healthcare 03One of the most interesting ironies within the healthcare debate is the most liberal healthcare solution, single payer healthcare, is the most fiscally responsible solution as well.  You can find many details about the finances of single payer on the Physicians for a National Health Program website.  Democrats are afraid to have the CBO score single payer because they will find it is the least expensive way to pay to cover everyone in America.  Single payer is the best plan for healthcare but everything written by experts on healthcare systems around the world shows that a healthcare system to be successful has to fit a country’s culture as well.  Even though most people who favor keeping their private insurance now favor it just out of ignorance there is just something un-American forcing people to enter a system that is not their choice.  If they is a public option the system will evolve into a virtual single payer system anyway.   How strong that public option is to start will decide how quickly or system will necessarily evolve into single payer.  The best estimate is it will take 10-20 to have a virtual single payer system where private insurance is relegated to supplementary insurance status.

Now the real ironic part.  It seems that since Democrats are realizing that they are going to have to go it alone to pass healthcare, the bills being considered for budget reconciliation have to contain a more robust public option because they lower the cost with anticipated CBO estimates the most.  One problem with the hypocrisy of the “Blue Dog” Democrats was their request to water down the public plan made the bill more financially unsound in the House.  The bottom line is the more the public option resembles single payer the more it lowers costs.

Talking Points Memo wrote a good article about how the reconciliation bill is being molded in congress.

51 Vote Rules May Force a Public Option Too Liberal for Some Dems

As Senate leaders begin work on a Democrat-only health care bill, they’re finding themselves confronted with an unexpected irony: Though the caucus has reached an uneasy consensus around a public option that’s modeled in many ways after a private insurer, it may be necessary to make the public option more liberal, and thus, more politically radioactive, if it’s to overcome a number of unique procedural hurdles.

This is the needle Democrats may have to thread if they want a public option, and at the same time, want to bypass a Republican filibuster. And the key for them will be keeping conservative Democrats on board.

“A very robust public option that scores significant savings would presumably be easy to justify doing through reconciliation,” says a Senate Democratic aide. “But it is still being studied whether other, more moderate versions of a public option could pass parliamentary muster.””

The obvious question is why do moderate and conservative Democrats want to water down the public option?  But the answer should be just as obvious by now that they want to serve their corporate masters and put off the inevitable demise of profitcare insurance as long as possible.  My take is if it takes only 51 Democrats to pass real healthcare reform so be it.  There is no reason to chase down more conservative Democrats than necessary either.


In a related story a new study is challenging CBO estimates saying they are not looking at long term savings that managed care can give.  The most managed care system we have in the US today is the VA care system.  Not only is VA care considered the best care by studies done by the Rand Corporation but they also are the best coordinated system to provide managed care.  Sometimes managed care has a bad connotation with people because it is sometimes associated with HMO’s but when addressing wellness and chronic diseases like diabetes and respiratory diseases managed care has much better outcomes for patients.

“U.S. health reform estimates need long view: study

The Congressional Budget Office may be missing potential savings from various health reform proposals by not looking at efforts to manage or prevent expensive, chronic conditions such as diabetes and heart disease, researchers said in a study released on Tuesday.

The study, published in the Tuesday edition of the Health Affairs journal, comes as members of the U.S. Congress prepare to return to Washington next week and again take up legislation to revamp the U.S. healthcare system.

President Barack Obama has made the overhaul a top priority this year, but debate has swelled in both parties in part over the CBO’s early projections the Democratic plan could cost nearly $1 trillion.

Obama and other Democrats have argued the CBO does not factor in how improvements to care such as primary doctor visits, although costly at first, could improve people’s health and lower costs over time.

The nonpartisan CBO, charged by Congress to estimate the cost of various programs, now uses a 10-year forecast that cannot look at the cost of program.”

Leave a Comment

Please Login to comment
5 Comment threads
8 Thread replies
Most reacted comment
Hottest comment thread
6 Comment authors
Questiniatyler-durdenKQµårk 死神AdLibKalima Recent comment authors
newest oldest most voted
Notify of

the problem i’m still seeing with this issue, and within the comments that follow this article, is the two-party mentality is still prevalent. we know the repubs don’t want health care, because they all have a vested [conflict of] interest in the success of the insurance companies. shareholders are doing very well right now. but we also know that dems are in this same pen, only wearing a sheep outfit instead of a wolf’s. the dem majority are demonstrating that they are NOT ON OUR SIDE. they are on the side of the insurance co’s. they are continually demonstrating a desire to protect the industry. there is constantly a cry that a public option could tank the insurance company. SO WHAT? if a govt program puts crooks out of business, i label that SUCCESS.

The american people need to let go of this repub/dem, 2 parties only mentality. there are independent, honest citizens, who can hold public office and represent us with some honesty and integrity. THESE PEOPLE MUST BE IDENTIFIED AND ENDORSED PUBLICLY.
i am tired of choosing the lesser of two evils. both parties are corrupt. the repubs are no longer “fiscal conservatives”. they are now corporatist elitists and religious zealots. the dems are no longer liberals who work on behalf of the public. they work on their OWN behalf.


The Republican “fears” are well founded in one respect, once the public option is created…and if the Dems want to keep Congress and the presidency it better be…there will be a gradual slide of the public towards favoring it, once they’re comfortable with it and see it doesn’t turn them into Communist Russians.

Single payer needs to be gradual because of all the terror the Repubs inspire. I do think things in this country would get worse if we put a single payer system in any other way than gradually.

But we must gravitate to it to survive economically in the world community.

The only drag is that it means the jerks who oppose it will have children with full sets of teeth, making them harder to tell apart from rational people.


No doubt the Dems best get HC reform passed, and damned quick.

We will lose seats like nobody’s business in 2010 if we fail, and Obama could easily be beaten if the thugs come up with a competent candidate.

Single payer, oh yeah!


Agreed on passing HC reform! ASAP and let it be all Dems because when it takes its place beside SS and Medicare, the Repubs will be in the wilderness for 30-40 years.

As for the Repubs coming up with a competent candidate…er…why break precedent now?


I was rather annoyed by the ridiculous assumption that the UK NHS is such a bad thing. I grew up there, was a young adult there and whenever I had a health problem, it was dealt with, I didn’t mind the long waits to be seen, at least I was seen on the same day.

One time I had an irregular heartbeat with a pulse rate of 120 pm, I was admitted to the hospital within 3 days as soon as they had an available bed.

A Swiss friend of mine now living in Tunisia, took her husband to a hospital in Paris, they are both Swiss citizens and my friend was amazed that after all the tests, she still only had to pay F 250, which was exactly the same as people who lived and worked there. So what is it with those stupid scare tactics, they should be ashamed of themselves, another huge lie for the world to see and disprove.


You know my position:

Insuring people for health coverage is a profoundly mundane thing to do.

There is no risk in this business. One gets a few million people together and all question of per capita cost levels off. Costs is costs.

The for-profit insurance companies work like beavers to create a semblance of product differentiation, and they do a swell job of it. Just ask anyone with a choice of plans what they think of their choices.

No. Health insurance is nothing more than pushing paper around and paying bills. There is no purpose in having for-profit companies in the market. This industry, of all the industries in the US, screams to be nationalized.

It is not as if the for-profit companies offer any value to the premium payers.

Pharma is a whole ‘nother enchilada. They at least create new products were none existed. And they take huge fiscal risks doing it.

Single payer is the way forward. I almost wish that this round of reforms collapses, but I don’t see us gaining much in Congress, certainly not in 2012 and going forward.