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Similar to The Public Option 2009
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The Public Option 2009
- 1. The Public Option This presentation originally created by Farheen Qurashi, 2009-2010 Jack Rutledge Legislative Director
- 2. Option to join a government administered program instead of private insurance Paid for by low premiums of those who enroll, just like private insurance, not taxes Payments are made by the government, but care is still privately delivered Costs are low – the goal isn’t profits, it’s good health care No profit margin – money goes back into the system Low administrative costs
- 3. “Robust” Is open to everyone, providing choice Competes with private insurance companies Is affordable to American families
- 4. The rest of the debate Provider Organization supporting the Public Option: American Medical Student Association (AMSA), Committee of Interns/Residents (CIR), American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP) Community Organizations Labor: AFL-CIO, SEIU - small business patient groups - faith based groups *The AMA has endorsed HR 3200, which does include the public health insurance option.
- 5. Health Care for America Now (HCAN) On of the largest coaltions In the country working for health care reform for over 2 years now – made up of physicians, nurses, faith-based groups, labor unions, small businesses, children’s groups, HIV/AIDS groups, women’s groups, etc.
- 6. The Legislation The Legislation HR 3200: National Exchange HELP: “gateways” Finance: Co-Op
- 7. How will it work? There must be a “market” You must be eligible* You can choose to buy in or select private coverage
- 8. Who will it work for? Small business owners Employers People not currently covered by private insurance People not eligible for Medicaid or Medicare
- 9. AMSA & Health Care Reform www.amsa.org/uhc/hcr.cfm
- 10. jrld@amsa.org To learn more… Sign-Up to be Rapid Response for Health Care Reform! Interested in single payer? Sign up for STAT! http://groups.google.com/group/stat2009/ or email healthcare.stat@gmail.com
Editor's Notes
- Most contentious part of health care – public option. But what does that mean? And why is it such a “big deal”?I’m going to talk about the public option: what it is, what the debate is around it, and where AMSA stands
- Definition: optionKey word: option “if you like what you have, you can keep it.”Government administered, but on a “level playing field” – not financed through taxes, but through premiums (just like private insurance)Still privately delivered, but payments through government “insurance plan” – somewhat similar to medicare/medicaid*low* costs: not-for-profit & low administrative costs
- But some people call for not just any old public plan, but a robust one. What does that mean?There are some key features: It must compete with private insurers (the level playing field mentioned before)It must be open to everyone (choice)It must be affordable to everyonethis all together provides increase access to care, which is the bottom line (for AMSA at least)
- So then what’s the big argument?Some orgs support and some oppose the public plan.Supportive provider organizations include: AMSA, NPA, CIR, AAFP, AAP. The AMA has come out in support of HR 3200, which does include a public option.Other organizations: small business groups (main street alliance), labor unions (AFL-CIO, SEIU), government workers, patient groups (HIV/AIDs groups, childrens groups). HCAN, national coalition, includes all of these groups and coordinates many of these groups’ efforts.Physician groups against: many of the AMA’s state society members did draft a letter not in support of a public option, although the AMA itself did endorse HR 3200. Most physician groups, if not openly supportive of a public option, do not openly oppose it, and do support reform (ACP, AOA)Other groups against: special interests like industry (insurance industry – AHIP), groups that misinterpret what reform is into “socialized medicine,” etc. That’s why education is so important. This really is a chance to IMPROVE healthcare, not hurt it.The Leg
- So, I went over the “ideal” public option. But, what do we have to work with currently? In the next few slides, I’ll go into more detail about the public option we currently have – in the House and Senate HELP bills – how and for whom will they work?HR 3200: Arguably the strongest bill in increasing access & affordabilitySenate HELP: state-based gatewaysSenate Finance: not yet done! Still being discussed as a “bipartisan bill” – but the deadline’s coming up!
- There has to be a market – a place where people can go to buy this insurance – to get the facts about each insurance coverage plan and make an educated decision (this is also part of reform) this market will be the only place people can choose to buy into the public plan option.In the House bill, this is called the “national exchange,” and in the Senate bill, they are making it state-based as “gateways.” Federal level plans are better because it increases the pool of people and thereby the resources that are shared with the rest of the pool, there by lowering costs and expanding access. It also standardizes and ensures stable coverage even if you move states.You have to be eligible to buy into this marketplace – but once you are eligible for the market, you are eligible for everything in itYou can choose any of the private insurers or the public option
- EligibilityAgain, you must be in the marketplace – either the Gateway or the Exchange – to be eligible to buy into the public option. It depends on which bill you look at, whether people can be part of the marketplace.In the Senate HELP bill, only small businesses and people without insurance (but not eligible for Medicaid) will be allowed in. In the House bill, there’s a toss-up: the final isn’t done yet, but it looks like of course people without employer-sponsored coverage but not eligible for Medicaid will be allowed in, and possibly all employers (although it could be based on the employer’s size)
- AMSA’s stance on all of this: find our full stance and/or legagenda at www.amsa.orgAMSA supports healthcare reform strongly. We first and foremost advocate for a single-payer system of health care financing – however, currently, in 2009, we support a robust public health insurance option. The current proposals although not ideal, would still increase access and affordability to our patients, so we support the House and HELP bill but are continuously pushing for something stronger. And we will continue working even after health care reform is passed to increase coverage to universal – completely universal – with Single Payer.We support increased payments to primary care physicians, esp. those in rural areas. We support strong funding mechanisms for the NHSC in the House bill, and good levels of funding in the HELP bill. We support insurance coverage reforms like abolishing pre-existing conditions and the practice of charging more for gender or location. We support strong preventative coverage, primary care, emergency, as well as dental, vision, women’s health and reproductive health care.