Health Care

Why Do We Need a Public Option Anyway?

Published November 03, 2009 @ 06:00AM PT

Public Option

Political games are alive and well in Washington, D.C. First the House releases HR 3962, a disappointing bill with an optimistic and completely misleading name – the Affordable Health Care for America Act. Then the GOP decides it’s an opportune time to release its own bill, which House leader John Boehner says will lower cost and expand access by “making the current system work better” with less government intrusion into the private sector. Sounds great John, only, well, there is no system … and that whole government intrusion line? Well, that brings me to my point. Why do we need a public option again?

It seems politicians on both sides of the aisle have lobbyist-induced amnesia on that aspect. Democrats hope including a public option – no matter how weak and ineffective (a more expensive alternative to private plans that covers 2% of the population? Please!) – is all it takes to please the public, even if it’s designed to fail. Meanwhile, Republicans decry government intervention and propose tweaks around the edges of our disastrous healthcare mess that conveniently avoid touching the profit-driven culprits themselves. In other words, the US has heart disease and our D.C. representatives suggest blood transfusions, an artificial knee replacement and a flu shot.

Case in point: the central aspects of the GOP bill are tort reform, insurance pools, and inter-state policy purchases. Two of the three are already in place in many states – they haven’t budged healthcare costs significantly (tort reform achieves 10% reductions in malpractice insurance, per the CBO.) Tort reform is a good idea anyway, but not for cost curve reasons. The third proposal, while useful, doesn’t help much when insurance costs are out of control nationwide.

Douglas Holtz-Eakin, a senior policy adviser to John McCain’s presidential campaign, knows that now. The same man who touted a $5,000 insurance tax credit per family as the answer to our insurance woes now remains unemployed and his $1,000 per month COBRA is running out. He’s shopping the individual insurance market at age 51 and with a pre-existing condition that insurers cite in denying coverage. Think he’s a bit worried? All politicians should be placed in that situation; maybe they would get a clue.

Anyone familiar with T.R. Reid’s body of work on international universal healthcare systems knows that a public option isn’t a part of many of them (gives “socialized medicine” a rather hollow ring, doesn’t it?) There is a single public payer in some (Canada), multiple private insurance payers in others (Germany, Switzerland) and some countries use a combination (England.) What’s the difference then? Very simply, their ‘private insurers’ are non-profit corporations governed by iron-clad regulations: no loopholes, no kickbacks, no lobbyist favors, no profit or surplus beyond required reserves.

Why is that? Insurers are there to provide payment for the care of country residents, with no deliberate and systematized waste and no tricks. Patients are not pawns in a giant profit mill. Now, does this sound like the situation in the US? It seems like the banks and the healthcare industry own Washington, D.C. While Joe Public pays for congressional salaries and benefits (with fantastic health plan choices), lawmakers actually work for Joe Lobbyist. So whatever regulations are placed around the health insurance industry, we can rest assured they will be weak and full of holes by design.

Making sure people are covered and making sure that coverage is affordable are two different things, a distinction neither party has addressed satisfactorily. A strong public option is just one of two methods to keep private insurer prices and practices in line, regulation being the other. But if regulation is to be the answer, we need a representativectomy and a lobbyist exterminator to spray the capital. That seems unlikely. As Nancy Pelosi “mistakenly” left Kucinich’s state single payer amendment out of HR 3962 (as of scheduling this post, it hadn't been reinstated), we can’t vote with our feet by becoming interstate medical refugees. So I’m still pushing for a strong public option.

Photo http://farm3.static.flickr.com/2579/3883236444_edbc207a32.jpg // CC BY 2.0

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Comments (10)

  1. Harold Lewis

    How radical is too radical to get action? Perhaps we should be a far less generous employer. We have a high deficit and can't afford t be subsidizing health insurance for public employees. What do you think? I don't see any public employee unions marching for our rights. To fat and happy?

    And the President? As commander in Chief, he can have the VA, that's all. Anyway, it's good enough and funded enough for those who have served, it ought to be good enough for him. Maybe the service will get better. Of course, he could fight for our rights along with his.

    Our governors, State reps, teachers, police, firefighters, mail carriers? Sorry, we're in debt and can't pay for your insurance. No worry, the market is your friend. Good enough for your bosses, good enough for you. Unless, you'd like to fight for our rights and not just for the things you alone deserve.

    Retirees reaping single-payer rewards while teabagging around town?  Hey, listen, your mortgage is paid up, your kids are grown. Mine aren't and I can't afford your Medicare. It's that simple. Ready to march for our rights, now?

    You're poor? You need Medicaid? Hey, listen, you've no claim to the entitlement any more than I do. In fact, for some reason, no matter what I earn, I'm not entitled to coverage but you are. Now, that's just not capitalist and we're broke. So, you're going to have to figure it out. Ready to get loud with me for our rights?

    Mr. Ban, how about some UN sanctions against the US until they get their human rights straight?

    The only good, strong public option is one that admits our commn cause, our equality, our human dignity, and our rights. It has to be open to all, funded by all, and serve all the same. Looking to compete on the same playing field as private insurance with the ground rules they've laid down is a waste of time and money. We have neither to spare.

    Posted by Harold Lewis on 11/03/2009 @ 09:44AM PT

  2. Jason Jaytheman

    Hey Doc, I have this stinging sensation 'round my backside...

    111 New Federal Bureaucracies Created in the new bill:
    http://www.cnsnews.com/news/article/56532 

    Posted by Jason Jaytheman on 11/03/2009 @ 05:55PM PT

  3. Harold Lewis

    I would object to labeling every lower-case titled program a bureaucracy but do agree that bureaucracies are served. In particular, the bill protects the bureaucrats of private health insurance, the auto, home, and casualty underwriters who also pay out for medical claims (from our premiums),  inefficiently operated care facilities, and financial regulators since Wall St is left with all the insurance profits kicking around.

    Then there's the oh so needed jobs of those tasked with denying claims and drafting loophole riddled insurance contracts. How about the lobbies which play a more integral a part in drafting the legislation than we do?

    It isn't that our government should not be involved, it's that we have surrendered our government to interests working against us. We need to take it back and create a health care infrastructure which serves us, addresses our needs and rights, not the desire for profit.

    Posted by Harold Lewis on 11/04/2009 @ 05:37AM PT

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  4. Jason Jaytheman

    OH, NO... NOT PROFIT!  Profit is what keeps people employed.  Why do politicians attack profit?  (because that's what the narrow minded will believe)

    Since when did "profit" mean the same thing as "greed".  Last time I checked, profit means you have happy customers. 

    Your first paragraph consists of two very long sentences.  Do you have any real proof of out-of-control profits?  Do you have real facts that you can reference from non-partisan sources?  I use www.state.co.us for all of my facts because everything the insurance industry does here is mega-regulated and well documented online. 

    ALL of the facts for Colorado are published including claims $$, premiums, claim appeals, increases in state mandates, and increases in costs due to increased mandates.  We even have a public option!  It gets 25% of its funding from "special taxes and fees on insurers".  We already have price controls... our insurance commissioner approves all the increases!

    Posted by Jason Jaytheman on 11/04/2009 @ 06:04PM PT

  5. Lauren Serven

    Jason, profit from delivering care (and I would consider that earning a professional compensation) is a lot different from the profit derived from using up to 1/3 of someone's health insurance premium to invest and NOT use it towards the reimbursement of a medical fee. In addition, those corporate profits never seem to benefit any group other than shareholders because the health insurers continue to raise their rates while recording profits. Not even the customer benefits from the profits generated. I don't know about you, but that pisses me off.

     

    Where have you been?? Do you actually think Wall Street profits keep people employed???? Wall Street profits usually mean people have lost their jobs, either thru down sizing or overseas exportation of that job. Once upon a time profit was returned back into the investment in people or technology or innovation or comapany growth. Now it just means some sharehoklder's stock value went up.

     

    Greed is ruining more than health care access in this country and when are people going to wake up to that fact? AS to your insurance situation in CO, Congratulations. Perhaps if you were experiencing the chicanery the rest of us are enduring you would have a bit more empathy towards the situation. 

    Posted by Lauren Serven on 11/04/2009 @ 08:37PM PT

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  6. Harold Lewis

    Jason,

    Somehting better must be trickling down on you than most hard-working people. Wall St profits have nothing to do with employment. Moreover, people can earn a living and businesses can profit without the economic rents demanded by corporations and, by extension, their stockholders.

    There should no more be profit from medical needs than from letting you vote, letting you live, letting you have free speech, letting you have fair and impartial juries. A right is not a means to profit. Nor are human needs.

    If corporations were profitting from efficiencies and from the pursuit of satisfying our needs, the reason any economy exists, we would need no reform, no regulation, and greed would not fit into the equation. Profit would be a byproduct of success, a welcome reward.

    But corporate businesses are not people and corporations are not the same as local entrepreneurs. To equate profit and market capitalism with the corporate capitalism we have is ludicrous.

    I live in Jersey and we have some of the most stringent insurance regulation known to this country. I know what insurers claim the mandates cost but there is a difference between covering the costs of funding medical care and paying more than that simply because the insurer wants more and wanting more is why the insurer is in business.

    The mandates are there to define the need that must be addressed. As with any economy, needs will be met and costs covered regardless of whether anyone profits. The sooner Americans wake up to this inexorable fact and dump the worship of wealth, the better.

    Having our government on the side of those non-human entities who simply want more and not on the side of the people's needs violates the very spirit of our Constitution.

     

    Posted by Harold Lewis on 11/05/2009 @ 01:09PM PT

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  7. CherokeeGirl  for Change

    So, I know I'm late to this thread, but let me get this straight, Jason is questioning us questioning high insurance company profits? Where HAS he been. In fact, he just hasn't done his research. Jason, you are defending profit valiantly in the name of capitalism, but you have forgotten that we didn't sign up for our corporations to do us in, literally. I think you need to watch Money Driven Medicine and read up on other systems around the world before you go jumping to defend profits.

    Is it okay with you that corporations profit while someone dies every 12 seconds with no access to healthcare in THIS, our beloved country?

    Posted by CherokeeGirl for Change on 11/12/2009 @ 02:40PM PT

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  9. Stephanie Hunter

    Great article.  It's becoming more and more evident as to why we need a robust option included.  If not, we'll need a lot more of these.  http://cli.gs/z3AtaY/

    Posted by Stephanie Hunter on 11/05/2009 @ 11:30AM PT

  10. M Arnest

    We need a public option because we all have to buy insurance.

    Nancy's bill says it is mandatory that everyone purchase insurance!

    Up to 250,000 fine and 5 years imprisonment for WILLFUL non compliance.

    They can go to%^&#.  I will not going forget this when next year's elections come around!  I'm no longer a democrat (It's time to go INDEPENDENT!)

    Posted by M Arnest on 11/07/2009 @ 04:15AM PT

  11. CherokeeGirl  for Change

    you and me both, M. I refuse to be forced to buy private insurance, I don't trust them with my care.

    Posted by CherokeeGirl for Change on 11/12/2009 @ 02:50PM PT

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Author
Gillian Hubble

Gillian Hubble is owner of Actively Fused, a consulting and healthcare advocacy firm, and a partner in KDG, a business development firm.

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