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Public Plan Option: Fair Competition or a Recipe for Crowd-Out?

Monday, April 27, 2009

One of the various proposals to expand coverage to the more than 45 million uninsured Americans is referred to as the “public plan option.” Though proposed only as part of a broader effort to expand coverage, the option is viewed in varying lights. Some see it as a tool for providing consumers affordable coverage by stimulating competition on the basis of quality and efficiency. Others see it as unfair competition for private insurers and, in the extreme, as a path to a single-payer system.

What is actually meant by a public plan and how would it work? Is there evidence of fair competition from public plans? Might private plans outperform a public option? What are some examples of private systems today that are delivering quality care efficiently? What can we learn about crowd-out from state initiatives? Would individual and employer mandates make the plan more palatable?

To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored an April 27 briefing. Panelists were Karen Davis, president of The Commonwealth Fund; Karen Ignagni, president of America’s Health Insurance Plans; John Holahan, Urban Institute; and Stuart Butler, The Heritage Foundation. Ed Howard of the Alliance moderated.


 Ed Howard, Alliance for Health Reform, Moderator
 Karen Davis, The Commonwealth Fund, Speaker
 Karen Ignagni, America's Health Insurance Plans, Speaker
 John Holahan, Urban Institute, Speaker
 Stuart Butler, The Heritage Foundation, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Public Plan Option: Fair Competition or a Recipe for Crowd-Out? (Adobe Acrobat PDF), 4/27/2009
Event Summary: Public Plan Option: Fair Competition or a Recipe for Crowd-Out? (Word Document), 4/27/2009
Full Webcast/Podcast: Public Plan Option: Fair Competition or a Recipe for Crowd-Out?

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Karen Davis Presentation (PowerPoint), 4/27/2009
Karen Ignagni Presentation (PowerPoint), 4/27/2009
John Holahan Presentation (PowerPoint), 4/27/2009
Stuart Butler Presentation (PowerPoint), 4/27/2009

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Word Document), , 4/27/2009
Speaker Biographies (Word Document), , 4/27/2009
Selected Experts (Word Document), , 4/27/2009
Public Plan Option: Fair Competition or a Recipe for Crowd-Out? (Word Document), , 4/27/2009
Panelist Responses to Written Questions (Adobe Acrobat PDF), , 4/27/2009

Offsite Materials (briefing documents saved on other websites)

A Government-Run “Public” Health Insurance Plan: Why Doctors, Hospitals, and Patients Will Lose (Adobe Acrobat PDF),U.S. Senate Republican Policy Committee, 3/24/2009
A Health Plan for All and the Concerns Its Raises, New York Times, 3/25/2009
A Lesson on Health Care From Massachusetts, The New York Times, 3/29/2009
A Modest Proposal for a Competing Public Health Plan, New America Foundation, 3/1/2009
Aetna Fights Public Health Plan as Industry Offers a Concession , Bloomberg, 3/24/2009
Can a Public Insurance Plan Increase Competition and Lower the Costs of Health Reform? (Adobe Acrobat PDF),Urban Institute, 10/8/2008
Competitive Health Care: A Public Health Insurance Plan that Delivers Market Discipline (Adobe Acrobat PDF),Center for American Progress Action Fund, 3/1/2009
Health Reform Without a Public Plan: The German Model, The New York Times, 4/17/2009
Health-Care Battle Set to Focus on Public Plan, The Wall Street Journal, 3/24/2009
How a Public Health Plan Will Erode Private Care (Adobe Acrobat PDF),The Heritage Foundation , 12/22/2008
Obama Aide Sees Public Health Plan as Part of Reform, The Washington Post, 4/15/2009
Pricing a Medicare-Like Public Health Plan, New York Times, 4/10/2009
Stakeholders start offering their own proposals for health reform, American Medical Association, 4/6/2009
The Cost and Coverage Impacts of a Public Plan: Alternative Design Options (Adobe Acrobat PDF),Lewin Group, 4/6/2009
The Path to a High Performance U.S Health System, The Commonwealth Fund, 3/1/2009
Healthy Competition: How to Structure Public Health Insurance Plan Choice to Ensure... (Adobe Acrobat PDF),Institute for America’s Future, 4/1/2009
The End of Private Health Insurance. Not., The New Republic , 4/13/2009
CPC Letter to Democratic Leadership (Adobe Acrobat PDF),Congressional Progressive Causus, 4/2/2009
Butler: Perils of a Public Health Plan, The Washington Times, 3/26/2009
Ensuring Access to Affordable Health Insurance (Adobe Acrobat PDF),The Heritage Foundation, 12/2/2008
How a Public Health Plan Will Erode Private Care (Adobe Acrobat PDF),The Heritage Foundation , 12/22/2008
Massachusetts Health Reform: Solving the Long-Run Cost Problem (Adobe Acrobat PDF),Urban Institute, 1/1/2009


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