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I'm all for competition, which I guess so-called conservatives no longer are. Offer me (and everyone) medicare-for-all coverage at my actual share of the total pool and let's see private insurance compete. If private insurance is better, if it's cheaper, if it offers better care or choice, they'll do just fine. Right? Cmon, what are the corporados so scared of? DLS can stick with Blue Cross and reap all the rewards that private insurance supposedly offers, while I slash 30% and lose the constant battles over coverage.

Oh, and BTW, there actually are cases of malpractice and lawsuits are the best and only current way to discourage shoddy practices and incompetence. Medical licensing boards are a joke. What do you suggest DLS? Let them skate?

Congress is willing to exploit them, while they see the future and want to be involved (for now and likely for later in a way the Dems would support).

I suspect that, in contrast to the Detroit automakers, the insurance companies know change (no pun intended) is coming, and they'd better be inside rather than outside the decision making, so that they continue to remain in business at least a few years more, in fact standing to gain rather than lose money compared to how they're now doing. Seriously, given a larger pool of (captive) customers, with federal money backing and boosting the revenues, they could do quite well (in spite of likely federal wariness about likely excessive rate charging). This, even though many of them probably know that arrangement would only continue in that form for a number of years at most, and that eventually they might be eliminated.

But not completely eliminated. No, for you forget, these are Democrats that will run the system, with grand plans (see below — health care in the USA is of interest outside as well as inside the USA). For you do realize that one major interest group of the Dems is, of course, the lawyer lobby, and if you thought junk lawsuits have been a problem now, just wait until the federal government has established complete command over health care in this country, and imposes mandates and required generous-settlement-and-restitution-payment minimums to further enrich lawyers who are operating the malpractice junk lawsuit industry. It will be the doctors and other providers, not the public, who likely will eventually be subject to mandatory insurance more expensive than is now the case, for malpractice insurance, to guarantee an ever-generous money flow to the lawyers, in a federal-government-run “single payer” [sic!] health care system of the future designed by the Dems.

Insurance companies eventually will remain in the system but as an indirect lawyer enrichment agent through junk routine malpractice lawsuit settlements and awards (a vast protection racket an order of magnitude or more greater than what doctors face now) while decision-making authority about health care provision (including indirectly, through funding, as with federal highway funds but more explicit in the case of health care) will include not only day-to-day decisions but broader policy decisions (refusing liver transplants for a few Republican voters in favor of rehab for many, many more Democratic-voting alcoholics, to name one suitable future example).

http://www.economist.com/world/unitedstates/dis...

http://blogs.wsj.com/health/2008/11/20/tom-dasc...

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Oh yes. The POOR insurance companies. It makes me want to PUKE how Congress is calling them in and nestling them to their bosoms. THE PEOPLE

Yes, the insurance companies are, as I have said, taking the initiative and trying to remain involved in health care, because they know the Dems are likely to make changes and they want to remain middlemen (to be PC, middlepersons, or let's also say “market makers,” as we would with lovely Dem emissions-laws cap-and-trade schemes). They want to remain included and to continue to make money as long as they can. That's the real issue here, even more than how they might want to enjoy subsidy payments (indirectly if not directly) or jack up rates higher than need be or desired by the rate payers once everyone would be required to pay — to reap all the profits then can until the eventual replacement of that system by direct federal provision or at least payment for health care.

That's what's already being sought, and the insurers know it, which is why they're nervous and being so compliant and willing to be cooperative now more than they were with a similar scheme by Hillary Clinton (”managed care under a cap”) in the early 1990s. Still fascistic, but that's typical of what the Dems often do and have done since the 1930s. This time, though, I suspect it merely will be incremental, on the way to “Medicare for All,” and even most in favor of the latter know the smartest thing to do now is to get everyone involved in a new system involving Washington at least indirectly. It's the perfect incremental move. Then as a solution to future insurance problems (real and fake) the move to Medicare is easy.

Meanwhile, what else can be done? Moving Medicaid into Medicare would be welcomed by the fifty states, and of course that could include long-term care. Absorbing VA would be good (perhaps in concert with eventual Defense Department reductions that are likely, anyway). And Indian Health Service. Convert S-CHIP (expanded in scope as the Dems have tried before) to Medicare for all children (under 25 if in college, right?). And then it's the end game, because the only ones left are the bulk of the ordinary taxpaying public. Take over the Blues, maybe Kaiser, to get a federal health infrastructure (nominally owned or controlled by the states as window dressing if need be). Game over.

It all makes sense, starting with this innocuous “private sector” “insurance” scheme.

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“I'm not convinced that a single-payer (government) program is the answer, but am glad to see some other ideas being put forward. The 'pre-existing condition' question is a great place to start.”

As someone with a pre-existing condition I have a view different from many, but I have noticed this. What this is, is a way for the insurers to get involved by offering a “bargain” — they will cover everyone and even treat all apparently in a “community rating” form, in exchange for the entire community, young as well as old, well as well as sick, participating. It's the broadest, lowest-cost-per-capita scheme, which the insurers want to keep themselves in business, while smart activists who want Medicare for All know it sets up a new system at least as far as scope is concerned for an eventual federal direct takeover. I don't see why the Dems would object to this.

Jeff Pickens — we should not be nagged, or much worse, forced to jump through hoops like circus animals in the name of “health” or “wellness.” That already is happening and this is inappropriate and excessive. (I can think of other extreme measures as well such as no insurance if one rides a motorcycle, for example, because of the extra risks and consequences of misfortune.) Many who are given already-excessively-costly gold-plated health plans (as state minima for insurance) with preventive care don't use it. But we should be hesitant before saying we should be compelling such people to do something, even on behalf of better health and lower costs.