During a Friday tele-town hall event, Senate Majority Leader Harry Reid told constituents that he doesn’t think the public option ought to be a government run program like Medicare, but instead favors a “private entity that has direction from the federal government so people that don’t fall within the parameters of being able to get insurance from their employers, they would have a place to go.”
Today, a Reid spokesperson tells me, “[t]he idea is that [Department of Health and Human Services] could contract with a third-party administrator to do the administrative stuff. It would still be policies set by HHS.”
Though this isn’t the reform community’s first preference, it is something they could get behind.According to Richard Kirsch, National Campaign Manager for Health Care for America Now, such an arrangement might work out OK.
The public option “doesn’t have to be a government agency, though we’d prefer it,” Kirsch said. “The entity would have to be accountable to the public, it’s risks borne by the public, and its policies set by a public entity.
Medicare, for instance, contracts out certain administrative tasks to private parties, but its prices and policies are set by the government, which bears all of the risk, and the program is accountable to voters–not to shareholders or a board of directors.
On Friday, Reid was careful to draw a distinction between the private entity he envisioned and Medicare, but those differences appear to have little to do with the administration of the plan (as Reid implied) and perhaps have more to do with the more substantive matters like price setting.