I probably don’t need to tell you that I’m deeply interested in the health reform debate. And lately I’ve noticed that the new buzz is all about “co-ops.” Before I jump in, this is what *I* think of every time I hear the word co-op:
Now that you’ve got that stuck in your head for the rest of the day, on to health care co-ops, which somehow seem way less fun than a community garden filled with puppets. The co-op plan has been presented as some sort of alternative to a public health insurance plan. The thing is, as Ezra Klein has pointed out, co-ops solve a POLITICAL problem, but not our actual health care problems. Ezra writes:
To put it bluntly, the co-op does not solve a policy problem so much as it solves a political problem. That political problem was, “How do you finesse a compromise on the public option?”
You could imagine a co-op proposal that actually offered a meaningful alternative to private insurers. Some months ago, Conrad, alongside public plan supporter Chuck Schumer, seemed to be edging in that direction. But I haven’t heard anything similarly encouraging since then. The co-op is now a favored alternative for Republicans who don’t agree that the profit motive is a problem in health insurance and who don’t agree that single-payer or Medicare-for-All represents an appealing alternative to the current situation. Given that constituency, it’s not likely to satisfy people who have the opposite perspective on all of those questions.
I wish I could spend this post enumerating the problems with the co-op proposal, except that, as the New York Times points out,
the co-op idea is so ill defined that no one knows exactly what it would look like or how effectively it would compete with commercial insurers.
As far as I can tell, every one agrees that not enough people are covered by our current health care system, costs are too high for the level of care received, and insurers are ill-inclined to listen to their policy-holders’ concerns or actually cover their care because they care only about profit and face very little to no competition for their market share. Solving this problem means creating an alternative, and it seems the co-op idea is about creating pools of people, much like the workforces of large companies which provide group insurance plans, to purchase group care from private insurers. This sounds like a half-assed, complicated, and expensive way to achieve exactly what a public insurance plan would achieve, but a public plan would achieve it with much lower costs (Kent Conrad, who proposed the co-op, says it is not a plan that would lower costs), with the added benefit of creating COMPETITION for private insurers, rather than just handing them more individuals paying premiums that add to their bottom line.
And would the co-op plan really solve the political problem with the public option, namely that Republicans and “Blue Dogs” say they won’t support it? Not likely. Steve Benen of The Washington Monthly‘s Political Animal blog notes that Republicans are already rebuffing the co-op plan as well, not to mention, “Republicans don’t support health care reform. Weakening the bill and scuttling good ideas to garner their support doesn’t make sense, since they fully intend to vote against literally any bill.”
I guess my major thought is, if you agree that insurers are a major part of the problem, if you agree that not enough people are covered, if you agree that we need to create some sort of alternative way to give people health coverage, wouldn’t you want to support the means of doing so that is most efficient, covers the most people, and cuts costs the most? That method is the public insurance option.
UPDATED TO ADD: This post can now also be tagged “Annals of South Carolinian Ridiculousness” because of good ole Sen. Jim DeMint(ed). DeMint apparently can’t tell the difference between a co-op and a public insurance plan:
Whatever they call it Neil, this is a government takeover. They may try to call it a co-op. They can call it a public option, but you know they’re all on record saying they want a single payer government system, so any Republican now that helps them pass a bill is helping them pass a government takeover of health care.
All the more reason to scrap this stupid co-op idea and go with REAL reform which includes a public option. I guess this means that DeMint won’t be taking to heart the letter I wrote to him last night expressing my wish for a public option.