All eyes were on the Senate Finance Committee’s draft bill for healthcare reform, and it seems very little of substance has changed.

In continuing the pursuit of health-care “co-ops”,  The Senate Finance draft bill provides a possible loophole for scam artists to form shell companies to drain away the government’s startup subsidy.  Moreover, multiple co-ops will be allowed in each state, severely diluting their market power against established insurers.

The bill does next to nothing to aid people who want to buy insurance across state lines, requiring “national” plans to be registered in every state they want to do business in.

The bill does nothing to grow the risk pool.  People will be permitted to buy plans that only cover catastrophic claims, leaving the rest of people who opt for traditional coverage with higher premiums than if everyone was paying a fair share.

And naturally, the Senate Finance Committee asks much less of health insurers in general than HR 3200.  Seniors will pay 5 times as much as young people for the same insurance policy.  HR 3200 limits this to 2:1.

The bill fails to take any sort of leadership on malpractice reform, instead suggesting that states try out some pilot programs of their own.

Kent and Max have compromised on almost everything, but with Republican “support” for any substantiative measure evapourating, what have they gained?  I say ignore Kent’s boondoggle and pass the HELP committee’s version through the Senate instead.

Reportedly, North Dakota’s airwaves are being flooded with ads on the heathcare issue. I say reportedly, because I haven’t actually seen any such ads.  The trouble with waging an ad campaign in the summer is that, well, there’s really not that much on, and not that many people watching it.  I could stick my eyes to the tube for a day straight out of morbid curiosity, or I can simply offer you my two cents during this monthlong doldrum before anything actually happens again.

The bottom line is this: North Dakota needs healthcare that is local, comprehensive, and affordable.  Local meaning that no one, even in the sparsely settled Badlands, should be very far from a doctor. Comprehensive, meaning that everyone should a health insurance plan that covers pretty well all of their health care costs.  Affordable, meaning that between premiums, co-payments, and out-of-pocket expenses, nobody should have to pay more than 20% of their income in a year for healthcare.

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As Senate Finance chairman, Kent Conrad continues to be a key player in the health care debate.  Though the House version of the health care bill is out in the open (just type “HR 3200″ into http://thomas.loc.gov/ ), visible to all, Kent is apparently insisting that the Senate version won’t see the light of day until it is finished from the perspective of his committee, but the good money’s on a cooperative plan.  Though it’s still got that bipartisan buzz, the new options may be too small to matter.

Conrad also clarifies how he shopped around for his house loan.  Take a watch:

MeritCare of Fargo is merging with Sanford Health of Sioux Falls, combining the two largest health providers in the Dakotas into a $3+ billion operation.

I would hope they take the opportunity to lower costs to patients through proper use of their scale of operations and reductions in administrative redundancies, and to expand service in outlying areas — rather than abusing their position.

The Senate has been feverishly whittling parts of the proposed health plan away, although the exact details seem to be out of reach, as even getting hardish numbers on the amounts being slashed from the proposal requires anonymous leaks.

This is the most important legislation of the decade and I’ve yet to see a draft. I’ll just have to ask for a copy.

One of North Dakota’s mega-rental firms has been caught scamming the disabled with illegal fees for companion animals. A Fair Housing of the Dakotas followed up on complaints and found Goldmark openly admitted to asking for a $235 up front and $20 a month.

That may not be unreasonable for your average pet owner, but it’s obscene to ask someone with a medical need for the animal to pony up.  If Goldmark does anything but immediately correct the problem and return its ill-gotten gains, then it is not a company that deserves anyone’s money.

It seems Kent’s plan isn’t making waves out there.

As a North Dakotan, I hear the word “cooperative” and get warm fuzzy feelings.  But I also know that the most successful cooperatives are the biggest ones.  So it is puzzling to me that this was not the goal of Senator Conrad’s proposal.  The problem with Kent’s idea isn’t that it’s a cooperative.  The problem is that it doesn’t even try to create the One Big Cooperative that would be needed to make an impact in the marketplace.

Instead, Conrad wanted to create the opportunity for people to create their own cooperatives.  This is a solution that is piecemeal and onerous on individuals and small businesses, as they either have to make their own co-op, or sift among the proliferation of tiny ones that come about as a result of the present proposal.  All of them will then be at the mercy of private capital firms, because each of these tiny cooperatives will need re-insurance against catastrophic claims larger than their customer base could otherwise pay for.

A key problem for me in judging the merits of this or any other legislative proposal which hasn’t actually hit the floor of Congress is that the text of these proposals aren’t readily and publicly available on THOMAS, the site that keeps track of officially filed bills and amendments, and amendments to the amendment, et cetera.  If Conrad’s measure is there, it’s not apparent to some serious search attempts.

Having key proposals like this being traded around backrooms, between politicians and better-placed journalists, is no way to run a country.

This week, President Obama called for a government-run nationwide health plan exemplifying the ideal of coverage for everyone, something that private insurers would have to compete with by offering better coverage or lower rates. Apopleptic conservatives immediately decried “Big Government” and reiterated their everlasting faith and fealty to the “free market”. Some cited an American Medical Association policy statement initially opposing a government plan, but the AMA’s views seem to be conflicted at best.

Though I do not share the fear of a direct government insurance plan, if it’s a political showstopper, then there needs to be a compromise that can still keep other insurance companies honest.  Accordingly, Senator Conrad has proposed that the health plan be administered by a cooperative owned by policyholders. It’s a business model that other health insurers use, many of which behave exactly like their corporate brethren, skinflinting patients with the best of them.  Some provide the savings to their members through rebates, and others simply pump up executive pay and fly themselves to tropical vacations.

Knowing this, it is obvious that cooperative ownership alone will be insufficient to maintain an honest insurance company, and in turn, set a proper example for others to compete against.  It will require organized, vocal blocs of people dedicated to ensuring that the co-op keeps healthcare the top priority, and ensures administrative overhead is kept to a minimum.

The Wal brothers are at it again — Wal-Mart and Walgreen’s, who spent upwards of $200,000 on lobbying against North Dakota’s laws that protect small-town pharmacies, have launched a petition drive to prop up the law that their money failed to pass. They hope to be able to start their pillage by the end of 2010.

The Department of Health is seeking southwestern farmers to participate in a health study into the effects of erionite, an asbestos-like mineral found in the area — most concerningly in the region’s many gravel roads.  30 more participants are needed.  Study participants will undergo testing in Dickinson and recieve $100 for the trouble — and hopefully will reveal the real-world lung cancer risk of breathing in Badlands gravel dust.