Bill Moyers had an interesting show (see here for transcript) last Friday on single payer health insurance – a troubling insight came from guests Dr. David Himmelstein, on the faculty at Harvard Medical School, and Dr. Steffi Woolhandler, founder of the advocacy group Physicians for a National Health Program.
It has to do with the so-called “public option” that I and others have been advocating as the “good vs. perfect” solution to our health care problems. I like it because I believe that if people are given an option to buy in to Medicare or VA, that it will slowly crumble the foundations of the private insurance system that is the heart of our problem.
Speaking of the downside of a public option, the doctors spoke of a program called “Medicare Advantage”, which is supposed to offer superior private insurance care to seniors:
Himmelstein …we’re worried that the public plan actually becomes a dumping ground for the unprofitable patients. As it’s happening in Medicare. … the private insurers have all kinds of tricks to avoid sick patients, who are the expensive patients. So, you put your signup office on the second floor of a walkup building. And people who can’t navigate stairs are the expensive people.
Wolfe …Get rid of the heart failure patients.
Himmelstein Or you have your signup dinners in a rural area at night, where only relatively healthy people are able to drive and stay up that late. So, there’s a whole science to how you sign up selectively healthier patients. And the insurance industry spends millions and millions of dollars on that. And would continue to as they’ve done under Medicare. Selectively recruiting healthier patients, who are the profitable ones, leaving the losses to the public plan.
Insurance industry shill Senator Max Baucus and his sub-shills are saying that there is a public option on the table, but are not specific as to what it is. Since the Democratic wing of the Republican Party has already abandoned single payer, we will be stuck with either no public option at all, or one that is structured in such a way as to allow private insurance companies to continue to operate as they do now: Cherry-picking healthy clients, dumping everyone else on government.
Himmelstein and Wolfe maintain that we can only succeed if we do what Canada did in 1970 – kick the insurance companies out of business. If anyone suggested in Canada that they go back to their pre-1970 system, there would be a bloody revolt.
PS: By the way, Medicare Advantage is 1) subsidized, 2) costs 15% more than regular Medicare, and 3) with the program, insurance people are up to their old tricks, skimming the Medicare population for the healthy ones and avoiding the rest. It could be a foreshadowing of the Baucus public option.
Prison seems too kind.
Piece of Mindful 