Some good questions raised, but they are independent of the context of the other reforms and the affect they will have on private insurance companies, many of which will make the coverage less onerous for the people they cover.

The idea is to fix the system holistically in an effort to move the ball down the field. Any health care reforms today, must be considered in light of all the other reforms we must make over the coming years, many of which are interconnected and will have unknown consequences to the system as a whole until after they are put in place.

Long-term, unless the American citizen fixes their voting handicap and inability to understand how important the primary elections are means any reforms will only last as long as the public is paying attention. Without the potential to lose their jobs every two, four or six years, Congress will never be a sustainable avenue for change.

All these other reforms highlight why taking the route the President and Democrats have chosen makes far less sense than developing some form of single payer. Why settle for moving the ball down the field for some undetermined length of time when you can go all the way down the field and score an easy touchdown for everyone by implementing some form of single payer plan? The convoluted logic of the course our "leaders" have chosen only makes sense if you ignore what makes the most sense for our people, our businesses and our country as a whole.

Thanks for pointing this out.

I'm also hearing that there is a provision in the law that says that you can keep any private insurance you have on the day the bill becomes law.

However, you cannot replace it with another private insurance after that, only public.

In other words - if you decide to switch from employer's insurance to your own, or change jobs; then you must use public option.

Did you come across that too?

No it didn't. What Sebelius said was that it depends upon the choice of your employer. If you were to switch jobs and the employer provided health insurance you would have to go with whatever they have (as we mostly do now since it's too expensive to procure as one individual or family).

This just means your employer will continue to be your agent in choosing health care providers. However, the next time around they will be able to choose the public option in addition to the array of private options.

Doesn't seem like a big deal to me. The major point is that private insurers will be in direct competition with the public option, which will force them to equalize or be left behind.

One weakness in this whole scheme is that it's difficult to compare competing insurance vendors on the basis of how hard they are going to fight against you when you make a claim.

This legislation is massively complex, so there may be some standards-based coverage coming in it, that will leave little or no room for weaseling out of paying claims. I haven't heard much on this front.

I don't know. This seems rather unworkable. There is nothing that says I HAVE to buy insurance from my employer right now. If they are going to make it a law that you HAVE to buy insurance from your employer, then there needs to be price controls in place, otherwise employers are going to start foisting off the entire cost of health insurance on their employees. The only thing that keeps them from doing that now is your ability to walk away when costs get too high.

Don't think your employer would profit off you like that? Take a look at the vending machines in the break room. Think about how much you pay for the company's product or to buy something off the company shelf. Sure, you may not pay retail, but neither do you only pay cost.

So to make this work, you have to put price controls on employer-provided insurance. Do you think price control is a policy they could ever get through Congress? But without price control, the entire system is going to blow up in our faces, and the Democrats will own that failure. Are they really that stupid?

Wait. I forgot. They are.

Maybe you should work for someone more trustworthy.

Health care is part of your compensation package. If your employer is overcharging you for it, that's just reducing your salary, making it easier for other companies to offer you a better deal.

I don't see that as a huge problem post-reform, when we won't be locked into the few jobs that still offer a plan. Competition will work that out once the healthcare barrier is broken down.

Not just the primaries - we really need to focus on getting dems out for the non-presidential election cycles. More repubs than dems always vote in those. We've lost some good people because of that.

This is how a kick-ass public plan could totally change the nature of the health care insurance world.

Combined with strict regulations of all the parties involved and a common medical IT system and we will have addressed half the problem. The other half is changing our lifestyle choices and becoming healthier as a nation. We need to change the way food is grown and the way livestock is raised. It appears we'll have to regulate portion control by way of strict caloric standards for a meal served at a restaurant. The whole country needs some serious education on this issue.

Failing that, no amount of health care reform will save the system from an entire nation has so much food it is killing us with a variety of chronic and expensive diseases.

You have a point there. As long as they are healthy, they would want the subsidies the government would pay out for the poor. But of course, the poor often have many more health issues that are a direct result of their poverty.

this wouldn't surprise me in the least. I have come to expect HTIB (Yglesias's term - hyper timid incrementalist bullshit) from this President.

He knows the right thing to do - but doesn't have the ability to lead all his fellow corporatist dems into actually making meaningful changes.

Obama knows we should have Single payer Universal Healthcare - like Britain or France. He just doesn't feel like fighting the good fight for the ideal solution. He could crack his whip and get the Dems into line - using fundraising/primary threats - but he doesn't really care enough to engage in the dirty work that is needed.

So we'll get a similar result as the stimulus package: start with a plan that is inadequate to meet the problem, then bargain away most of it to a few Republicans who don't have any power, then negotiate more of it away to the damn blue dogs, and corporate Dems. Then claim victory, knowing full well the solution is completely inadequate to solve the problem.

This beautiful and informative article, thank you very much.
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