Dean Baker, a widely respected economist, published a column today on why the insurance companies don't want to compete with the government.

There is a history here: Privsate insurance companies compete with the government for Medicare recipients, and most opt for the government plan, not a private plan.

To the argument that people who work for insurance companies will lose their jobs because of the competition, Baker says,  "That is what happens when you eliminate waste in the private sector, just as eliminating waste in the public sector often means laying off unnecessary workers. In principle, the economy should be able to find productive employment for these workers elsewhere."

And to those who say the government screws up everything it touches: "Apparently, the private insurers don't feel they would fare any better on a level playing field in the market for insurance more generally than they have in Medicare. Hence, they are arguing against allowing the government-run plan because it would put them out of business.

   " This is extraordinary. In the old days, we used to think that private businesses could provide many goods and services more efficiently than the government. Now, the insurers are complaining that because the government can provide health insurance more efficiently, they should not be forced to compete with a government plan."

To read the entire column, visit


The Center for American Progress, admittedly a liberal think tank, has some great thoughts on how we combine public and private to build a health care system that works.

What most of us think when we debate the issue is about what's wrong with each one. What's real is that we already have government involvement, and there are strengths. There also are strengths in private industry. The so-called free market isn't the answer.

The answer lies in a working partnership:


If It Ain’t Broke, Use It: Expanding Public Programs in Health ReformPublic health insurance programs—notably Medicare, Medicaid, and the State Children’s Health Insurance Program—have evolved to insure people with the greatest health needs or the least resources. These programs cover one out of every four Americans, including the elderly and the disabled under Medicare; low-income families, the elderly, and the disabled under Medicaid; and low-income children and parents under SCHIP. The federal government also provides health benefits to federal employees, American Indians and Alaska Natives, military personnel, and veterans, while state and local government manage health benefit programs for their employees and some low-income populations.

Despite their proven success, some question what role, if any, public programs should play in a reformed health system. Some believe that public programs have no role in health reform. They argue that private insurance and market forces will ensure seamless, affordable, and quality health coverage. Others see the flaws in public programs and would choose to eliminate them altogether rather than improve them as part of a broader reform effort. In contrast, advocates for public program expansions argue that there are inherent limitations to private coverage, and that reform should focus on expanding public programs to ensure that all working families have health coverage that meets their needs.

The line between public and private coverage has blurred in recent years. Medicare, Medicaid, and SCHIP all use private health plans to cover at least some of their enrollees. While the federal government funds approximately 75 percent of the health care premiums for its employees through the Federal Employees Health Benefits Program, it contracts with private insurers to provide the coverage.

Despite the complex and overlapping roles public and private payers play in our health insurance system, rhetoric in the health care reform debate suggests stark divisions. Conservatives demonize the role of public coverage while emphasizing the sanctity of private coverage, while progressives have accused private insurers of seeking profit at the expense of care and, sometimes, lives.

Reviewing the success of public programs will be critical to the growing discussion about health care reform. This does not mean that public programs are perfect. Medicaid, for example, must be transformed and strengthened in several areas, including by ensuring enrollees access to providers and specialists. Medicare faces significant controversy around its provider reimbursement rates and Part D payment rates. And SCHIP could use a more equitable formula for dispersing federal funds to the states.

In health reform, we now have a vital opportunity to capitalize on what works and improve what does not in public programs. The achievements of private insurance should also be considered and incorporated into any effort to transform the system. As Jeanne Lambrew, the new deputy director of the White House Office of Health Reform explains, "The question is not whether or not there should be a public plan role in health reform, but instead what balance of public and private plans best moves the system toward affordable quality coverage for all.”

It still hits me like a ton of bricks now and then.

I was having a great day yesterday, with our old friends Craig and Cindy visiting from New Jersey.

We were at Merlefest, waiting to see Doc Watson and the Frosty Mon Reunion -- always my favorite part or Merlefest, and a woman behind us in line said something about someone being very sick with cancer.

I was transported back to the final days of Mike's life.

I told Cindy tonight I've learned to continue to function in these moments.Other people don't know they're happening, but they happen every day.

I see him broken and dying. I see him unable to stand up without help. I see him trying to tell me he loves me with his last ounce of strength and I realize it never should have happened that way.

I've learned to function with a broken heart.

Today's Washington Post has an article about how there's already trouble brewing over President Obama's plan.

The health care industry lobby is complaining that a governement-sponsored plan would have less overhead and be able to be more efficient, meaning the private insurance companies wouldn't be able to make as much profit.

See, the government wouldn't have multi-million-dollar executive salaries at the top and it wouldn't need to satisfy shareholders or pay out millions to lobbyists and e, so it could sell an insurance policy for less.

These are some of the same people who have claimed all along that the government is inefficient and can't provide health insurance.

So, which is it?

The insurance companies don't want to compete with the government. Here's what that want: They want the government to mandate that everyone buy insurance from them. That way, all the high-profit healthy people who choose not to buy insurance now will be forced to buy it.

That makes the pool bigger and it's very high profit.

When it comes to insuring older and sicker people, that's when they want the government to come in and subsidize the care, which would make their risks even lower and their profits even higher.

The problem is that policymakers are buying into the insurance lobby's bull, and unless we're aware of going on and object to it, the insurance companies will walk away with even bigger profits and we're screwed.

Always find out who's demonstrating nearby beforehand.

We arrives to police barriers and orange cones all over the place, and no one wanted to come hear what we had to say because it seemed we were troublemakers.

Fred Phelps' Westboro Baptist Church (the God hates gays "pastor" and his followers) were setting up. Cops arrived soon after we started and they were everywhere.

We had a dozen or so people and a whole lot of passers by who stopped and listened for five or 10 minutes before moving on. Several cars stopped, windows rolled down to listen. A security guard came out of the building across the street and listened.

But right next to us, the cops were setting up barricades and orange cones. Once the hatemongers showed up, we knew there would be no talking at all, then it started to sprinkle so we broke down a half hour early.

There were some amusing moments, though. This group had all the love of a Klan rally. They were so filled with hate that their hollering and their posters made no sense at all.

There was one with a picture of a burger on it and the words, "Bitch Burger."

I have no idea what that was supposed to mean, but Janet asked if it was organic and whether it came with fries.

Another sign said, "You will eat your babies."


I felt compelled to holler, "My God loves everyone -- even you."

They hollered back something about my god being my private parts and a police officer who couldn't suppress a chuckle suggested we not engage them.

So, next time, I ask whether there's another group using the park that day.

We reached a number of people today, but it could have been more. I'm missing Mike, who I KNOW would have found great humor in today's events.

Several people have said in the last week that they're sure we'll have meaningful reform this year.

I'm not so quick to believe that. The insurance companies are not going to go along willingly. Already, they have "offered" to insure everyone as long as the government subsidizes them.

That means they want the government to force healthy people who are not in the system now to buy insurance from them. These are the most profitable customers. Of course the insurance companies want to add them to their rolls.

We must - MUST - have a competing plan from the government. It is the only way the partnership will work. Otherwise, the government takes all the risk and the insurance companies take all the profit.

This is our first Easter without Mike and I think it might be the hardest holiday yet. It's all about rebirth and new life, and that makes me miss Mike all the more. With joy all around me, I found myself crying in church this morning.

Mary Cowal, whose lifelong partner, Mary Etta Perry, died the day before Mike, was subdued too. But she had a poem of Mary Etta's to read, which was the high point of an otherwise sad morning.

Danny called this afternoon and he was feeling the same sadness.

If Mike is in a better place -- and I believe he is -- isn't it selfish to wich him back?

Perhaps, but I miss him terribly. I just want to hear his laugh. I want to go look in the Easter basket and find all the dark chocolate and all the Cadbury Creme Eggs have been eaten. But it's all still there because there's no one to steal it and then laugh when I find it's gone.

I spent the afternoon in the garden, digging a new 8-foot by 8-food bed for herbs. I'm exhausted. The work seems to help the sadness, at least for a little while.

It's just a week until our Raleigh rally. That will keep me going through the week.

Life o' Mike is officially incorporated as of Wednesday, and today we got our first three pieces of mail addressed to Life o' Mike Inc. All of them were junk mail, but still ... 
Insurance companies are worried about President Obama's proposal to create a public health plan to compete with the private plans. The ideal for them is a private non-partnership that would force all of us to buy insurance from them and then take even more money from the taxpayers to make up for having to cover people who might actually get sick.
A government insurance plan would be competitive with the private plans, but it would force them to compete instead of having it all as they do now. They don't want that because people will choose a government plan if the coverage is good and the price affordable. It would force them to keep their prices reasonable and their profits under control.
This would not create a "socialized" system of health care, but it would create a competetive market. And if the government is as bad at being in business as some people beileve, no one will buy the public insurance plan and the private sector will be our provider of choice.
That's the key here: Choice.
Giving it all to the private sector will take our choices away because they don't want to change.
How much choice did Mike have?
How much choice does my friend Carolyn Comeau have since her COBRA expired?
How about the 87 million Americans who have been without insurance for part or all of the last two years?
I think if there was a real choice in the private sector, those people wouldn't choose to be without access to health care.
I believe it has to be a real public-private partnership or it won't work. If it's just the government pouring money into private insurance companies to entice them to pool the risk, then we the taxpayers will continue to foot the bill for a proven ineffective system.