Senator Nelson and the Public Option

UU.S. Sen. Nelson says “public option is dead,” believes Co-Ops will be possible alternative for nation’s 47 million medically uninsured

U.S. Sen. Bill Nelson, D-FL at the Greater Miami Chamber of Commerce monthly luncheon Wednesday said when it came to a comprehensive change in health care delivery and medical insurance being debated around the country, the Senate; a smaller body will likely craft much of the final product and believes it will involve the use of medical insurance “co-ops that are owned by the policy owners.”
Senator Nelsons support for a co-op sounds more like a cop out.
What does he really support? Few politicians can clearly define either of both entities. The only thing they know that it’s politically less risky to use the term co-op than the perceived evil word “public option.”
So what would it be? Insurance co-ops or health insurance purchasing co-ops?
An insurance co-op requires sustained funding, must develop a large network of providers offering discounted health care services, develop brand identity, figure out how to handle claims, develop actuarial expertise, establish reserves, meet state licensing requirements and solvency requirements. Once a co-op passes all those hurdles it needs to attract and retain customers, lots of customers, to compete with existing insurance companies. In contrast, health insurance purchasing co-ops are based on the idea that consumers bargain with insurance companies to buy insurance. They’re not insurance providers themselves. Most of such initiatives failed to provide the desired benefits for their member.
So what’s left? 1) a solid public option offering an insurance option for those who currently cannot afford to buy insurance or are underinsured; 2) a political consensus to strictly regulate insurance companies like we do with utilities; 3) a single-payer insurance plan, a public service financing the delivery of healthcare.
Single-payer health insurance operates by arranging the payment of services to doctors, hospitals, and other health care providers from a single source established and managed by government. This source replaces private insurance companies with a single, public entity.
These are the options and the choice is ours.Lets have a honest and unbiased debate about those options. Time (or better money) is running out!

Bernd Wollschlaeger,MD,FAAFP,FASAM
Immediate Past President, Dade County Medical Association