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Monday, December 28, 2009

Wither the Public Option

House Democrats are already conceding that the public option will have to die to get the Senate to pass a final version of health care reform.
1-The public option had two purposes, the first was the (supposedly) create more competition for insurance companies, because the 1200 or so already selling health insurance don't have enough.
2-The more covert purpose, was to get enough people enrolled to make it a quasi universal plan. That was Joe Lieberman's objection to it.
So if number 1 is off the table, how does the government get to number 2? That's actually pretty easy. The choke hold of regulation. The Senate version of health care reform puts so many new regulations, from administrative overhead restrictions to documentation and litigation that they hope to drive insurance companies out of business.
Maine has already driven the vast majority of insurers out of the state with their Dirigo plan. Regulation on "for profit" insurers has left the state with it's own insurance (who's cost has gone up about 175% faster than anticipated) and a few not for profits selling policies.
My guess (educated, but without insider info) is that the conference bill that comes to the House and Senate will be designed to drive for profit insurers and the"non-protected" (see Longshoremen) classes out of the insurance business by making it nearly impossible to sell insurance without losing the proverbial shirt.
After a few years of States seeing their medicaid rolls (except Nebraska, the feds will pay for theirs) swell with those who's private insurers stop writing policies, the States will scream for DC to fix a new "national health care crisis" that is of Washington's own making.
Keep in mind, most of the legislation that's supposed to help the consumer doesn't go into effect until the law is on the books for 3 years. The taxes and regulations start immediately. This gives Congress the ability to say that insurers aren't doing their part before they are actually required to do anything, and insurers will most certainly have to look for ways to save money in that three year period.
There is a problem with the waiting period, though. The Democrats have to hope they hold onto enough seats, preferably majorities, in both Houses to make it possible to bring up the public option down the road as the "savior of the masses".
The GOP regaining control of either house would probably kill that idea in it's track, and require (gasp!) meaningful reform to be negotiated between both parties. Who knows, maybe then the President would have to hold true on his promise to televise the negotiations on C-SPAN so everyone could see what's going on.

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