I understand the question, but it’s a dumb question.
Q: You have a 100% free throw percentage this year. If you miss one, will the percentage not be 100% anymore?"
A: Uhhhh
As I have always understood it, “public option” is basically equal to “Medicare for all who want it”.
I could be wrong, but there is a chance that politicians who use the phrase “public option” don’t actually know what they’re saying.
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Odds are, neither does he.
At least as far back as the debates around ACA, “public option” has a fairly specific definition based in prior state-level legislation. See here if you want a lot of background: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.0363
The idea of a public option within a state-based health insurance exchange was initially set forth in a proposal known as CHOICE. This was part of California’s Health Care Options Project (HCOP), 1 an initiative to update and develop ideas and options on how to expand coverage in California, and was funded by a federal planning grant to the state Health and Human Services Agency. The CHOICE proposal 2 built on the model of managed competition, with its array of competing private managed care plans. However, it added a new option, the public option, to the exchange, to broaden the array of choices available to individuals and families. The public option was also designed to compete with private plans in the exchange and to serve as a policy compromise between a single-payer system and managed competition among private plans.
That is, if the basic idea of the ACA is a state-managed and regulated exchange in which individuals could purchase privately run insurance plans, then the “public option” means a state-run insurance plan that competes against the private options in the same exchange. That was the original design of the ACA, but it got cut.
It could be like “medicare for all who want it” if it were designed as an opt-in to Medicare, or paid Medicare rates, but I’m not sure it was ever that well specified at a federal level, and obviously the CHOICE program is not exactly like that. The other way it would probably be different (if it builds on the ACA) is that “all who want it” probably wouldn’t include people who have employer-based health insurance options? In the same way that individuals with employers who offer health insurance can’t participate in the ACA exchanges.
Now you guys got me posting in other threads. Not going to make a habit of this.
You left out the part where you pay a premium for the public option, in the form of a tax. Depending on which candidate’s plan it is, that could range from the per capita sticker price of Medicare to that price adjusted for income (some pay more than the sticker price some pay less).
So the degree to which it mimics single payer depends on the degree to which low income workers get a subsidized rate. Biden probably wouldn’t be subsidizing his plan very much, nor would Pete. Warren, maybe so.
Yay!
Boo.
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Didn’t realize this. Seems problematic. States suck at doing a lot of things.
I think “state” means federal here. I meant like “state” vs “corporate” (public vs private). Sorry for making it confusing.
Here’s maybe a better explanation of some of the proposals from the time: Public Option Vs. Single Payer - FactCheck.org
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The part the media does an absolute dog shit job of explaining clearly is the immense cost inflation that results from insurance companies existing. Their coverage inevitably goes straight to BUT HOW YOU GONNA PAY FOR IT, with zero analysis of why costs are so high in the first place.
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More from Grandpa (he’s absolutely benefiting from being senile, people are scared to look mean calling it out):
Silvios version is the real version now.
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Overhead two MAGA hats at shift change talking about how unfair CNN was to Bernie at the debate. Amazing. Bernie is going to absolutely roll in Iowa.
So this whole time you’ve been viciously attacking Warren and Pete and saying you’d not vote for them, you had no idea what the public option was? And now you’re enthusiastically supporting an even worse version than either of them proposed!
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Bernie is not in favor of a public option. He is in favor of Medicare for all - a single payer system where everyone is automatically enrolled into a zero premium, zero out of pocket cost, government administered insurance plan that is paid for entirely by taxes.
Biden and Pete are in favor of a public option - basically keep the existing insurance scheme in place but offer a (presumably cheaper) government administered insurance plan that you can enroll in. It will still have monthly premiums and out of pocket costs, but will be subsidized and likely better than most private plans. They will sometimes give lip service to the idea that the public option will be SO POPULAR that it will crowd private insurers out of the market, but that ignores the numerous baked in advantages that private insurers have, as well as the fact that a public option is not going to be anywhere near as efficient as m4a would be. And, much like how people blasted Obamacare in its first few years because of problems with the exchanges and other hiccups, a bumpy start to the public option could very well erode public support for a single payer m4a option.
Warren says she wants two years of public option, then let’s vote again and see if we want single payer. The second half of my last paragraph describes why I think that is a dishonest, bad plan.
5 years ago even a public option was looked at as radical and a nonstarter in terms of electability. Due largely to Bernie’s efforts, it’s now considered the bare minimum in terms of acceptable healthcare policy.
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I really need to catch up on this stuff but I’m 1000 posts behind not counting the original thread 
While I’m posting for a couple days (damn it I got pulled in to all these threads), let me make a suggestion:
Instead of arguing with people constantly and being militantly Bernie or Bust, spend the next month or so on here asking more questions when you don’t know all of the details about something. At least if you’re going to be a militant Bernie or Bust guy, know what the others are proposing, what the public option is, some policy detail on major issues, etc.
The knowledge base of regular posters on this forum is astounding. Tap into it more, argue less, at least for a little while.
Cause it’s a really bad look to be this super huge BERNIE OR NOBODY guy, trash the other candidates as being just like Trump, then be like “Oh this public option thing sounds awesome! No way Biden supports it…”
Given what you’ve said in the last couple hours in here, I have a feeling that if you learn more and argue less for a little while, you may come to realize that what you used to think was a slight crack of daylight between Biden/Pete and Trump is actually a world of distance.
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Adding to this (realizing we do have a M4A specific thread)
A risk of the public option is that it lacks the purchasing power single payer does, unless major cost controls and antitrust actions are also taken. While it could lead to a death spiral leading to M4A, providers (hospitals/doctors), rx, and insurers know this, so will do all they can to make it fail, so they can say “well, we tried”.
True single payer (in addition to reducing admin costs) allows the government to set provider reimbursement rates and rx prices. Right now, provider consolidation and Rx regulatory capture has given them the power to raise costs on a product people can’t go without, and eliminated competition so consumers can’t shop for lower prices (even if they had that luxury - excuse me Mr. Ambulance Driver, please take me to my in network hospital). Insurers can’t carve high cost low quality providers out of their networks, or redirect members to higher quality low cost providers, because they’ve all been bought up by a single provider group in the area to eliminate competition. They cant leave high costs drugs off the formulary, because there’s only a single drug (or distribution channel) for some conditions. So consumers (and even insurers, who want to keep costs down after selling a policy), can’t price shop and force costs down.
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I’m not expert on all this, but I think the real risk of public option is that millions and millions of people won’t pay because they’re poor, poorer than their income would suggest, unwilling or unable to jump through whatever hoops it takes to get subsidies, and end up not getting care and going to the emergency room when they’re about to die instead. Where do people end up in this system who gets jobs, lose jobs, move around, get married, get divorced, have kids, make more money, make less money?..all the things that happen to a ton of people all the time. What happens to people like that in Germany or the UK? They just keep having the same health care, right?
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