The Patients’ Choice Act ~ dnd

The Republican’s approach to health care reform is summarized in The Patients’ Choice Act outline.

This is a fascinating proposal on a number of levels.  First there are a number of reasonable ideas, some even surprising coming from the right.  For example, the push for universal access to affordable health care conflicts with the right’s argument that this would result in “rationing.”

0_61_320_hc_luntz A closer examination reveals that the document has adopted the rhetorical tactics outlined in Luntz’s 10 pointers in “The Language of Healthcare 2009.”

Even the name “The Patients’ Choice Act ” is rhetorically carefully chosen, the implication being that other approaches deny patients’ choices.

The main approach to the proposal is a few tweaks to private health care insurance regulations will allow every citizen to choose the type of health insurance coverage that’s right for them.  One thing that’s glaringly misleading is the notion that consumers would have a meaningful choice.  How can this be?

Let’s look at the top 10 benefits typical of any plan: premiums, plan type, office visit copay for primary doctor, office visit copay for a specialist, coinsurance, annual deductible, annual out-of-pocket limit, lifetime maximum, HSA eligibility and out-of-network coverage.  Each of these benefits has a number of different options.  It is easy to see that then number of combinations of these benefit options result in an a enormous number of plans available.

While this may seem advantageous to the consumer, it turns out it’s not.  Barry Schwartz, PhD, a Swarthmore College psychologist and author of “The Paradox of Choice: Why More is Less” makes the argument that when faced with an overwhelming number of choices, we often make a bad choice.  The goal in choosing a health care plan is to maximize the coverage you need for the least cost.  But few, if any, can predict the coverage they may need.  Because of the large number of plans, finding comparable plans is difficult.   In addition each insurer negotiates different prices for different services from  providers, making it virtually impossible for the consumer to determine their ultimate costs when choosing between equivalent plans from different insurers.

The Patients’ Choice Act is interesting, but fails to address the most important reform when it comes to “choice” in determining a health care plan.



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60 responses to “The Patients’ Choice Act ~ dnd

  1. nannymm

    Excellent piece, dnd. Your analysis of the repug plan is spot on. It seems to me that they are doing everything they can to prevent any real and meaningful reform of the healthcare system. What they propose will not work. It is too complicated. And ultimately, it will be far more costly when healthcare consumers find themselves with plans that are either inadequate for their needs or too expensive for them to afford. Same old story in a new package with a shiny new name….

  2. nannymm

    BTW, I forgot to say that “universal access” to coverage is a far cry from the “universal coverage” that we need. One might actually argue that we have “universal access” now, provided, of course, that one can afford the high premiums.

  3. The Patients Choice Act is nothing more than a shabby attempt at maintaining the status quo and heaping on a whole new layer of corporate welfare to our tax code. The Republicans should step aside and let the grownups fix the problem, obviously they have no interest in doing so.

  4. eprof2

    dnd, thanks for the information and insights. Single Payer for everyone!

  5. “Single Payer for everyone!”

    Ever the optimist aye eprof?

  6. eprof2

    Really, Brian, now is our only chance in the midst of the economic mess to bring online a health system that works for everyone. Social Security was born in the midst of the Great Depression; let the US give birth to a national health system that will work for everyone. Yep, I’m the eternal optimist!

  7. No argument from me eprof, but aint going to happen. I’ll be more than happy with a working public plan.

  8. nannymm

    I’m with you, eprof. Now is the time for single payer healthcare for all. Whether or not we’ll get it is another story, I’m afraid. But let’s keep hoping and pushing.

  9. trout boy

    health care shelth care real question is “Was the fix really in on American Idol this year?”

  10. Am I the only person on the planet who has never watched American Idol?

  11. dnd

    Air Force Academy graduation ceremonies streaming on:

    Biden’s commencement address is suppose to be around noon, MDT.

  12. nannymm

    “Am I the only person on the planet who has never watched American Idol?”

    Nope! I’ve never watched it either.

  13. dnd

    I can understand the arguments against single-payer. But I can’t understand the arguments for for-profit insurance companies. It makes absolutely no sense to have health care coverage controlled by companies that make money by denying claims.

  14. The only some what valid argument in favor of private health care coverage in my opinion is that to scrap the entire system in one fell swoop would be too disruptive. I’m not sure that’s true, but I do think it’s an argument with some merit.

  15. Burris, dead man walking!

  16. nannymm

    Burris’ lawyer admitted to Nora O’Donnell that Burris came to him and asked him to make the donation to Blago for him. The lawyer declined and told Burris that this was not a good plan. So we now have proof that Burris intended to pay Blago but was stopped. He should be expelled from the Senate.

  17. Well if he resigns he won’t have to have his “head stone” redone.

  18. trout boy

    actually I have not watched the American Idol either. I was just joking around. 🙂

  19. Has Richardson cleared up his legal issues yet? That would drive the PUMA crowd crazy if she did that dnd!

  20. nannymm

    Hey, Doots, glad to have ya in the “No Idol” club. Seems like there are more of us than we knew. 🙂

    Brian, I’m all for Hillary appointing Richardson if his issues are resolved. In fact. I’m for anything that upsets the PUMA crowd. However, I must point out that there is nothing anyone can do to drive them crazy. They’re already bat shit freaking INSANE!

  21. dnd

    Aside from the trust the North Koreans feel for Richardson, think of the political symbolism. Obama, Clinton and Richardson were rivals in their quest for the WH. When Richardson endorsed Obama, Clinton was not happy with Richardson. Then Obama appoints Clinton, his main rival, as Sec. of State, a position Richardson wanted.

    So for Clinton to appoint her rival as special envoy to North Korea, as Obama appointed his rival as SoS, it would be political gold.

  22. dnd what about his legal issues?

  23. nannymm

    dnd, don’t forget Biden. He was one of the rivals, too.

  24. dnd

    Yeah, Nannymm, I forgot Biden. Talk about your “team of rivals.”

    Brian, he’s still under investigation. If he can de-nuke North Korea, I don’t think many will be concerned with the allegations.

  25. If he’s still under investigation he’s not going to get appointed to anything!

  26. dnd

    Oh, and for the record, I’ve never watched American Idol either. 😉

  27. nannymm

    Can we just make this an “Idol Free” blog?

  28. Seems like it already is nanny!

  29. eprof2

    I, too, am in the never watched an Idol program club. Of course, one can’t help but be inundated with the Idol details from local news, et cetera.

    Single Payer health system: What happened to the “Yes, we can” slogans of the last election (which I seem to recall winning with the slogan)? Is it already dead?

  30. eprof we all know the public action is part of the path to single payer. Lets not cut off our noses to spite our face!

  31. eprof2

    “we all know the public action is part of the path to single payer.”


  32. that should read “public option”

  33. nannymm

    I’m glad you clarified that, Brian. However, I think we could win with single payer if we fought hard enough. If we can’t win now, we never will. People are hurting; they need this. And we control the presidency and both houses of congress. That’s a recipe for success if we “cook it up” right.

  34. dnd

    Clearly a public option is the path to single-payer. For-profit insurers won’t be able to compete with a not-for-profit plan with a huge pool. Business’ will all go with the public plan to reduce costs.

    My guess is that the government would have private companies underwrite the plans via some sort of bid arrangement to minimize costs.

    I’m also guessing that there will be a lot of “supplemental” plans that will cover things the public plans don’t.

  35. eprof2

    Ah, I understand now what you were saying. However, the “public option” in Obama’s plan only pits the private for profit sector against the public sector for patients. All of those patients in this country who have pre-existing conditions will be pushed off on the public sector. This will result in private insurance companies making even more money from the healthiest amongst us and lead to the charge that the public sector is “inefficient” and should never be allowed to handle the complete health care of all. (It’s the post office argument all over again.)

    Check out why the Republicans wanted the prescription drug, Part D, of medicare coverage as law. The private HMO’s got huge subsidies, the private HMO’s were allowed to skim for the healthy amongst us by putting in the “donut hole” coverage, made it illegal to buy drugs in Canada and Mexico, and prohibited drug pricing negotiations. Yet, they made it sound like a public option.

    Single payer system now!

  36. nannymm

    I agree with everything you said, eprof.
    Single payer system now!

  37. You two should get a banner and march up and down Penn. Ave

  38. eprof2

    Interesting that you should mention banner waving in DC for SPS: There are, right now, several medical groups, including doctors and nurses, protesting the Senate Committee headed up by Baucus of MT for refusing to even hear the SPS pros and cons by practicing medical personnel as opposed to hearing private insurance point of view. See last Friday’s Bill Moyer’s Journal on just how many are protesting and how many thousands, if not millions, of Americans, starting with Michael Moore, are advocating for a SPS in this country.

  39. Well MSNBC just reported that Bill is still a snit over Teddy and Richardson’s endorsement of Obama.

  40. dnd

    Bill’s snit is in the NYT Magazine preview:

    Bill doesn’t like people he can’t charm…

  41. Burris, seriously dead man walking!

  42. trout boy

    Dnd, thanks for that Paxton piece. I missed it. Stephen was everything Bill said and more.

  43. Seriously, these attacks against Sotomayor are really lame!

  44. trout boy

    you knew it was gonna happen Brian. Ever since the opposition of Thomas, it has been very continuous.

    Tommy Tancredo is a fuckin’ moron.

  45. eprof2

    My post today at is about Gingrich and his racism remarks. Come on over and sit a spell!

  46. dnd

    Just turned on the “Ed” show and he showed the old clip of Bush 41 talking about then nominee, saying he had “empathy.” Zing!

    A caller to Stephanie Miller this morning noted that in psychological terms, people without empathy are known as sociopaths…

  47. you got enough seats around the cracker barrel eprof?

  48. dnd

    Great post on your blog. I tried to post a comment, but forgot my password.

    I think Sotomayor’s entire background, being the daughter of poor immigrants who worked to get her a good education, in addition to being a Latina, add to her view. If it didn’t, I’d really question her character.

  49. eprof2

    Sorry about that 86. The password is in your shoe!

  50. eprof2

    Of course, Brian, there’s plenty of room. Do you remember Kate Smith and the Cracker Barrel sessions?

  51. “Do you remember Kate Smith and the Cracker Barrel sessions?”

    No! I’m not that old!

  52. eprof2

    It was one of the earliest tv programs in NY. Came on about 4 pm for an hour. Variety and politics. My mom’s favorite program at the time.

  53. 4 was when Dark Shadows was on!

  54. loriG

    Hi Brian ;o}}

    Single Payer Plan Explained.
    These Docs say, “govt. owned by Insurance Lobby”

    The Patient’s Choice Act

    Sen Durbin says “govt. owned by the banking lobby”.

    Can we get anything back?

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