Aug 24 2009
What started with a "couple of liberal policy wonks" is now in the center of the debate over government's role in the health care system and has placed President Obama "uncomfortably in the middle," The Associated Press reports.
"A look at the roots of the idea shows that the policy experts who proposed early versions believed the government plan would become one of the largest insurers in the country. But Obama and other candidates saw it as a compromise between rival Democratic factions. One side wants Medicare-for-all, while the other prefers to subsidize coverage through private insurance plans — as Massachusetts has done. The debate within the party still rages, with Obama in the crossfire. Former North Carolina Sen. John Edwards was the first Democratic presidential candidate to propose a public option as part of his health care plan, unveiled in 2007."
Yale political scientist Jacob Hacker proposed "Medicare Plus" in 2001 that would have paid for Medicare-like public insurance through a payroll tax. Helen Halpin in Berkeley proposed a head-to-head competition between a government and private plans (Alonso-Zaldivar, 8/21).
Hacker answered questions about a health insurance exchange Thursday in a New York Times blog: "'It's a place where individuals can go and shop for a health plan. Today, large employers can select from a choice of plans that spread risk and reduce administrative costs because of the large work force. But the options available to small employers are much more expensive. And individuals find it very difficult to get coverage. The exchange would make a range of more affordable options, including a public plan, available to individuals and employees of small businesses'" (Underwood, 8/20).
Politico in a video: "Life here in August can be pretty slow, but not this year, thanks to the debate over health care. Those in favor of a public option took to Capitol Hill to make their voices heard." Activists expressed optimism that a public plan will be part of the final bill that passes (Gavin, 8/20).
USA Today writes about co-operatives, the alternative to a public plan that some in Congress are proposing. "Co-ops, which would be run by their patients instead of the government, have been under discussion in Congress for months but gained renewed attention this week when Health and Human Services Secretary Kathleen Sebelius signaled the administration might support the idea." The paper also looks at specific co-operatives and shows how they work like private insurance while having some administration like a public plan (Fritze, 8/21).
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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. |