Published: August 20, 2009 01:12 am      

Dems will decide health care debate

In the end, the debate over health care reform will come down to Democrats vs. Democrats.

The vast majority of Republicans have made it pretty clear that they aren’t going to vote for a health care plan in any form, so the trick is for Democrats to reach a consensus on what sort of plan they’re willing to support.

And therein lies the problem.

Moderate Democrats, particularly in the Senate, have been balking at the idea of a public option. They’re worried about the cost, and they say they’d like to see health insurance remain in the hands of the private sector.

Liberals, on the other hand, favor a plan that would put health care entirely in the hands of the federal government. They see the public option as a compromise, and at least so far, they say they’re not willing to compromise further. Without some government role, they say, there really is no reform.

The Obama administration has upset the liberals in recent days by saying that the so-called public option really isn’t essential. Administration officials have indicated they might be willing to accept health care cooperatives instead.

The question is whether such co-ops would have enough negotiating clout to help consumers without threatening private insurance companies.

As a nonprofit, member-owned group, a health-care co-op would assemble a network of health care providers and negotiate payment rates with them.

Membership would be strictly voluntary. Consumers would decide whether a co-op’s costs, coverage, provider networks and other features were superior to those of private plans.

It’s not clear what effect such co-ops would have on private insurers. Proponents say co-ops would force insurance companies to be more efficient and fair, but they say the co-ops would not have enough advantages to threaten good companies.

Co-ops so far have had mixed success. Many have failed because they were unable to compete effectively or because they could not resolve tensions between doctors and consumer-oriented governing boards. But some, including a co-op in Washington state, have operated successfully.

At this point, it appears that the U.S. House of Representatives will approve a measure calling for a public option, but the odds are that the Senate will not.

If you have an opinion on the issue, now would be a good time to let your congressman and senators know.



– Pharos-Tribune, Logansport, and Kokomo Tribune