The public health insurance option, also known as public insurance option or public option , is a proposal to create a government-run health insurance agent that will compete with another private health insurance company in the United States. Public choice is not the same as publicly funded healthcare, but is proposed as an alternative health insurance plan offered by the government. The public option was originally proposed for Patient Protection and the Affordable Care Act, but was removed after Sen. Joe Lieberman (I-CT) threatened a filibuster.
Video Public health insurance option
History
Debate on 2009-10
Public options are presented in three bills considered by the United States House of Representatives in 2009: Proposed Affordable Health Care for American Law (HR 3962), adopted by Parliament in 2009, predecessor, Proposed American Choice of Affordable Health Act ( HR 3200), and the third bill, the Public Option Act, also referred to as "Medicare You Can Buy Into Act", (HR 4789). In the first two bills, the public option takes the form of a Qualified Health Benefit Plan that competes with a similar private insurance plan in exchange or an internet-based market, which allows citizens and small businesses to purchase health insurance that meets minimum federal standards. The Public Ops Act, by contrast, will allow all citizens and permanent residents to purchase into public choice by participating in public Medicare programs. Individuals covered by other employer plans or by state insurance plans such as Medicare have not yet qualified to obtain coverage from exchange. The federal government's health insurance plan will be financed entirely by a non-subsidized premium from the Federal government, although some plans require government seed money to start the program.
President Barack Obama promoted the idea of ​​a public option while running for elections in 2008. Following his election, Obama downplayed the need for a public health insurance option, including calling it a "piece" of health care reform, but is still campaigning for the option. until health care reform passed.
Eventually, the public option is removed from the final charges. While the United States House of Representatives issued a public option in their version of the bill, public options were rejected in the Senate Finance Committee and public options were never included in the last Senate bill, instead opting for state-directed health insurance exchanges. Critics of the abolition of the public option accused President Obama of making a deal to drop the public option from the final plan, but the record shows that the agreement is based on vote counting rather than backroom deals, as evidenced by the last vote in the Senate.
Since 2010
In January 2013, Representatives Jan Schakowsky and 44 other Democrats from the House of Representatives introduced Hr 261, the "Public Ops Deficit Reduction Act", which would change the Affordable Care Act to create a public option. The bill will set a government-run health insurance plan at a premium of 5% to 7% percent less than private insurance. The Congressional Budget Office estimates it will reduce US public debt by $ 104 billion over 10 years. Representative Schakowsky reintroduced the bill as H.R. 265 in January 2015, where he obtained 35 cosponsors.
Ahead of the 2016 Democratic National Convention, the Democratic Platform Committee approved a board supporting the addition of public options into the Affordable Care Act. The decision was seen as a compromise step between Hillary Clinton's campaign during the 2016 presidential presidency advocated for safeguarding and reforming the ACA, and Bernie Sanders campaign that advocates to cancel and replace the ACA with Medicare for All program single payers. Clinton's campaign stated shortly before the board added that as president Clinton would "pursue efforts to provide Americans in every state elected state of choice of public insurance plans", while Bernie Sanders applauded the decision to "see that all Americans have the right to choose the option public in their health care exchange, which will lower health care costs ". The call was echoed by President Obama, who in an article for the American Medical Association stated that Congress "should review the public plan to compete with private insurance companies in the territory of the country where competition is limited."
Maps Public health insurance option
Rationale
The purpose behind the public option is to make health insurance more affordable for people who do not have insurance that can not afford the tariff or are rejected by private insurance companies. Supporters argue that government insurance companies can successfully lower their rates by using greater leverage than private industry when negotiating with hospitals and physicians, as well as paying employees from the salary of publicly preferred insurance companies rather than paying under individual medical procedures.
Supporters of public plans, such as Washington Post columnist EJ Dionne, argue that many places in the United States have a monopoly where one company, or a small group of companies, controls the local market for health insurance.. Economist and New York Times columnist Paul Krugman also writes that local insurance monopolies exist in many smaller countries, accusing those who oppose the idea of ​​a public insurance plan as a defender of a local monopoly. He also argues that traditional ideas of lucrative market competition do not apply to the insurance industry given that insurance companies primarily compete with risk selection, claiming that "[t] the most successful companies are those who do the best job to deny coverage to those in need that's mostly. "
Economist and former US Labor Minister Robert Reich argues that only "big, national, public options" can force insurance companies to cooperate, share information, and reduce costs while accusing insurance and pharmaceutical firms leading campaigns against public options.
Many Democratic politicians openly support public options for various reasons. President Obama continues to campaign for public options during the debate. At a rally in Cincinnati on September 7, 2009, President Obama said: "I continue to believe that public options in a basket of insurance options will help improve quality and lower costs." The President also discussed the Joint Congressional Meeting on September 9, 2009, reaffirming his call for a public insurance option, saying he was "not interested in putting the insurance company out of business" while saying that the public choice would "be self-sustaining" and succeed by reducing overhead costs and profit motive. Democratic Representative Sheila Jackson-Lee, who represents the 18th congress district in Houston, believes that "strong public choice" will be included in the final bill and will "benefit the state of Texas."
Alternate plan
The latest Bill, Patient Protection and Affordable Care Act, including provisions to open health insurance exchanges in each state on October 1, 2013. Because the law requires Americans to purchase health insurance, the federal government will offer subsidies to Americans with the income level rises to four times the federal poverty rate.
The alternative proposal is to subsidize private, non-profit health insurance cooperatives to make them big and well-established to possibly provide cost savings Democratic politicians such as Howard Dean critically abandon public choice in support of cooperatives, raising questions about the cooperative's ability to compete with existing private insurance companies. Paul Krugman also questioned the cooperative's ability to compete.
Although politically difficult, some politicians and observers argue for a single paying system. A law, the United States National Healthcare Act, was first proposed by Representative John Conyers in 2003 and has been continuously proposed since, including during the debate on public options and the Patient Protection and Affordable Care Act. President Obama has opposed the current single-payer reform, stating in a joint session of Congress that "it makes more sense to build what works and improve what is not, than to try to build a completely new system of scratching." Obama previously stated that he was a supporter of a single payer universal health care program during the AFL-CIO conference in 2003.
A number of alternatives to public options are proposed in the Senate. Instead of creating a network of public plans across the state, Senator Olympia Snowe proposes a "trigger" in which plans will be enforced at some point in the future in countries that do not have more than a certain number of private insurance competitors. Senator Tom Carper has proposed an "opt-in" system in which the state government elects itself whether or not to institutionalize a public plan. Senator Chuck Schumer has proposed an "opt-out" system in which the state government will initially be part of the network but may choose not to offer a public plan.
In January 2013, Representatives Jan Schakowsky and 44 other Democrats from the House of Representatives introduced Hr 261, the "Public Ops Deficit Reduction Act", which will amend the Affordable Care Act 2010 to create a public option. The bill will set a government-run health insurance plan at a premium of 5% to 7% percent lower than private insurance, with the Congressional Budget Office estimating a $ 104 billion US public debt reduction for 10 years.
Opposition and criticism
Both before and after sections in the House of Representatives, significant controversy surrounds the Stupak-Pitts Amendment, added to the bill to ban the scope of abortion - with limited exceptions - in public options or in one private health insurance swap plan sold to customers who receive federal subsidies. In mid-November, it was reported that 40 House Democrats would not support the final bill containing the Amendment provisions. The amendment was abandoned after an agreement between Bart Stupak's Representatives and the voting bloc would elect the bill as written for the signing of the 13535 Executive Order.
Republican House Minority Whip Eric Cantor argues that public plans will compete unfairly with private insurance companies and push many of them out of business.
Michael F. Cannon, a senior fellow of the libertarian CATO Institute, argues that the federal government can hide inefficiencies in administration and attract consumers from private insurance even if the government offers lower products. A study by the Congressional Budget Office found that earnings accounted for only about 4 or 5 percent of private health insurance premiums, and Cannon argued that lack of earnings motives reduced incentives to eliminate wasteful administration costs.
Dr. Robert E. Moffit of the Heritage Foundation believes that public plans in competition in personal plans are likely to be used as a "dump" for families and individuals with health risks higher than average. This, in his view, will cause the cost to be paid by the business being forwarded to the taxpayer.
Marcia Angell, MD, Senior Lecturer at the Department of Social Medicine at Harvard Medical School and former Editor-in-Chief of the New England Journal of Medicine, believes that the outcome of the public option will be "under 55" preferring to pay penalties rather than insurance purchase under a public-preferred scenario, instead of recommending Medicare to age 55 down.
Aetna's chief executive, Ron Williams, opposes public options based on justice issues. At News Clock with Jim Lehrer , Williams noted that the public option creates a situation where "you are basically a player in an industry that is a participant in the market but also an in-game regulator and referee." He said, "we think that the two roles really do not work properly."
Public opinion
Public opinion polls consistently show majority support for public options. A July 2009 survey by the Quinnipiac University Polling Institute found that 28% of Americans want to buy a public plan while 53% prefer to have a personal plan. He also stated that 69% would support his creation in the first place. Survey USA estimates that the majority of Americans (77%) feel that it is "Quite Important" or "Very Important" to "give people a choice of both federal government-run public plans and personal plans for their health insurance" in August 2009 A Rasmussen poll The report, taken Aug. 17-18, states that 57% of Americans do not support current health care bills considered by Congress excluding public options, a change from their findings in July 2009. The NBC News/ Wall Street Journal , conducted Aug. 15-17, found that 47% of Americans oppose the idea of ​​public options and 43% express support. The Pew Research Center report published on October 8, 2009 states that 55% of Americans support government health insurance plans to compete with private plans. The result is very similar to their vote from July, which found 52% support. The October 2009 poll Washington Post /ABC showed 57% support, USA Today /Gallup survey described by USA Today article found on October 27th found. that 50% of Americans support the government's plan proposal, and a poll from November 10 and 11 by Angus Reid Public Opinion found that 52% of Americans support the public plan. On October 27, journalist Ray Suarez of The News Hour with Jim Lehrer noted that "public opinion researchers say that the waves have shifted over the last few weeks, and are now unspectacular, but solidly supporting public options. "
Between 28 October and 13 November 2009, Democratic campaigning organization Senator Dick Durbin surveyed America to rank them support for various forms of "public options" currently being considered by Congress for inclusion in the final health care reform bill. 83,954 respondents rated from 0 to 10. Full national options got the most support, averaging 8.56, while no public option was the most preferred, with 1.10 on average.
Doctor's reaction
Survey designed and conducted by Drs. Salomeh Keyhani and Alex Federman from Mount Sinai School of Medicine conducted during the summer of 2009 found that 73% of doctors supported the public option. A survey reported by the New England Journal of Medicine in September, based on a random sample of 6,000 doctors from the American Medical Association, stated that "it seems clear that the majority of US doctors endorse public use and personal insurance options to expand coverage. "
In contrast, an IBD/TIPP poll of 1,376 doctors showed that 45% of physicians "will consider leaving or taking early retirement" if Congress passes the health care plan desired by the White House and Democrats. The poll also found that 65% of doctors opposed the White House and Democratic health reforms. Statisticians and polls Nate Silver have criticized that IBD/TIPP polls for what he calls unusual methodology and bias and for the fact that it's incomplete when published as a response is still coming.
See also
- Multipaid health care
- Health care versus
- Health care reform in the United States
- Publicly funded health care
- SustiNet
Note
Source of the article : Wikipedia
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