Senator Schumer’s ‘level playing field’ last, best chance for public option
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On Tuesday, the Senate Finance Committee will begin debate on the issue of a public health insurance option. As it currently stands, there is no such option in the bill as proposed by committee chairman, Sen. Max Baucus (D-Mont.) However, committee member, Senator Jay Rockefeller (D-W.Va.), has promised not to vote any bill out of committee that does not contain a public option. That means that Baucus cannot afford to lose one more Democratic vote or the Senate Finance Committee will likely find itself without enough votes to approve a bill to send to the floor of the Senate.
This leaves Senator Charles Schumer (D-NY), an active advocate for a public option and a member of the finance committee, in the catbird seat. If Schumer votes against the final finance committee bill, it could go down to defeat absent a Republican crossing over to vote with the Democrats.
Three public option amendments have been proposed for the committee’s consideration, one from Sen. Rockefeller and two from Sen. Schumer.
Rockefeller’s amendment is very close to the language in the House bill proposing a broad public insurance option plan. Schumer’s first amendment closely tracks the public option contained in the Senate H.E.L.P. Committee (the “Kennedy” committee) legislation while the second Schumer amendment includes the “level playing field” option.
“Level playing field” is the one to watch. If there is any chance of getting some form of a public option into a final finance committee bill, this is the one that could do it.
Schumer’s amendment would create a public insurance option that would be required to function on its own without much in government subsidies to prop it up. The program would have to negotiate with health care providers just as the private companies do, which means that the Schumer proposal would not utilize the Medicare rates that the government currently uses, rates dramatically lower than what private insurance companies pay to health care providers. As a result, there should be no ‘rush’ to leave private insurance programs to sign up for the public option as the differences will not be that dramatic, thus creating an opportunity for real competition. The amendment also proposes reorganizations in the delivery of health care that would be favored in the public option that promise to hold down the out of control costs of medical care.
But, if the Schumer plan is going to operate in so similar a manner as the privates, why bother?
Because Schumer’s public option, while having to worry about keeping its doors open, would not be required to earn a profit. This allows the program to play fair in the insurance market, put its customers first and force the private markets to do the same.
Schumer’s program would come with no bonus payments to employees for rejecting claims, no tricky codification and nomenclature schemes designed to result in the claims mistakes which drive medical provider overhead into the stratosphere, no overhead wasted on marketing and promotion and no multi-million paydays for senior management.
While many progressives are likely to find fault with the Schumer approach in that it falls short of using the public option as a back door to the single-payer system that progressives tend to favor, the Schumer plan is a pragmatic, sensible and, ultimately, highly beneficial plan that will help to keep prices in check while protecting the middle class from being priced out of the health insurance market.
Keep your eye on this one in the coming week. If there is to be a future for a public insurance option -which remains a long-shot- it is going to come in the form of the Chuck Schumer amendment.
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Let me be clear, I favor a public option, but the reasoning given above is faulty. That the public entity does not need to make a profit AND THEREFORE will play fair with the public simply doesn’t have any basis in fact or experience. There are many public entities that do not make a profit, but don’t play fair with the public. Let’s take the post office as a good example. They are cheap and relatively good at delivering mail, but their customer service sucks, they consider the interests of bulk mailers ahead of the general public, and they drop popular services to curry favor with large businesses (try opening a savings account at the post office these days; you used to). Not turning a profit doesn’t mean the entity doesn’t have to cover its costs and it can easily transfer money to its employees, mainly management, through salary and bonuses rather than profit sharing and stock. Many a nonprofit are a rather good deal for the people that run the place.
The Boy Scouts of America doesn’t turn a profit, but it has hardly been fair, unbiased, reasonable in its treatment of gays and the nonreligious. They don’t make a profit, but aren’t a good example of fair.
We need a public option because it will be government controlled. If it does anything too outrageous, it is under direct popular control. A simple call to your Congressional Representative’s constituent services division and things have a way of working out well. Kaiser and Medicare are big, bureaucratic institutions, but I can give Medicare a kick in the pants if I need to. Government agencies work under the Freedom of Information Act and are closely monitored by the media (what little we have left). Can anyone even tell me who runs Kaiser? Whose in charge there?
We need a public option so we have a way to compete with the insurance companies and see how its done. If, for example, the public entity manages to cover a wider variety of treatments and conditions at a lower cost, then why can’t the insurance companies? In the end, if the only thing insurance companies offer is worse coverage at a higher cost, then we will really know something.
We will know we should have just gone with single-payer government health care all along.
That is why we need a public option.
I’m having a hard time understanding your point. Is there a different public option that you think will treat the public more fairly or are you saying that no public option is going to treat the public fairly because it’s, somehow, like the post office? Do you think that a government public option will be as unreasonable with the public as private insurance companies?
In response to another comment. See in context »Rockefeller’s amendment is by far the better of the three and both Schumer and Rockefeller have agreed to vote yes for all three. I can live with “level playing field” coming out of Finance, that will mean all committees in both chambers have passed a bill with a public option in one form or another meaning it is highly unlikely that a final bill will come out of conference committee without a public option, if this amendment proves to be the weakest of the options the only direction to negotiate is towards a stronger public option. Schumer is wise to put this amendment up it’s a tactical tour de force that serves the process well.
Rick frankly I don’t think many of the left will find fault with the amendment. This is about tactics and nothing more, I seriously doubt Schumer expects “level playing field” ever to be signed into law.
Not sure if you are saying that you don’t think the Schumer amendment will be signed into law because something better will result or because there won’t be a public option going through. I suspect its the first and, as you know, I can’t figure out where you are finding these votes in the Senate for a better public option that Schumer’s amendment. Frankly, I don’t believe that his “weak” amendment will make it through the Senate, but it is, clearly, the best chance.
In response to another comment. See in context »“Level playing field” isn’t robust enough to pass the house, something better will have to come out of conference committee and frankly I don’t think that’s going to be a problem when you consider who the Leader and the Speaker are. I don’t think there is going to be a problem getting the 60 to vote to end cloture.
Baucus’ smack down of Kyle was very telling of how this is all starting to sort out.
http://www.youtube.com/watch?v=LlDKeMcBwFM
Handwriting is on the wall Rick, you should check out the following:
Health Care Is Hazardous to Poll Numbers for Grassley, Other Senators
http://www.fivethirtyeight.com/2009/09/health-care-is-hazardous-to-poll.html
In response to another comment. See in context »well….I like your optimism but still don’t see where these 60 votes are.
In response to another comment. See in context »There will be 60 for cloture.
In response to another comment. See in context »Is that a light I see at the end of this tunnel? My doctors have asked for this from the beginning; have some reasonable rates above Medicare for providers and cut out some of the 34% profit margin insurers currently build into their policy.
Only if it can make it through the senate.
In response to another comment. See in context »[...] the Schumer amendment, which offers a ‘level playing field’ option on health care that our Rick Ungar blogged about at the weekend. And as Martin Kady II points out Politico, there are also the public options [...]