most of us now realize that max’s plan didn’t work out very well, did it?

http://www.youtube.com/watch?v=pg7xhTyOtAk&feature=player_embedded#!

by problembear

the next citizens initiative i would like to see in the 2012 election cycle is for: Montana Public Option health care insurance. check this site out and let’s get the ball rolling here:  http://twitter.com/MTPublicOption

first order of business:

we should start drafting legislation that will enable employers of this state to pool their health insurance premiums into a public option insurance policy that actually uses the money for paying for health care for the insured rather than simply create more profits for private health insurance companies who are raising our rates and increasing our deductibles with impunity since max baucus’s gift to his friends in the health insurance lobby.

montana could enact legislation to develop a public option health insurance program which would:

  • lower most insurance rates by 33%
  • guarantee coverage for all insured who opt in
  • provide stability to employers tired of searching for decent HC plans
  • attract businesses to MT who want our plan for their employees.
  • increase participation of all health care providers who want in.
  • bring costs back in line with benefits for both insured and vendors
  • take away the uncertainty of dealing with private insurers.
  • make private insurers who do business in montana more competitive

now who can argue with that?

(besides max and his friends, i mean.)

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  1. The Polish Wolf

    That is such a good goddamn idea. Indeed, it ought to be run in every State next election – re-connect with the base, correct the failures of HCR, and make Max and the rest choose sides. It would be like the good twin of the Defense of Marriage movement in 2004.

  2. and maybe help in the race against rehberg???…..

    hello mr mcdonald? ……hello? anybody in there???

    @mcdonald4congr …. anybody at all?

    HELLOOOOOOOO????

    apparently no one is around since sept 17th. time is ticking away there folks. i can’t keep doing all the thinking for those expensive three piece suits posing as political operatives in the democratic party. i’m just one bear with a very simple brain.

    just one question…. how is rehberg going to win if he campaigns against public option and FOR the health insurance companies who are screwing us?

    put him in the same boat with baucus.and then sink the s.o.b.’s simple. sheesh!

    it’s not that hard to figure out if you get out and talk to real people out there in the state.

  3. Ingemar Johansson

    Or you could go this route.

    “A Tea Party activist is working to get state backing for a constitutional convention to pass a constitutional amendment that would give two-thirds of the states the ability to repeal congressional acts, such as the new health care law.

    “It restores a lot of the sovereignty and a lot of the power that the states have lost,” said Marianne Moran, executive director of RepealAmendment.org and *former executive director of Tea Party In Action.”

    Read more: http://dailycaller.com/2010/10/02/tea-party-affiliated-group-seeks-constitutional-change/#ixzz11JIFWhgK

    • JC

      Why do this, when you would end up with nothing?

      The new HC bill gives states the power to opt out of the national system, and setup their own and tie into federal revenue streams.

      People without healthcare want to fight for a sensible system that gives them access now, instead of fighting abstract ideological issues like sovereignty.

      That’s what t-partiers just don’t get. Not everybody wants to follow them down the rabbit hole.

    • there are reasonable people in the tea party who might like a private non-profit entity that gives them another option besides private insurers to get their health insurance. but repealing baucus-no-care would serve no purpose since Montana Public Option could work within the framework of that bill just fine.

      i know quite a few tea partiers myself who would welcome a private non-profit alternative to their current health care plans. one guy owns a small trucking firm in conrad. another guy is a private contractor ceramic tile setter in greenough. both of them have lousy blue cross plans with huge deductibles and crushingly huge premiums. but really, party should have nothing to do with this. everybody needs affordable and dependable health insurance. it should be a plan for all montanans who want decent health care with less worry.

  4. The Polish Wolf

    What purpose would that serve, exactly? First of all, the will of most Americans is not to repeal the bill, but expand it. Why would you introduce another mechanism to veto laws when the problem is that the system doesn’t allow for the passage of laws the majority wants?

    Also, the most populous third of States has two thirds of our population. Another governing body based on sheer number of states, not how many people they represent, will just be another Senate, and if HRC demonstrated one thing it’s that representation by State isn’t the best way to hear the will of the people.

    All that said, it’s an interesting idea and I’m glad you brought our attention to it.

    • JC

      You work within the federal system, as it has been reformed.

      But you do it at the state level, and outside of the mechanisms and mandates that have been enacted at the federal level for a national plan.

      Without getting into the details, their are provisions for states to go their own ways.

      So we need to avoid the battle with the feds, and all they have/haven’t done with this issue. Otherwise its t-party vs. sanity, in a political battle to unseat Obama and the dems. WHich is where Ingemar is trying to lead us.

      • one advantage of a private non-profit is that after it is successful, it can reinvent itself state by state much like blue cross did before it went evil.

        of course, the charter for Montana Public Option would include the proviso that it will always remain a non-profit and it cannot ever be sold to insurance companies like Wellpointe who absorb it into their network and create a monopoly in the states where they operate to increase profits.

        ronald reagan himself encouraged the creation of private non-profits in the early eighties to get government out of the charity business altogether, and most of that idea has born excellent fruit. everywhere you look private non-profits are providing shelter for homeless, food for hungry and countless other services that government once did. i see no reason why we should not create a private non-profit that gives montanans a decent health care insurance alternative.

        the purpose of the citizens initiative would be to provide tax credits and vouchers and tax breaks for those who participate. for instance, if my friend with the trucking business wants to opt in to Montana Public Option, he could get a tax break for providing this to his employees. also, if someone is currently on medicaid with the government and he/she would prefer Montana Public Option, then he/she could get a voucher from the state that allowed him/her to pay to join MPO instead.

        also, tax credits are used by investors to build affordable housing. i see no reason we couldn’t use tax credits to leverage investors into providing a lot of the infrastructure and initial investment needed to implement it.

    • The Polish Wolf

      My above comment was to Ingemar, btw…sorry if that was confusing.

  5. JC

    Nice article, pb. The firest step, though is to analyze how the new HC legislation allows states to craft their own plans.

    My quick take is that this would have to be a multi-faceted approach. You don’t enact legislation via a CI (constitutional initiative)–that just amends the constitution.

    I think that a simple, one concept change to the constitution to allow the setup of a montana public health authority may be necessary (but I’m not sure if it is essential).

    That would be paired with a regular initiative laying out the conceptual framework for the public health authority and how it will be funded.

    There’s a lot of different ways to get to a state public health authority. I think the first thing to do is to drop the term “public option” as it was the lightening rod during the federal debate, and referred to a federal program. And bill this as an alternative to a federal mandate.

    As with the flak from the right already having started with Ingemar’s attempted diversion, the focus needs to be on a Montana solution within the federal framework. If Max wanted a “uniquely American” solution to the health care crisis, let’s give Montanans a “uniquely Montanan” solution.

    So how it is presented early on will pretty much guide the debate. And the best way to do that is to contrast it with the unsavory aspects of the federal bill (mandate enforced by IRS, faux-universal, private-only system, etc.) and construct a state alternative that captures the interest of a majority of Montanans. It should be truly universal.

    Here’s how you market it (this is a silly example, maybe)–take a good acronym (ThUMBS) and pair it with a good graphic (a thumbs up) and blanket the state with it.

    The
    Universal
    Montana health
    Benefits
    System

    As I said, that’s a bit silly, but it is positive, and gets the point across.

    • thanks jc. good suggestions. would it be necessary for an amendment to the constitution to enact a private non profit system separate from the government?

      i trust private non profits with a board of representative citizens much more than i would something controlled by politicians and parties and such.

      i guess what i am envisioning would be drafting an initiative that gives some authority by the people to provide a start-up fund to initiate it. not sure i agree that public option is necessarily a bad name. public means it is a private non profit open to everyone and option means you can choose it or your private insurer.

      • JC

        Well, the fed bill did this:

        “The Affordable Care Act calls for the establishment of the Consumer Operated and Oriented Plans (CO-OP) Program, which will foster the creation of qualified nonprofit health insurance issuers to offer qualified health plans in the individual and small group markets.

        to get private, nonprofit plans onto the exchanges.

        Also, states can initiate a Basic Health Program (modeled after Washington’s) as an alternative to mandating people onto the exchanges. And starting in 2017 they can apply for waivers from the fed system, altogether.

        • People thought that insurance companies could no longer refuse coverage for preexisting conditions, starting now. Turned out not to be the case.

          Do you really believe that in 2014 the insurance companies are going to allow public competition?

          I don’t. There’s got to be a catch. They didn’t write this bill to allow competition.

          • that is one reason to propose this as a citizens initiative. it should by the way be proposed as bipartisan. party politics kill too many good ideas in this country. in fact, i believe party politics is actually killing the country period. it is turning regular people away from politics entirely.

            Montana Public Option should be independent of both parties and yet invite all to join in the cause individually.

            • JC

              I still think using the term “Public Option” is going to start a political war.

              Pubic option is synonymous with “a government ran plan” which is what ignited the Tbaggerz (at the behest of their corporate funders and handlers) protests.

              A nonprofit coop is owned by, and ran by the people. That’s a 180 degree turn around from the notion of a federal “Public Option.”

              A better term would be “Montana People’s Option,” or “Montanan’s Health Option,” or some such. I’m not tied to what it could be called, but I have strong feelings on what it shouldn’t be called.

              Believe me, words mean everything in this battle, and carrying over all that baggage from the national fight is a waste of time and energy.

              • rats! i was hoping to get Ron White to help us get the word out and he says PUBLIC so well….

              • The Polish Wolf

                “People’s Option” has some unfortunate connotations as well – like a “People’s Republic”.

          • JC

            Yeah, I’m sure there’s going to be lots of surprises going forward.

            Once the insurance cartel got their hands into the public trough (subsidies), I’m sure they’re going to work to keep healthy people out of the nonprofit coops. How they accomplish that, I’m not sure.

            But when healthy people start leaving their private plans for the nonprofit coops (because they’ll be cheaper and with better benefits), they are going to get nasty.

            • by the way, if any UM law students or pro bono attorneys out there who may want to investigate how we can draft this “whatever it is we decide to call it” Montana Health Insurance Plan for a citizens initiative campaign in 2012 please contact me at problembear@vzw.blackberry.net

              thanks

              J.C.- do you want to serve as board chairman? i don’t mind kicking it off but bears work better alone.

              my first grade teacher got it right in 1960 …”does not play well with others.” hence the name problem which predates the internet by quite a few decades.

  6. Good idea, and I hope it gets traction. It is not only good public policy, but also a great organizing tool.

    The key to a functioning public option is adverse selection. Montana already has a PO in a sense, called MCHA, but it has one big problem: You must be unable to get insurance in the private sector (or it must be non-competitive). This guarantees adverse selection, sky-high rates, and low participation.

    So your plan has to be crafted in such a way that it is a viable first choice for clients, and not a fall-back after refusal by private insurers.

    Man are you grabbing the wolf by the ears. Kudos.

    This is why the so-called exchanges that open up in 2014 will fail, and why the “elimination” of preexisting conditions now has not changed anything now.

  7. just as a refresher for everyone- this is the best few minutes you will ever spend on learning more about why we need to create our own Montana Health Care plan …..

  8. Ingemar Johansson

    Screw the public option. Why would Montanans want to pay for alcholic chain smokin’ crack whores.

    Better yet why don’t you put the screws to Blue Cross/Shield by repealing McCarran-Ferguson. Via Ann Colter:

    “In the first sentence, Congress will amend the McCarran-Ferguson Act to allow interstate competition in health insurance.

    We can’t have a free market in health insurance until Congress eliminates the antitrust exemption protecting health insurance companies from competition. If Democrats really wanted to punish insurance companies, which they manifestly do not, they’d make insurers compete.

    The very next sentence of my bill provides that the exclusive regulator of insurance companies will be the state where the company’s home office is. Every insurance company in the country would incorporate in the state with the fewest government mandates, just as most corporations are based in Delaware today.

    That’s the only way to bypass idiotic state mandates, requiring all insurance plans offered in the state to cover, for example, the Zone Diet, sex-change operations, and whatever it is that poor Heidi Montag has done to herself this week.”

    • JC

      You’re a wealth of contradictions today, IJ. First youtalk about restoring “the sovereignty that states have lost” then later on you lambast “idiotic state mandates” and advance an idea that negates state sovereignty.

      Like I said earlier, you just want to make health care into a moral based wedge issue by deflecting the conversation off onto political, ideological tantrums.

      But you know, you are in a radical, extremist minority, and most people want to see a sane health care policy enacted that doesn’t just downgrade insurance to that of the lowest common denominator (Delaware based corporations, i.e). And something more than just a society that is based on a highly structural income inequity system that allows access to health care based on some weird merit system based on income, and one persons idea of moral choices.

      • The natural “free market” result of people crossing state lines to buy insurance will be a flow of customers to the cheapest policies, which is natural during budget squeezes, which is all the time. As a result, they will buy the weakest policies. Only later will they find that “cheap” insurance costs more than its expensive counterpart.

        The whole private insurance game sucks, but the state lines battle makes is suck even more.

        • Ingemar Johansson

          Kinda like car insurance, Mark?

          Do you buy local?

        • This is a perceptual problem – to equate health insurance with property and causality insurance.

          P&C insurance works because payoff events are relatively rare – houses seldom burn down, and odd as it seems, car accidents are rare too. Consequently, rates are low and participation is generally done on a voluntary basis by people who don’t plan on making claims.

          In health “insurance,” it is virtually guaranteed that we will all make claims on the insurers at some time, especially as we age (which is why insurers dumped old-age health coverage on government.) A better model for coverage is a universal pool run by a non-profit entity -either government, or tightly regulated insurance companies. In this manner, we are not playing the “insurance” game where we try to avoid risk, but the “retail/wholesale” game. Everybody is covered, and rates and costs are kept down because there is no longer any reason to play hide and seek with sick people. (Cost avoidance is a large part of what drives our costs sky high.)

          Enuf. IJ – a primer, for you, I hope it sinks in a bit.

          • Ingemar Johansson

            PC and HC insurance can’t be that far off.

            First of all houses seldom burn to the ground-is that rate comparable to terminal cancer/illness?

            Especially when applied to some one making healthy choices?

          • JC

            You just don’t get it, Ingy. Maybe 1% of people will make a claim on their car/homeowner/renters insurance every 5-10 years. 100% of people will make a claim on their health insurance.

            One insures things. The other insures our body. We can do without one, but not the other.

            Youwhine about moral and lifestyle choices. What about the people who get diseases and injuries that are no fault of their own, but yet are precluded from buying insurance on the individual market because they have a preexisting condition (like say, asthma, which is genetic)?

  9. This is a discussion about a citizens initiative.

    I’m not going to waste any more time with a corrupt congress.

    And it needs to include everyone who wishes to opt in.

    • Moorcat

      What bothers me about your comment is that you are conceeding congress to the corrupt SOB’s that WE have elected. Sorry, but I don’t accept that. We need to work harder to elect less corrupt individuals and hold those we do elect to a higher standard.

    • The Polish Wolf

      There is the basic problem of economics – how do you offer care at a much lower cost than insurance companies?

      One advantage of course is cutting out corporate profits. And that could be accomplished by using the government, since the government has no pressure on it to show a return on investment, so it can put up start-up capital and then offer health insurance at-cost.

      The problem is that at-cost may still be too expensive, hence the high premiums that accompany covering people with pre-existing conditions.

      What is really needed is for us to spend less money on health care, period. And that means a couple things – preventative care and screening to keep people from needing more expensive treatments, for one. Better efforts to prevent obesity would be another. All of these are public policy efforts that need to be addressed.

      • i know it is a challenge, pw but i cannot help but believe that with the right people in montana working on this for the right reasons we should be able to improve what all the wrong people in congress screwed up for all the wrong reasons.

        i think it is worth a try.

  10. The Polish Wolf

    Definitely, and even if we just cut out whatever profit margin the insurance companies run, it’ll be a big improvement. It would help if we also as a society realized that our lifestyle choices do have consequences, and that in an insurance-based system those consequences don’t just effect us as individuals.

  11. Ingemar Johansson

    Yeah, that morality thing always gets in the way.

    So tell me JC, do you think Montanans as a majority would want to pay for chain smokers, drunks, drug addicts, sexual risk takers especially after those people know that the hospitals and clinics will welcome them with open ams?

    Didn’t we learn the lessons of “no-fault car insurance”?

    “The study compares auto insurance premiums under three different systems: no-fault[endnote 1], personal responsibility[endnote 2], and hybrid/choice[endnote 3]. According to the analysis of premium data as reported by insurance companies to the National Association of Insurance Commissioners:

    Premiums are 19% higher in no-fault states than in personal responsibility states.
    Seven of the ten states where auto insurance was most expensive in 2002 had no-fault or hybrid/choice systems.
    States with some form of no-fault insurance are consistently a majority of the highest priced states in the nation, forming six to eight of the top ten every year since 1989.
    Auto insurance premiums rose 92% faster in no-fault states than in personal responsibility states between 1998 and 2002.
    Six of the ten states with the greatest premium increases between 1998 and 2002 have mandatory no-fault systems.”

    And finally I don’t care which path you take state mandate or state sovereignty, any one is better than PO or our current mess.

    • JC

      There you go again… equating cars with bodies. You can’t look to car insurance as a method of analyzing health insurance. But go ahead and delude yourself. I never deny a right wing crazy a good fantasy every now and then.

      “do you think Montanans as a majority would want to pay for chain smokers, drunks, drug addicts, sexual risk takers “

      Know anybody in one of them categories Ingy? Do wish them to get health care and get well? Or would you just rather they crawl off under a bridge and die?

      You pass out moral judgements like they’re going out of style. The last thing I would ever want want is someone who is so willing to hand out life and death sentences–based on their own personal moral predilection–have anything to do with the creation and implementation of health care policy.

      You know, Ingy? That person you describe above may someday be you, or your parents, or your kids, or another relative. Are you still so willing to sentence them to death by excluding them from the health care system?

      • Ingemar Johansson

        I’m just preparing you for the mountain you’ll have to climb.

        I don’t think Montanans as a whole will be willing to subsidize bad or unhealthy behavior. I think the majority think a PO option is a black hole when it comes to funding-you can blame this adm. (and Max) mostly for that impression.

        Good luck. But if I where running the opposition to this proposal my ads would show abusers lining up for treatment, counseling, needle exchanges, paid for by the working responsible members of the MT electorate.

        • well, i appreciate the devil’s advocacy, IJ. and that phrase of yours never fit so well as it does when i edit it just a bit….for my commercials…

          “…my ads would show corporate ceos lining up for subsidies, preferential treatmen, and a complete monopoly on our health insurance , paid for by the working responsible members of the MT electorate.”

          i see you support more of that good old republican “personal responsibility” while you support private health insurers in their own bad behavior in their ruinous continuation of record profits supported by our government.

          so i guess corporations are persons when it comes to being able to influence our government to provide them with a greased slide to easy money, but corporate thieves cease being persons when your version of “personal responsibility” is pointed at the most vulnerable and the poorest of us.

          i, like you believe in responsibility and in not rewarding bad behavior. we just differ in who we choose to punish.

          i say we should develop an option for people that makes these vultures more competitive.
          what say you to that idea?

        • JC

          “I don’t think Montanans as a whole will be willing to subsidize bad or unhealthy behavior.”

          We already do. In oh, so many ways. Keeping sick people from getting needed health care only exacerbates the problems.

          In Montana, the cost of alcohol abuse is in excess of 642 MILLION DOLLARS. The cost of alcohol abuse in Missoula County is 73 million.

          So let me get this straight. You’re willing to deny sick people getting the treatment they need to get well, because you think it might cost some money? Have you considered that it might be money well spent–an investment that lowers our overall social costs of alcohol and drug abuse?

          What’s your alternative to reducing the social costs of alcohol and drug abuse? Hasten people’s death by assuring they can’t get access to health care and treatment?

          And none of that dollar amount included the following (from the BBER’s report author Steve Seninger):

          “We have to remember that these costs are the financial ones and do not include the toll on families and communities in psychological and human suffering,” Seninger said. “Each year as a consequence of drinking and driving, children die, families are torn apart and people’s lives are shattered.”

          It’s easy to be a cold-hearted bastard. But your moral outrage, and anti health-care reform stances will assure that people suffer, and Montanans accrue massive social expenses ($$$) because some people think it is better to make a moral argument against certain people, instead of looking at a problem in its totality, and working together to find ways to solve them.

          • Ingemar Johansson

            PJ O’Rourke quote.

            “It you think health care is expensive just wait until its free”.

            • then i assume ij, we can put you down as against competition in the marketplace when it comes to health insurance…..

              but for government subsidization of same.

  12. this is interesting http://tpmdc.talkingpointsmemo.com/2010/10/daschle-admits—-then-denies—-that-white-house-agreed-with-industry-to-scrap-public-option.php

    i knew they were just jerking us around!

  13. Chip Bull

    Lots of complaints regarding max, the ACA and the lack of a PO. One thing that should not be forgotten is that the ACA does one very important thing — provides an alternative to the worst health insurance program in the world, the one we have now. For you public option advocates pay close attention to the Montana Health Care Exchange it has the potential to provide at a pathway to “THUMB”‘s up Montana plan. …… C Bull

  14. chip – the woefully misnamed Affordable Care Act which is usually known as Obamacare, does provide a few scraps of patient protection but at what cost?

    and funneling all the high risk clients to a Montana Health Care Exchange is no answer. what we need to do is to provide one truly affordable option for everyone. the only way we can to that is to provide an option that saves money but also is well-funded so that dependable health care insurance is provided.

    the ACA encourages private health insurers to sign up healthy clients and leaves the sick and high risk people to fend for themselves unless they qualify for medicaid. Montana Public Option would combine high and low risk clients into a sound but affordable plan which takes the complications out of the exchanges. most employers and their insured employees in this state want a simple plan which is affordable to join rather than enter into the government run exchanges which simply funnel you into thousands of pages of complicated plans, none of which seem to do what we really want- provide affordable stress free insurance with no complications.

    i believe montana voters are tired of listening to government bureaucrats and politicians with their lobbyists.

    it is time we create the health insurance plan we really want and can afford with a citizens initiative in 2012. politicians and bureaucrats only pay attention to us when we enact laws ourselves. the system of representative government which is our congress and our legislative bodies are no longer reliable for representing the will of the people.

    we must do it ourselves.




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