Health care: Why the 'public option' is crucial
THREE QUESTIONS about the health insurance "public option": Is it in? Is it out? Does it matter? Three answers: No one knows yet. No one knows yet. But yes, it matters. It matters a lot.
THREE QUESTIONS about the health insurance "public option": Is it in? Is it out? Does it matter?
Three answers: No one knows yet. No one knows yet. But yes, it matters. It matters a lot.
In a series of messages more mixed than than the contents of an Osterizer blender, the White House last weekend seemed to signal that it was dropping its support for a government-run insurance option in its health care reform legislation.
President Obama, who previously had insisted that a "public option" would "keep insurance companies honest," said Saturday that the "public option" is only a "sliver" of the health-care reform package. Similar word weaseling from Health and Human Services Secretary Kathleen Sebelius followed. Yet a day and much public outcry later, the White House was claiming nothing had changed.
Whether the weekend madness was weakness or political bungling or both, the president is right about one thing. The "public option" is a "sliver": It's just about the only sliver of true reform left in the proposed legislation. Without it, so-called health-care reform could turn into a trillion-dollar corporate welfare program.
Even discounting the outright lies being perpetrated by opponents of reform - the "death panels" and forced abortions - there's still substantial confusion about what's at stake.
So, once more, with feeling: Health-care reform legislation supported by most Democrats - but almost no Republicans - would expand insurance coverage by instituting stricter regulations that would keep insurers from denying coverage for pre-existing conditions, or imposing lifetime limits.
At the same time, everyone would be required to buy insurance, with government subsidies if necessary. This would mean millions more customers for private insurers, representing millions more in premiums.
But since there is barely any competition among private insurers now - for example, about 75 percent of the people in Southeastern Pennsylvania are covered by Blue Cross - there would be little incentive for private insurers to lower costs or find better ways to deliver care. Of course incentives to find ways to circumvent the government regulations would remain.
That's where the public option comes in. Phased in gradually, it would allow consumers to choose a government-run program from among an array of private insurance companies. With no profit motive and no incentive to get around regulations, the government program could provide lower premiums, better coverage - that is, true competition.
Choice. What could be more capitalistic? What could be more threatening to private insurers? (Monday's stock market report told the tale: When it looked like a national "public option" would be replaced with regional - read weak - co-ops, health insurance stocks went way up.)
But the reports of the death of the "public option" have been greatly exaggerated. Sixty progressive Democrats in Congress - including Philadelphia's Chaka Fattah - have signed a letter insisting that a "public option" remain in the legislation. Now's the time to encourage other members of Congress to join them. Ignore the so-called "pragmatists" who want to settle for something they can call reform but isn't.
Just wondering
A block from the convention center in Phoenix where Obama was speaking on Monday, a dozen people showed up carrying guns, including at least one AR-15 assault rifle. Imagine the reaction if, in 2001, a dozen men showed up outside of an appearance by President George Bush with guns and automatic weapons?
