any new legislation..

What's not being addressed with the current free market system, is the ability of the insurance agencies to pick and choose what they will pay, thus leaving the insured often times with a large bill even though the insured thought they were covered.. that "of covered benefit" clause is an easy out for the insurance companies to ensure the least amount of coverage is provided and usually with little to no recourse by the insured.. this problem needs to remedied in whatever products are finally agreed upon....

and forget about the 2013 begin date.. people need assurance of affordable healthcare now...

As Joni Mitchell sang, "That was just a dream some of us had."

Of course, if I were going to be realisitic, I'd have to resort to sarcasm and say "change,... my ass!" .. this healthcare debate was settled long before this summer..... and not in favor of the American people...

Maybe we should start looking at how the people in the depression era sought healthcare... I hear butchers were known to provide bone setting services when people would break an arm or a leg, since they understood anatomy the best...

The co-ops strike me as someone's concept of "if people think health insurance companies suck so bad let them run their own". It might be educational, but is otherwise irrelevant.

Co-ops are one step better to local control. I recently heard a piece on the radio of a successful co-op in Minnesota. Among the things it allows for...

- a locally elected board
- annual member meetings (akin to shareholder meetings)
- a real grievance procedure for claims that are denied

Not to trumpet republi-conomics, but won't the establishment of more co-ops (insurance providers) increase competition and bring down consumer prices?

I wish I knew the answer, but before completely writing off health care reform as a loss, I think it's worth better understanding it. Most people don't even know what a "co-op" is.

For more info on co-ops:


Finally, for you cyber-cynics, I'm just a regular guy, no puppet for the co-op movement. To prove it, I live near the Laurelwood, which was recently featuring a Double Oregon Hefeweizen.

How can a Co-Op compete with the deep pockets of a large corporation... Don't Co-Op's have to absorb losses as well as gains.. since the pay off of an insurance product deducts from the bottom line, not adds, how can a Co-Op that gets an unusually high amount of "high level of care" insured succeed?...It could easily put a Co-Op in bankruptcy... then what?

I think ultimately the goal is to get social programs under the state govt and out of the federal mandate... I also think this administration knows what the ideal goal is and its not what the people want, its what the multi-national corporations want...

Isn't it odd how the politicians who have the majority just don't want to listen to the what a majority have said they want? If you want to look at how corrupted our political system is, look at our former Senate Majority leaders (Daschle) ties to the insurance industry as well as his wifes...I thought the democratic party was supposed to be more aligned with labor (thats most of the people) and the republicans with business leaders?

If you examine how this Co-op operates at www.reformwascoelectric.com you will never, ever want to belong to a Co-op.

Aren't credit unions sort of co-ops? They're relationship to the commercial banking industry has been given as an example that the health insurance cooperatives could follow.

Expanding Medicare as the public option seems a no-brainer. The infrastructure in negotiating and paying claims is already in place. The anti-fraud unit needs to be beefed up regardless.
If however, we are going to reinvent the wheel with a Co-op, the only way it will compete and lower premiums is to be a single, nationwide entity without a profit motive.
Besides political considerations, the question is if Medicare were expanded - with a higher premium than the $96.00 per mo. currently paid by seniors, to cover those under age 65, (say 2-3 hundred bucks monthly) would it cost less to get up and running than the 6 billion proposed to set up a Co-op?
As far as start-up time, Medicare could offer a policy for the rest of us, at a reasonable premium, with it's existing claims infrastructure expanded, much more quickly than a Co-op could become functional. Why doesn't Congress get behind this "no-brainer" solution? Politics as usual.

Should we treat food, housing, transportation and entertainment like we do medical services? We could legislate an employer mandate to deduct X dollars from worker's pay and deliver it to someone else to manage, arguably for the benefit of workers.

Alternatively, should a worker be free to say I'll take my pay, all of my pay, in cash so I can spend it as I damn well please? Every employer mandate would be treated as just an increase in the minimum wage.

The cost of delivery of health care (including insurance) can and will easily expand to accommodate any amount of cash thrown at it. A 60 dollar doctor visit to get a prescription for a 4 dollar set of pills can instantly grow to 80 dollars for a 4 dollar set of pills.

The higher inflation rate for all things medical-related is strongly correlated to the schemes to compel folks to spend their own money on things medical-related. If labor itself is not rewarding enough to perpetuate the inflationary spiral then the health care delivery lobbyists must turn to demanding direct transfers from government; tapping into the government taxing power itself.

If workers, including public employees, are free to go skiing with pay that would otherwise be dedicated to the medical lobby then prices for medical services will fall. Proof? (Sort of.) If every worker were required to contribute to a skiing fund even if they did not use it themselves what would happen to the price to go skiing? It would go up, of course. And the typical legislative response to the need to ski, given the higher prices, would be to intensify the distortions that brought about the high prices in the first place, in a fit of ignorance-slash-corruption.

Legislative authorization to privately form a coop exists so as to avoid running afoul of anti-trust laws. A coop does not need a hand out, it only needs an exemption from anti-trust liability relative to government and private insurers/purchasers.
See notes on Capper-Volstead Act of 1922.

Do you think that the State of Oregon (or subdivisions thereof) would let employees use their health care contribution to go skiing instead or to voluntarily join some private medical service purchasing coop?

Would a purchasing coop be able to demand a 10 percent discount or even a 24 percent discount for its member's purchases, as discussed in the McKenzie-Willamette Hospital v. Peacehealth bundling price discrimination case?
I would think that a private medical purchasing coop, including voluntary participation by government workers, should be able to get at least as high a discount as would a "government" purchaser, thus removing any need or requirement that the government itself be the sole purchaser for the arguable benefit of the worker.

The key question as far as I am concerned is that an individual remain free to reject all offers of participation in health-related schemes, be they corporate sponsored or government sponsored or involve any coop. None-of-the-above must be an option. I'll take my pay in cash and I will associate with whom I choose.

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