Peter Harbage: We Must Design A Public Plan That Brings Providers On Board

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"Peter Harbage: We Must Design A Public Plan That Brings Providers On Board"

The Wonk Room’s Peter Harbage has released a paper detailing how a public health plan could compete with private insurers on a level playing field.

The paper is an effort to define the public option and push back against the growing chorus of Republican and industry critics who, without seeing draft legislation or plan specifics, have taken to characterizing the public option as a government take-over of health care.

ThinkProgress sat down with Harbage to discuss how policy makers could design a public option that addresses industry concerns of crowd out and allies providers’ fears that a government-sponsored health insurance plan would underpay doctors:

In order to stimulate the kind of competition that we’re really looking for in the public plan, it’s important to have a government entity that really does compete on a level playing field, where you’re looking at the individual market, you’re bringing in the fair payment rates, the timely adequate payment rates, that providers need in order to participate in a public plan. To be effective, and to have a network where there are going to be providers that enrollees want to use, you need a situation where the payments are going to be timely, and adequate, and efficient.

Watch it:

“If providers were sure that the public health insurance plan in Public Plan Choice would make timely adequate payments absent the paperwork gimmicks (such as pre-authorization) used by insurers today, and without undue coercion to participate, then Public Plan Choice could be seen as a major benefit to health care providers,” Harbage writes in the report.

Read Peter’s full report here.

Transcript:

You talk about the structure of the public plan. Is it really something that you should just expand Medicare to do, with Medicare payment rates and Medicare systems, or should you have something that’s a separate system that’s going to compete on a level playing field?

In order to stimulate the kind of competition that we’re really looking for in the public plan, it’s important to have a government entity that really does compete on a level playing field, where you’re looking at the individual market, you’re bringing in the fair payment rates, the timely adequate payment rates, that providers need in order to participate in a public plan. To be effective, and to have a network where there are going to be providers that enrollees want to use, you need a situation where the payments are going to be timely, and adequate, and efficient. And that’s something that the public health insurance plan is going to have to look at. Every state is different in terms of its market structure and you can find differences within states in terms of how much payment rates are. And so that’s what the public health insurance plan is going to have to face squarely and directly, because unlike Medicare , they’re not going to have a population where you can necessarily have providers take whatever payment you’re offering just simply because there are so many people in the population.

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