President Obama
Your speech was excellent! And, you have my full support for reform as long as it is real reform, not reform in name only. I'll just focus here on my suggested improvements.
You talked about the economic downturn. Great, but I would suggest making a connection between those economic conditions and health insurance reform. The fact is that genuine assurance of health care (single-payer) would be the greatest aid to the economy across the board for individuals, businesses small and large, cities, counties, states, organizations and anyone who employs someone or manages tax dollars and elements of the health care system. It would meet ALL of your goals thoroughly. I realize that we're not going to implement single-payer now, but the point remains. We're only taking half measures here, and, in absence of single-payer, a national government-run public option is essential.
You implied in your speech that it was only people on the left who favored single-payer. Not so - fully 75% of people favor at least a government-operated public health assurance option. A substantial number of those folks have insurance now and a substantial number must be conservative and moderate. Single-payer is not the far left idea you portrayed it to be. We, the citizens, have been very clear about what we want.
As it stands now, our plan is a boon for the for-profit health insurers who are not in need of financial help. There are some consumer-friendly changes to be sure. However, I caution that what is said in speeches be matched by what is in the bills. For example, I understand that, although we have been repeatedly told that people will not be excluded from coverage due to pre existing conditions, the bills don't contain that reform.
Your goals are 1) Security and stability for those who have insurance 2) Insurance for those who don't have it and 3) Holding down costs. Simply put, you cannot achieve 3) without the government-operated public health assurance option available widely.
Exactly what the public option will be, or even IF it will be, is unclear. For example, you said that it should compete with the private insurance programs on a level field by being funded primarily by premiums. That's fine, but next we were told that people who have private insurance cannot choose the public option. Thus, the only market in which it can compete is the uninsured market. That immediately means that it will provide no incentive for private insurers to control premium costs; in other words it won't be the competition we need. Simply put, the public option must be available to everyone. Co-ops just won't accomplish anything.
Another important aspect of controlling costs is to prevent insurers from charging differential premium rates for people based on pre existing conditions or other characteristics of the person " age, sex, etc. There is nothing in your plan about this at all. While insurers may not be able to deny coverage to those with pre existing conditions, what's to keep them from charging so much that effectively people are still bankrupted for being/getting sick. So-called "high risk pools are running the same scam right now. They are often the functional equivalent of "death panels.
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