Healthcare Professionals for Health Reform has proposed an alternate plan for reform called EMBRACE in the Annals of Internal Medicine:

The group proposes a tiered plan, the core of which (Tier 1) would be lifetime, basic, publicly funded coverage for the entire population on the basis of the best evidence about which therapies are considered life saving, life-sustaining, or preventive. Optional coverage (Tier 2) would be funded by private insurance and cover all therapies considered to help with quality of life and functional impairment. Items considered to be luxury or cosmetic (Tier 3) would generally not be covered, as is the case under the current system.

Should Congress consider EMBRACE as an alternative to the plans currently being discussed?  How would a tiered system compare with the current system and with the reform being discussed in Congress?

An editorial in the Philadelphia Inquirer asserts that public plan is the best option for controlling costs and increasing coverage:

The most assured means of tamping down costs while providing greater access to health coverage could be through the government-run health plan that Obama proposes as a new option.

Private insurers so far oppose that idea, but congressional proposals being developed would level the playing field between the public and private health plans. That’s a good approach.

Is a public plan option the best way to control cost and increase access?

In a Wall Street Journal op-ed, the CEO of Eli Lilly argues against the public insurance option:

On the contrary, without new, more effective medicines — along with new devices and diagnostic tools, and better treatments and surgical techniques — it will be impossible for larger numbers of Americans to obtain better health care at a manageable cost. So it is vital to all of us that we insist that reform proposals pass the “innovation test.” Providing insurance to millions of Americans through a government-run plan would fail the test.

Does increasing access to health insurance via a public plan hamper medical innovation??

The Boston Globe reports on concessions by the insurance industry in response to the threat of a public plan:

The health insurance industry offered yesterday to end its practice of charging higher premiums to women if all Americans are required to get coverage, its latest concession as it tries to head off creation of a government insurance plan that would directly compete with private insurers.  Last year, insurers offered to end the practice of denying coverage to sick people, and earlier this year they went still farther by offering to stop charging sick people more.

Are these insurance company offers enough?

A New York Times editorial counters the argument that a public plan would overtake private industry:

Innovative, nimble private plans with well-integrated service systems might outperform any government plan, just as some now outperform Medicare through better coordination of services, stronger preventive care and broader benefits.

A new public plan is neither the cornerstone of health care reform nor the death knell of private insurance. It should be tried as one element of comprehensive reform. If, over time, a vast majority decides the government plan is superior, so be it.

Can public and private insurance compete on a level playing field?  Should they?