What choice does anyone with diabetes, asthma, a history of cancer, kidney problems et.al. have? They simply cannot buy private insurance. Their only choice is to ask for charity from a local hospital (ours has such a program), wait and see if they can live long enough to qualify for Medicare, or just give up.

I did not understand what Rep. Tsongas did not sign up for. Federal employees have a choice of plans, and I thought she said she picked out one. Someone explain please.

It isn't. He's saying more government manipulation will make things worse. That doesn't imply what we have today is good or that he's against improving it.

While I don't agree with the word “uniformly” because certainly some people benefit from price-controls, I agree that such controls are generally bad. Luckily, no such policy is being considered by anyone in Congress. If you're saying that letting insurers participate in exchanges of their own free will (subject to abiding by the rules of the game of course) is a price control, then I believe you are mistaken.

If the exchange is so bad, then consumers and insurers can stay out and continue their business as usual. All the exchange does is expand choice by creating a marketplace that people can voluntarily participate in, if they so choose. If they don't want to, there's no change relative to the status quo.

Then Jazz: “Every time I try to raise this point here I get an immediate rush of responses insisting that all this plan does is “create competition” which will drive down prices by reigning in the evil, money grubbing insurance companies who are ripping us all off.”

He's not? Sounds like a defense of the insurance companies to me.

No, Lit3, pooling risk has nothing to do with hospitals' outrageous “sticker prices” and the dramatic “discounts” insurers negotiate. Those are a bit of theater that hospitals and insurers (including government) collude to stage for us. Insurers benefit because they look like heroes. Hospitals benefit because the inflated prices put them in a better negotiating position with their other customers (like the uninsured). They get away with it only because there's so little real competition in the market.

And all of y'all who are portraying Jazz as defending insurers or the way prices are set today should read his post again. He said nothing of the kind.

The system needs price review because the average uninsured consumer can never ever afford them. Every insurance company (and Medicare) pays a pittance of a hospital bill because they can pool risk and customers. What do the hospitals do? Artificially raise prices so they can get a decent portion of what they charge.

Maybe we don't need a public option. But millions of Americans DO need some form of insurance. I'm still waiting for the Republican plan to give it to them, but they're too busy running around crying “socialism.” (Price controls was a cleaver euphemism.)

Secondly, if you are talking about the Senate version, they don't mandate that insurance companies join the exchanges…they just have to in order for individuals to get subsidies. The House also doesn't mandate it, you'd just have to pay an extra fee if you aren't part of it. I believe the Senate version will be the one passed.