Collins: "I oppose the Washington-run public plan proposed by the Administration."

by: Gerald Weinand

Sun Aug 23, 2009 at 08:30:28 AM EDT

I continue to have many reservations about the Obama Administration's health care policies, the bill reported by the Senate Health Committee, and the legislation approved by the House committees. The Washington-run public insurance plan that would be created by these proposals would have the federal government administer the plan and determine benefits, premiums, and payments to physicians and hospitals. Proponents of a public plan claim that it would challenge private insurers to compete on cost and quality. Opponents see it as unfair competition for private insurers and the first step down the path toward a single-payer system because a public plan most likely would lead to the collapse of the private market.

Collins' statement that "the federal government administer the plan and determine benefits, premiums, and payments to physicians and hospitals," is of interest, since currently Medicare does exactly this same thing (of course, for-profit insurers do the same thing, but they aren't part of our elected government). Also, the Veterans Administration hospital system goes even further than that, actually providing care to veterans and those who qualify. That Maine has one of the highest per capita counts of those aged 65 and older (2nd behind Vermont) as well as retired and active duty servicemen and women ought to weigh heavily in the balance for Maine's junior senator.

Apparently these demographic groups do not:

I oppose the Washington-run public plan proposed by the Administration. The nonpartisan Lewin Group has concluded that a public plan open to all and offering Medicare-level reimbursement rates would result in 119 million Americans losing their private coverage. This kind of mass shift would destabilize the insurance market and is also inconsistent with the concept of building on our current system. It also would run contrary to my commitment to ensuring that families are allowed to keep health care coverage that is working for them.

As was noted in these pages, the Lewin Group is hardly a non-partisan think tank:

Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation's largest insurers.

More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician's group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the "usual and customary" doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.

This practice of providing bogus data seems prevalent in the for-profit insuance system, as Wendell Potter explained in his testimony to the Senatte Committee on Commerce. Collins' colleague, Olympia Snowe, sits on that committee - perhaps the two of them could get together at some point and have a little chat.

Collins' continues:

I also oppose having a single-payer system for our country. The experience in other countries with single-payer systems demonstrates that it causes many patients to face long delays in needed tests and treatments. For example, some Canadians are forced to come to American hospitals for treatment because they face lengthy delays in Canada.

Here Collins' repeats conservative talking points that have long since been debunked. First, it is important to remind her that our own Medicare system is a single-payer, and was used by Taiwan as a model for their own health care system. Secondly, those 46 million Americans that do not have health insurance face long delays as well, delays that often result in their ailments becoming acute, and requiring invasive - and expensive - care.

And while the Canadian system is not without fault (what system is), it is telling that Collins does what most opponents of single-payer do: not mention that France not only has a single payer system that covers everyone in that country, a system similar to our Medicare, but that it provides the best care in the world for half the cost that Americans pay (percentage of GDP).

There's more:

In addition to these concerns, I am deeply concerned about the high price tags associated with the plans before Congress. The nonpartisan Congressional Budget Office (CBO) has estimated that these plans could cost as much as $1.6 trillion over the next decade. These costs may be borne by middle-income families and small businesses in the form of increased taxes at a time when they can least afford it.

The greatest barrier to health care coverage in America is cost. Whether I am talking to a self-employed fisherman, a displaced worker, the owner of a struggling small business, or the human resource manager of a large company, the soaring cost of health insurance is a vital concern, and any legislation Congress considers must address this issue.

Notice how Collin's uses "health care" and "health insurance" as if the two are interchangeable. She writes, "The greatest barrier to health care coverage in America is cost," which I take to mean that it is the cost of health insurance premiums that account for so many Americans lacking such coverage. But since most Americans with private health insurance coverage are covered through their employer, it is these businesses that are finding it ever harder to provide it.

Collins recognizes this, and so wants to try to maintain a failing system by providing tax credits to employers, ignoring that this will do nothing to control premium costs - in fact, it will simply enable for-profit insurers to raise premiums further, relying on their friends in Congress to approve higher and higher credits.

These cost increases have been particularly burdensome for small businesses, the backbone of the Maine economy. Maine small business owners want to provide coverage for their employees, but they often simply can't afford to absorb double-digit increases in their health insurance premiums year after year. Our efforts should be focused, in part, on making health care more affordable for small businesses by, for example, creating new tax credits that will help them cope with rising costs. This will also help us move toward the goal of universal coverage since uninsured working Americans are most often employees of small businesses.

The fact is, it will be very difficult to achieve our goal of covering all Americans until we find a way to control the health care costs that have driven up the cost of coverage for families and small businesses. That is why I was particularly alarmed when the Director of CBO warned that the House bill did not propose "the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending." He went on to say that, instead of saving the federal government from fiscal catastrophe, the proposal would worsen an already bleak budget outlook, increase deficit projections, and drive the nation more deeply into debt.

I recently met with the President to discuss health care reform. I urged him to accept a more realistic timetable and not to try to push through a bill that affects every American and one-sixth of our economy. I also impressed upon him the importance of transforming our health care delivery system. We should focus on holding on to what is good about our system and improve what is not working. It is especially important that high-quality, low-cost states like Maine are not harmed by reforms, but rather rewarded for their efficiency and innovation in improving quality while reducing excessive and unnecessary costs. There is strong bipartisan support for these changes.