Roll up your pant legs and get your paddles out, folks, because we are about to be sold down the river. I know some people are trying to give a fair shake to the idea of health care co-ops as a compromise measure on the public health plan. Sen. Kent Conrad has been offering the concept of co-ops as something that originated in his office. His whip count says it would get enough votes to pass, whereas the public plan might not.
Simply put, Sen. Conrad is not an honest broker here. He’s not offering the co-op proposal in good faith. I’m in the health insurance business, and when you understand why I’m calling Conrad out, you’ll be peeved. Read on:
I had been reading Ezra Klein's excellent blog entries, including his conversation with Sen. Conrad on these healthcare co-ops and thinking to myself, "He's describing a mutual plan, and we've already got a bunch of those."
A mutual is a tax-filing status and an ownership structure for an insurance plan, distinct from for-profit and non-profit, in that the policyholders are the shareholders in the company -- just as Conrad describes these co-ops he's offering as a compromise measure.
It’s actually an inherently better structure than a for-profit, since the executives of the company are ultimately answerable to the policy-holders. But they are nothing new, and they are hardly the humble, little grain elevators Conrad invokes in his description of them.
Indeed, the fourth largest insurer in the country by enrollment, Health Care Service Corp., is already a mutual, a consolidated holding company for four single-state, mutual Blue plans -- Illinois, Texas, New Mexico and Oklahoma. Eight other independent Blues are structured as mutuals -- Arkansas, Hawaii, Kansas and Louisiana spring to mind -- as are non-Blue plans like Medical Mutual of Ohio.
Oh, and there's one more: wait for it . . . Blue Cross Blue Shield of North Dakota, Sen. Conrad's home-state plan, which, I might add, is highly expansionistic. Google the subsidiaries Noridian and Northern Plains Alliance to see how many other pies BCBSND has its finger in! Privatized Medicare plans across all the northern plains states and beyond, and standalone Medicare Part D prescription drug plans, too.
So how does one characterize Conrad's idea of co-op health plans? The next big thing? A grand gesture of bipartisan compromise? Or just cheap, crass, home-state parochialism?
I hope somebody besides me calls Conrad out on this crap. I’m busy today or this diary would be longer, and I really don’t have the time to call Conrad’s office for an explanation, but I’d appreciate it if someone else could: (202) 224-2043.
If somebody really wants to go for style points, they could go to OpenSecrets.org and see how much campaign cash Conrad has collected from BCBS of North Dakota, and perhaps other mutual health plans like Health Care Service Corp.
Look, Ezra has really defined where the rubber meets the road: liberals have advanced the public plan to test their theory that government can be the superior provider of health benefits coverage. The right is afraid we may be right, and wants to do all it can to prevent the public plan from happening.
All other discussion on the topic of the public plan is just window dressing, and Conrad's proposal for co-ops barely rates as a sideshow.