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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: JohnM who wrote (131689)	2/28/2010 10:04:34 AM
From: Lane3	Read Replies (2) \| Respond to of 541355

I have neither the time nor the interest to continue that discussion. OK. I don't either. If you won't address my argument, I am left to repeat myself and that's a waste of time. I can't help but note the starkest point at which we disagree, Karen, and it's in the quote above. The only institution in the US that gets close to the British is veterans care. I will make one more stab at it. What we have is a continuum. On the public end of that continuum is the NHS model. Yes, of all US systems, veterans' care is most like the NHS model, all but fully socialized. Medicare, not so much. The other end of the continuum is the "private insurance industry." You keep placing the exchange in that paradigm. I have challenged that. I say it's closer to the NHS end of the continuum than to the private-insurance-industry end. John: "We were talking about regulating private insurance companies in the exchange." Your "private insurance companies" won't be performing the most fundamental functions of private insurance companies like underwriting, designing products, and setting premiums. What they will be doing is registering clients indiscriminately for a federally established plan, collecting federally established fees from clients, and processing claims according to the benefits set by the feds, a purely administrative function. You don't need an insurance company to do that. You need a bunch of clerks and a computer. Sure, insurance companies will bid for that business but so might any data processing company or bank or property management company, any company that is set up to handle financial transactions--collecting fees and making payments. That's not the insurance business. All the insurance business functionality will reside in the federal legislature and bureaucracy. If there's any regulation at all it will be simply to assure fiduciary accountability. More likely, the "regulation" will look more like contract performance standards than like industry regulation. Now you can disagree with me on where Medicare or the exchange would sit on that continuum between private insurance industry and the NHS, just how close it is to NHS. But I don't see any way you can reasonably claim that the companies that will be players in the exchange are performing as a "private insurance industry." The only likely slippery slope here is that industry reps gain control of the regulatory process when the Reps are in control of the WH and both houses of congress. We differ a great deal on this. Yes, we differ a great deal. You're worried about the R's controlling the regulation. I find that bizarre since there won't be any regulation to control since there's no insurance industry involved to regulate. Can't get much farther apart than that.