Co-op Kay?

Could the pressures of corporate apologists be getting to the junior Senator for North Carolina?

But asked if she thought such as public option was necessary for the public health care overhaul, Hagan replied: "I am going to have to wait and see what the Finance Committee puts forward from the cost standpoint to really analyze that."

::

Hagan also seemed to be open to the alternative idea of allowing the states to set up health care co-ops patterned after electric co-ops. She said she had given that idea some thought several months ago and noted that Sen. Kent Conrad, a key committee chairman, favored the idea.


Oh joy, a state co-op! Maybe it'll turn out to be as great as Electricities, the North Carolina power cooperative with the highest rates and the crappiest service in the state.

I'm hoping the Dome is doing some sloppy journalism with that last paragraph. What does it mean that she "seemed to be open" to the idea?

Does anyone know anyone in Hagan's office who can get a straight answer about something? It would be nice to know if the Senator is still committed to helping people more than she's interested in helping big business. I'd call, but they never respond to my questions, so I don't even bother any more.

Co-ops are a half-assed solution that no one really likes. Throwing them into the mix, especially in hopes of getting the other side onboard, is just plain stupid.

Comments

Co-ops sound so reasonable on the surface

but scratch an inch deeper and there's not a shred of evidence that they'll do anything to influence the cost structure of healthcare, cover millions of uninsured, have lower administrative and marketing costs, or actually work in real life.

North Carolina's main experience with a co-op model is Electricities, which has proven itself in recent years to be incompetent at everything except for having parties in Myrtle Beach.

I hate the term "co-op"

I guess many here will not agree with what I've got to say on this, but I must say it anyway out of conscience.

Government must be involved in our health care system as I've said here a number of times. Those that cannot afford health insurance in our country should have that availability.

With that being said, I disagree that we should have any kind of "single-payer" plan ala government-payer plan. Our government is just ill-equiped to handle such a huge undertaking and it would most certainly be full of problems ranging from abuse to politics in how it is administered. That isn't from a democratic or republican perspective, it is just from a realistic perspective. After all, if a government plan or better put a "single payer" plan directed by the government is passed, republicans may very well once again gain control and that would mean they could (not "would") change how this is administered.

I don't like the term "co-op" when it comes to my belief that each state can and may very well be able to develop a health care plan that would see a huge number of state citizens involved in coming together with insurance companies in a group so as to have "group coverage" much like industries have now. I know from my employment that I was put into a "group" and the cost of coverage was determined by how that group performed with regard to health costs. That kept costs down and it could very keep costs down under this as well. Yes, government has to continue its efforts to control abuse and has to maintain vigilance with regard to overcharges by doctors/hospitals. Government has to enact legislation to keep costs down, that's the key. Follow-up on this has to be first and formost.

Now, don't get me wrong. I still know that those in our country that just can't afford health insurance under this kind of plan should be afforded "vouchers" to pay for that. It is only right and only fair. I have absolutely zero problem with that.

If we ask our government to manage a health care system so huge that it entails everyone in our country, we're asking for more than they can deliver for us. It is just not feasible.

There are more than 45 million Medicare beneficiaries today

whose healthcare coverage is managed by a government agency. From all I can tell, the vast majority of those enrollees seem pretty happy with the basic service. They'd be happy with supplemental coverage, too, if Congress hadn't hand-cuffed the plan from negotiating with providers.

I've seen excellence in government service ... and I've seen pathetic government service. Republicans want to make sure that whatever comes out of all these negotiations is crappy so they can say, "see, I told you the government can't do anything right."

What's wrong with this country that we can't have an American Health Plan that rivals the best in the world? Are we just fatally stupid or incompetent? Or are there simply too many people who want to see government fail at any cost.

(Except when it comes to war, of course. Then we're all ga-ga about government service.)

I do understand your position here James

I just cannot fathom a U.S. government being efficient and "fair" and "just" when it comes to putting everyone in our country on a single-payer, government-controlled health care plan.

I agree that government should be involved when there are people that cannot afford health care on their own. But, even though the majority of those on Medicare like the government system, it is underfunded and it faces a great many challenges when the babyboomers enter the system. I am 64 and will enter the Medicare system soon. I actually look forward to that. Hopefully it will not be busted by then and hopefully I won't have to face the "donut" and hopefully I will be able to afford Part B and Part D. There is more about Medicare than meets the eye, James. In addition, Medicaid is in a budget crisis and that is what states pick up when illegals go to the emergency room and have to get extended medical care as well as many of our "single parents" and their children and so forth. Again, it is underfunded. What is going to happen to that and how will Obama's health care plan shore up those problems?

I guess I sound like the "devil's advocate" here but I am not. I am asking legitimate questions and although I SOUND like a repub, that's the farthest thing from the truth.

Hard to address quickly

I just cannot fathom a U.S. government being efficient and "fair" and "just" when it comes to putting everyone in our country on a single-payer, government-controlled health care plan.

The White House has taken this off the table. Having said that, our "single payer system" of Medicare is larger than the single payer system of Canada according to Congressman Price.

But, even though the majority of those on Medicare like the government system, it is underfunded and it faces a great many challenges when the babyboomers enter the system. I am 64 and will enter the Medicare system soon. I actually look forward to that. Hopefully it will not be busted by then and hopefully I won't have to face the "donut" and hopefully I will be able to afford Part B and Part D.

There are two big problems with Medicare. The first is that because the costs of the health care system continue to rise at astronomical rates, its hard for Medicare to keep up. That is even with the fact that spending on Medicare has increased slower than spending on health care in the private sector. Second, Medicare is unable to negotiate for lower prescription drug prices thanks to George Bush's friends in 2003. Those same friends came up with the donut hole idea.

If you don't like the idea of the donut hole then support this bill. It immediately covers half the gap, and will eliminate it entirely in the next 5 to 10 years.

"Keep the Faith"

I don't support nor do I oppose the bill, actually

Thanks for the information Blue South. I just see a problem in funding and you are right about some of the reasons we are having a shortfall in Medicare. Can't some of those things be corrected through some kind of legislation? Good to hear what you are saying about that donut hole since I have a chronic problem that could eventually run up my "usage costs" getting me to the point of going into the donut. I hope not, but I know many people on Medicare that are concerned about that one part of it. I think a lot of people are waiting to see the final product on this bill before they get all reactionary as some have done so far. I am one of those.

Funding

If you are talking about the initial bill, then it has to be revenue neutral or the President won't sign it.

But long term, the nice thing about the bill is that it will help to rein in some of the increasing costs in Medicare and Medicaid, but more importantly the public option will be funded largely by premiums paid by members. That is why its essential we have a strong public option that allows anyone who wants to to buy in on day 1. If we do what some "moderates" want and restrict who can buy into the public option it will continue to require government money to sustain itself. But if its passed like the House bill has it with actual premiums from working people it will be large enough to sustain itself without an annual expenditure from the federal government.

"Keep the Faith"

Republican leader Rush blasts Co-ops

Don't Fall for Democrat Head Fake, Obamacare Still Must Be Defeated, August 17th show.

SEBELIUS: What we don't know is exactly what the Senate Finance committee is likely to come up with. They've been more focused on a co-op, a not-for-profit co-op as a comm-petitor as opposed to a -- a straight government-run program. What's important is choice and competition and I'm convinced at the end of the day the plan will have both of those but that is not the essential element.

RUSH: I'm sorry. She doesn't believe that. She's a liberal. Choice and competition is not what they want. If they want choice and competition, then the government should get out of this altogether and let the private sector do the reform. Let the market take care of it. They don't want competition and choice. And these co-ops like we're too stupid to know what that's all about. Co-op? Why don't they just call them communes? Look, I know liberal lingo when I hear it. A co-op? Yeah, let's go to the farmers market. Let's go to the community garden! What, do they think we're idiots? They said they want to cover the uninsured. We can do that without doing this. They said they want competition, they said. Okay, great, we can do that, too. But they want single payer and they're not going to give up and there's no competition in single payer.

See, it really doesn't matter what your voting record is Kay, Republicans won't vote for you because you don't have an "R" behind your name.

Just read the comments on this article on the Fayetteville Observer.com . Except for Doris, everyone including the editorial page editor, Tim White, gives Huddelston a pass on his misrepresentation of his opponents record.

Republicans and their corporate media will allow this over and over again. It's not about what's best for "We the People", it's all about having more Republicans in office...PERIOD!

Non-profit vs Co-Op

Blue Cross and Blue Shield of NC is a non-profit. I have never really understood why it did not operate as a co-op in the interest of its subscribers. That it has overhead, executive salaries, board stipids,etc that eat up overhead similar to that of for-profit insurers shows how a Co-Op might operate. We go after United Way Chapters for similar behavior. At a Chamber Health Forum here in Catawba Co we were told that insurance company profits were just 3%. The sposkesman did not mention that insurance company overheads, including lobbying against reform at $1.5 million per day, amount to about 15% compared to Medicare overhead of 1.5 to 3%

Easy to understand

BCBS NC made 180 million in profits last year.

Their CEO made a salary of almost 4 million dollars, and the other top 10 executives made salaries at or above a million dollars.

Its easy to see why they don't operate as a co-op when you see those numbers

"Keep the Faith"

Salaries instead of profits

That's a good point about overhead, Steve. There are a lot of games that can be played with profit to minimize state and federal tax. If funds to support lobbying efforts were taxed at the same rate as profits, that would probably reduce the money being poured in to lobbying. But as it is now, clever management knows that money used as an expense to persuade lawmakers is a good investment for higher salaries in the future. And legislators who've become dependent on corporate money are reluctant to pass any sort of legislation that will kill the goose.

Medicare 2.0: H.R. 676

dont get your hopes up about co-ops. The need a half million members to be financially feasible.

Co Op is a give away to Insurance companies

Blue Cross of Blue Shield of NC has a 72.5% market share. When you look at individuals trying to buy coverage for themselves that number jumps up to around 95%. They use this monopoly to exert pressure on providers and push out competition. In 46 out of 50 states one company controls 40% or more of the market.

A co-op does nothing to stop that monopoly.

Only 2 co-ops for health insurance still exist in this country, with dozens upon dozens having failed. When these new co-ops fail because of monopolies like BCBS of NC we will be in even bigger trouble, because of the new personal mandates. Requiring people to get health insurance when there is an affordable government option that brings down prices makes sense. Requiring people to get health insurance when there are zero costs controls and only one option is criminal.

"Keep the Faith"

Co-ops also a diversion

They sound good in practice, but they would never work in theory:) That's meant as a joke, but the ambiguity also explains why things like co-ops, gateways, etc. have been thrown out there as half measures. They make surface sense until the deep questions of cost control and discipline come up, then the answers get cloudy. Insurance lobbies push for anything to divert attention away from the one thing that makes clear sense for the public, which is a government managed option, and we expend a lot of energy examining all these diversions instead of moving forward.

Good article, momaizo

The article explains the one thing about co-ops that makes perfectly clear sense.

Non-Profit??

How can a non-profit have $180,000 in profits? Were those profits taxed?? If BCBS is a non-profit under NC law, it seems to me it should be required to provide the lowest possible cost service to its subscribers. Who but it's subscribers and participating health care providers has an interest in its management and board membership. Corporations are ultimately controlled (in theory at least) by their Stockholders. Who controls BCBS of NC? Who tries to limit their overhead? I do not hear that doctors and hospitals are getting excessive payment from BCBS of NC. It seems to me that with the monopoly status of this non-profit in NC, we should have amongst the lowest health care costs in the nation.

It is taxed somewhat

180,000,000 in profits in 2008, and they were taxed on some of it.

But they have no real stockholders or anything because of their non-profit status that I know of.

They tried to become a non-profit a few years ago, but the state said they would have to pay back the almsot 2 billion dollars in cash reserves they have that was set up with state money (and which they are required to have something like 500-750 million by dept of insurance regulations). They decided they didnt want to do that.

"Keep the Faith"

State Charters of Non-Profits

I think every organization, for-profit or non-profit, that is chartered by the state has to file a set of bylaws or a charter that defines who controls the fate of the organization. Yes several years ago, BCBS of NC did attempt to redefine itself as a for-profit and was rightfully blocked. I assume that attempt involved "giving itself" to some group of individuals. Many states tripped to this and allowed their BCBS to "give itsef" to key employees and other "interested individuals and entities" (of course none of the recepients were politically connected). The same was attempted, with more or less sucess, to many Credit Unions. I guess this was sort of like when Russia gave away its steel, oil and other state enterprises. So anyway I wonder how the BCBS of NC State Charter lays out control for that entity??

Sell it to the state

Why don't We the People buy BCBS and United and turn them into our national public option? Give them some money up front, hell, give them a BUNCH of money ... but tie their real upside to making it work over the next twenty or thirty years. That would be fun.

"We the People"

should go for it. Sounds like a interesting plan. I might be willing to chip in, but you'll have to convince me that it's going to be worthwhile.

----------------------
"The natural wage of labor is its product." -- Benjamin R. Tucker
A liberal is someone who thinks the system is broken and needs to be fixed, whereas a radical understands it’s working the way it’s supposed to.

Sorry, Doc.

If you think the idea has merit, get behind it and make it happen, make it better. Winning the support of people who say they need to be convinced doesn't strike me as a good use of resources.

Come on, Quigley. Just jump in, damn it.

Details

Hey, you can't expect me to just spend my money to help make a big purchase like without some clear details about how the new system will work. I'm willing to make things better and put my own money on the line - anything short of violence is fine by me.

----------------------
"The natural wage of labor is its product." -- Benjamin R. Tucker
A liberal is someone who thinks the system is broken and needs to be fixed, whereas a radical understands it’s working the way it’s supposed to.

Good question

"So anyway I wonder how the BCBS of NC State Charter lays out control for that entity??"

If it's a nonprofit isn't there even more reason to funnel money into anything other than profit, to steer the revenues towards salaries, perks and public relations expenses instead?

I didn't know BCBS had such a large market share in NC. If that's the case then it makes sense that they are making a strong case with our representatives. And I can empathize to a degree with legislators who're thinking that BCBS is taking care of the lion's share of all this already and should be given a serious ear.

But I'll bet there are plenty of executives every bit as qualified to lead BCBS for a lot less than 4,000,000 a year. I'd gladly take on the responsibility for 1/20th of that and with the right contract I'd give the company the first year salary free. I'd plow all the money being wasted now on bloated salaries, perks, buildings and public relations (lobbying and propaganda) into reductions in premiums. I'd streamline the company so that it could offer insurance that's competitive with a public option.

I think that's what BCBS is going to end up having to do, anyway. And it really should happen.

I remember when the CEO of BCBS was on "NC People" with Bill Friday last year and the guy talked about his having graduated from East Carolina. I will never forget what he said - "I'm a Pirate." At the time I had a friend, a Chapel Hill grad, who was paying BCBS over $1200 a month in premiums for an individual policy because he'd been diagnosed with bi-polar disorder, even though the condition was regulated with lithium. I looked at the TV screen and thought to myself, "You sure are... you sure are a pirate".

i have a hard time understanding all the supposed...

soul searching for the 'right' system of health care. We are surrounded by all these single-payer type systems in the most civilized countries, and with the people 'not' complaining that they would like a system like the USA! I have been on Medicare for almost three years, plus I'm backed with my former Employees BCBS. Maybe I shouldn't have anything to complain about? But I still keep with this debate, because I hear all the bellyaching about having the gov't pay when people get sick. These same people don't bellyache about the hundreds of billions poured down a hole for the last few wars of choice, or the stiffing of the taxpayers for the executive bonuses of bailed out finance companies, and for that matter, these fucking parasites who are running these crooked heath insurance companies like they're are their personal piggybanks! No, it's always easier to stick it to the powerless! SO yes, I feel pretty insecure watching many friends over the years, who like myself stepped up when the country wanted me, and who did do the work for a career, and then lose their insurance backing when they're most vulnerable. People need to get together over this and not be misled by the scumbags who have their own agendas. It's really not that complex!

Not a good argument, denno

When you try to equate "These same people don't bellyache about the hundreds of billions poured down a hole for the last few wars" to what people either worry about or defend with regard to health care, you lose just too many people in the discussion because most folks know it is like comparing apples to oranges, so to speak. I agree that we have spent just FAR too much in our idiotic wars recently and continue to do so even under Obama, but that shouldn't be used to defend paying out what will most certainly be an enormous amount of money to ensure health care for all in America, regardless of the spin that is being put out against that these days.

We definately need a health care plan that gives everyone in our country an "option" and yes, even giving those people and families that can't afford health care a way to get it without losing their home or not being able to pay their daily-life bills. I will support something that is presented that does that. I just don't think that we should say: "hey, we spent billions on war, we should now spend billions on health care even though both must be looked at to get the best buy for the buck for our taxpaying citizens. War? I think we should just get out of Afghanistan and let that situation go wherever it goes and in my opinion we're not getting out of Iraq soon enough. But, that's just my thoughts on it.

Whoa !!

The way that fell here it looks like you are responding to me...Foxtrot. Man, you have misread my presentation big time. I know the insurance companies have raked us over the coals for many, many years now and I have said repeatedly here that there needs to be legislation/oversight with regard to that.

Maybe we just have our wires crossed or maybe you were responding to some other message.

Please explain where I don't understand this sentence...

'that shouldn't be used to defend paying out what will most certainly be an enormous amount of money to ensure health care for all in America'
Isn't that the reason we're having this national debate? We are spending 70% more for health insurance than the nearest civilized country, and yet we're down near #30 ranking by WHO. So what plan do you favor, if any. Or do we just let it go because it's another 'socialized'experiment like Social Security. If I misinterpret your position, please point it out.

I see where you've misinterpreted

I'm glad you answered back denno. By saying "that shouldn't be used to defend paying out what will most certainly be an enormous amount of money to ensure health care for all in America", I meant that I am convinced that eventually, even right away, providing health care for everyone in America with the public option will most certainly cost a huge amount of money the government will have to pay. In know there are arguments that it won't cost taxpayers any more than they're already paying out due to medicaid and so forth, but I am just not convinced of that. I might very well be wrong here and if this goes through as is, I certainly hope that when Obama says this isn't going to be put into affect unless it adds nothing to our national debt and/or expenditures already being paid out.

I consider myself pretty intelligent (pat on the back :) and for the life of me, I just cannot see adding in 40 million people with new government health care benefits not costing considering just the administrative costs let alone the benefits for those that will then be able to go to doctors all across our country when their kids get the sniffles or have a temperature or when they have back pain, well the list goes on.

Again, I might be missing something here. I'm man enough to be set straight.

And your answer to my question?....

I'll try one more time. What type plan are you in favor of having done? Or should we just forget it. I see you post a lot of comments with all 'anti' this or that, and it's always easier to be destructive, than constructive. Just answering about this being too expensive doesn't hold water. Social Security was passed in the depression, when there wasn't much money to be had. But the people that were sent to government had spines, and knew they had a moral issue, not so much economic.

I'll try

You are very right about many of my posts denno. I go right up to the line sometimes to try to get some dialog going about what the "anti's" are saying and thinking and yes, sometimes I have the same questions that some of the anti's have also on some issues. My feeling on healthcare/insurance reform in America, as I have said already, is that the insurance companies have raked us over the coals for far too long (number 1) and that we definately need to come up with a way to help those in our country that just cannot afford health care (number 2).

I am like a lot of people right now democrats and republicans alike that think that it is wrong to say "hey, we have to do something even if it isn't the best way to go" and that a gigantic bill may not be the best way so we should take some time with this very important issue. I don't know the answer to what we should have. To answer one of your questions, though, I would like the insurance companies to be reigned in and far better controlled with a great deal of oversight and I would like to see people in our country that absolutely cannot afford health care get it.

I'll have to work on my delivery here, because I have one more post (another issue) to answer up for where one of the other posters here took offense to what I've said. I am learning the hard way.

Obama promised health care 4 all as good Federal Employee Benes

Sen. Barack Obama (D-Ill.) said in 2007 at the beginning of his campaign, that, under his health care proposal, all residents would have access to "health care that is as good as the health care that I have as a member of Congress."