Jay Rockefeller and the Question of Compromise
Later today, Sen. Jay Rockefeller (D-W.Va,) will be introducing the Consumers Health Care Act into the Senate. The legislation has two parts: The Health Insurance Trust, which is essentially a ratings agency that will assess the quality of insurance plans and help consumers make informed choices, and a public plan.
I got an early look at Rockefeller's proposal (pdf) and it is, to my knowledge, the first piece of Senate legislation laying out what a public plan could, and probably should, look like. The public plan is given, for its first three years of existence, access to the provider networks used by Medicare, and for its first two years, access to the payment rates negotiated by Medicare. This helps it get off the ground. After that, it's on its own. If providers don't feel that the public plan is worth accepting, they can terminate the contract while still keeping their access to Medicare.
This is a smart solution to the problem of start-up: Given that private insurers have had years to build their networks and negotiate their rates, giving the public plan temporary access to an existing infrastructure is exactly what's needed to ensure it starts on a level playing field, rather than is forced to build from scratch. And if, after a few years, the fears of its critics manifest and the public plan proves itself so deleterious to health-care providers that they can't bear to contract with it, they can simply stop.
It is likely, of course, that Rockefeller's proposal will be considered a "liberal" bill. Meanwhile, Sen. Kent Conrad's (D-N.D.) co-op plan is being touted as the centrist compromise. But the concept of compromise only makes sense if you're clear about what you're compromising on. As Rep. Lynn Woolsey argued to me last week, to liberals, a public plan along Rockefeller's lines is a compromise from single payer. And a public plan along Sen. Chuck Schumer's (D-N.Y.) lines would be a compromise from Rockefeller. And a co-op plan along Conrad's lines would be a compromise from Schumer.
In other words, the co-op idea, whatever its many merits, is not a compromise between liberals and conservatives. It is a compromise between, on the one side, conservatives who don't want any nonprofit competition for insurers, and on the other side, Schumer's proposal, which is already a compromise of a compromise of a compromise.
(Photo credit: Joshua Roberts)
June 17, 2009; 11:40 AM ET
Categories: Health Reform
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