Doubts about public option

Photo by Dean—steve Erkenbrack at Club 20—Setn as Erkenbrack S File 3-20 49x

The House health-care bill unveiled last week has something to irritate just about everyone, but not so much that many Grand Valley experts want it ditched immediately.

A major feature of the plan unveiled by House Speaker Nancy Pelosi and backed by U.S. Rep. John Salazar, D-Colo., is the so-called public option of government-provided health insurance.

“The public plan could be a particular challenge for Mesa County,” depending on the form it takes, said Rocky Mountain Health Plans President Steve ErkenBrack. If such a plan negotiates its rates with providers, that “would help a bit,” ErkenBrack said. If it simply uses rates based on Medicare, it would drive up rates and shift costs, he said.

It’s one thing to say rates would be negotiated, he said.

“The question is: What does that look like when it hits the real world?” ErkenBrack said.

One shortcoming of the bill is that it contained no provision aimed at reining in expensive litigation that drives up medical costs, said Dr. Michael Pramenko, a Grand Junction family-practice physician. Still, it’s a much-needed beginning, he said.

It’s a bad start to a worse end, said Dr. Larry Tice, a Grand Junction neurosurgeon.

“Gradually, over the next 10 years, it will change medicine,” Tice said. “Ten years from now, we’ll have a socialized system like England.”

The bill falls short of the promise of the nonprofit operating system pioneered in Grand Junction, Pramenko said.

“I don’t think we can do better with the public option than we can with the local nonprofit approach,” Pramenko said. “I truly believe the Grand Junction model could bear a lot of fruit.”

All things considered, Pramenko said including the public option “won’t bug me because the for-profit insurers have been feeding at the trough for a long time.”

The pressure to change the health-care system is the result of a lot of “fear-mongering,” Tice said.

“Bill Clinton said the same things 15 years ago” about the imminent collapse of the system, Tice said.

The system envisioned in the legislation seems to be one in which no one pays for anything, he said.

“I think the solution is for everyone to have some skin in the game,” he said. “People have to pay something and make choices. Otherwise, it’s not going to work.”

Salazar, who declared his support for the House bill hours after it was unveiled, was a canny player who “represented what Grand Junction has done extremely well,” Pramenko said.

By refusing to take a hard position, Salazar kept his negotiating options open, Pramenko said.

“If he was against the public option, he would have had no place at the table,” Pramenko said.


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