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Four Reasons Why the Public Health Care Option is Irrefutable
I'm not a healthcare wonk. Of course, I want the 46 million uninsured Americans to get coverage, but they have not been my primary concern in healthcare reform (even though I have been among the uninsured many times in my life). I have to admit I'm being a bit selfish here because I mainly want to have less expensive health insurance that still gives me decent coverage.
Why? Because these healthcare costs are killing us. It significantly impacts our family's life. We're just like everyone else, getting crushed under these bills. And what drives me crazy is that after paying more than any other country in the world, we get the 37th best coverage. That's unacceptable. We need to change this system.
This is why I'm in favor of the public option. I need lower bills. Republicans are saying that the public option is unacceptable because it will be too cheap and too efficient, so private companies cannot keep up with it. Great!
Frankly, I don't give a damn what happens to private insurance companies, I just want less expensive coverage that does the same job (or better). And that's what the Republicans are telling me is going to happen.
Mitch McConnell literally said this weekend on Fox, "The private insurance people will not be able to compete with a government option." Doesn't this prove that the private insurance companies will not be able to do as good a job as the government? Then step aside, Butch.
Here are four indisputable reasons why the public option must be part of the healthcare proposal:
1. The government doesn't have to advertise. No marketing budget means less costs to pass down to the consumer.
2. The government will not take a profit. That is about 10-30% of costs wiped out immediately. Private companies by their nature will add a certain percentage to the product for their own profit. That comes directly out of our pocket. An option that doesn't take profit also doesn't take as much money from us.3. The government will have enormous negotiating leverage with drug companies and health care providers, so they can drive down the costs to the consumer even more.
4. It is an option! If it turns out that the government option does not work as well or costs more, no problem, just use the private insurance you have now. This is only an option you have in a more competitive market. Who can argue with that?
There are legitimate concerns that progressives have with the public option. It is not single payer. The government does not pick up the tab. You still have to pay a premium and the current system is largely maintained. But I think this is better than single payer. It gives us a choice and allows the market to dictate which system works better in the healthcare industry - public or private.
If in the end, more people choose the public option, then obviously it worked. If they don't, we've lost nothing because they can still get private insurance.
Another important point to remember is that the doctors, drug companies and medical providers are still private entities. They can compete with one another for more business by producing better products or making them cheaper. The base of healthcare services is still the same. It's just how you pay for it that would change a little.
And no one is getting between you and your doctor (unless it's your current provider who won't let you go out of network). You can pick any doctor you like under the public option; you just pay him from your public insurance rather than your private insurance. And it costs less. So, where's the harm?
Well, some would argue that the costs of the public option might be more than we realize. For example, the government will cover pre-existing conditions, and that could add to the costs of the plan. No problem, if you can find a better private plan, take it! If you want to add on to the coverage the public plan gives you, do it! Nobody is stopping you from getting more or different coverage from a private insurance company.
Plus, there are even more savings that are likely from the public option because the government has proven to be more efficient in how they run healthcare insurance policies. Medicare has 2% in overhead, while the average private insurance plan has about 10-25% of their costs in overhead. That's an enormous difference. But even if you think the government can't run an enterprise as efficiently (though the evidence clearly shows otherwise), you would be hard pressed to think they couldn't at least cut costs significantly because of the first three reasons stated above.
So, given all of this, it is absolutely clear that the public option must be included in any real healthcare reform plan that comes out of Congress. Otherwise, it's a joke and the lobbyists have won again. The public option is the whole enchilada here. Politicians who talk about compromising on it have no policy ground to stand on. They are simply doing the bidding of their benefactors, large healthcare corporations who feed their campaign coffers. Don't believe any sweet talk about necessary compromises. It is a deception meant to kill the heart of the bill.
It must be the public option or bust. There will be many things to negotiate in the final bill, but this cannot be one of them. Otherwise, there will be no real reform.
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Something is truly disturbing here.
There is great confusion over the difference between "single payer" AS AN OPTION,
(which it can be, and is - in France, for instance)
and 'just any' "Public Option."
Namely, "#3. The government will have enormous negotiating leverage ...etc."
- IS NOT TRUE. The versions almost exactly like this, tried in MA and other states, are going bankrupt.
The problem:
The assumption that an "exchange" providing government "negotiated" plans
but FROM PRIVATE, FOR-PROFIT HEALTH INSURERS
-(btw exactly what we have now)-
Does NOT eliminate profit from the picture at all.
Think about it. Why would an Insurer negotiate a decent price with the government
("Exchange" or Co-op") in DIRECT COMPETITION WITH ITSELF ?
Of course they wouldn't. They would instead operate at a loss for years and years
TO AVOID EVER NEGOTIATING IN GOOD FAITH.
THIS IS WHY THE "OPTION" MUST BE SINGLE-PAYER, (again as in France,)
where the government plan bypasses FOR-PROFIT Insurance "providers"
- like Insurance Companies AND HMO's.
The Democrats have a once-in -HISTORY opportunity of clout and political capital (in the Reconciliation process,) and it would be TRAGIC to see that wasted on a plan the Massachusetts experience already proved does NOT WORK.
"Co-ops/Exchanges," and "Trigger," are the two classic ruses moderates have used to emasculate a government plan.
Additionally, what sense does it make to levy a FINE on someone who can't afford health insurance or pay taxes (to get mitigating credits.)
Reason #5 - The government is far more committed to society than private enterprise.
1st - If you live in a town where you can get thru either the Post Office or DMV, then congrats. You are a lucky soul. Clearly you haven't tried mailing things in Los Angeles. I am NOT apposed to a free market, but mark my words - Socialized or Nationalized medicine hasn't worked.
Have ANY of you spoken to a Canadian citizen. I do a lot of business in Canada and so far, ALL I hear about is the high cost, and poor service.
I LOVE all the comments that say "If you don't like it, then don't buy it".... That is fantastic "idea" but the fact still stands that there are close to 11 million "claimed" illegal aliens. The number is more than likely t times that. Someone will have to pay for them. Who do you propose that will be. You!
Nationalized health insurance does not insure equal access. Elderly people in Canada, UK and New Zealand report difficulty in obtaining health care.
I think you might consider looking into the FACTS before jumping on the Obama Spending Wagon. Health care is such a mess in part of Europe that Sweden, Germany, and Austria are now looking to establishing free-market alternatives in an attempt to alleviate problems caused by their nationalized health care systems.
Yeah, in NZ we do have long waiting lists. It sucks, but there is no WAY I'd choose private health care over public. Most of my family has had to go to hospital for something over the past 5 years. We're not rich, so under a private system we'd be crippled. And the level of healthcare I personally recieved in the public system was great. The private option is there for those who want it though.
Sure, it's not perfect, but ask anyone and you'd be hard-pressed to find someone who'd say we should go back to a fully privatised healthcare system (of which we haven't had since 1937).
Now the subjeict of paying taxes to maintain roads I'll never drive on, all because Aucklanders are too cool to carpool...that what annoys me!
Um....yeah, I HAVE talked to Canadians. Every single one of them LOVES their health care system.
Will we be served health care for profit or for honor? The health insurance industry has already failed America, and I already can't afford any of that. I'm kind of afraid that they will pass health care reform and force me to pay for some overpriced solution that will actually drag more Americans to bankruptcy than solve any problem of Americans going bankrupt for visiting a hospital. I really hope I'm wrong about that, but I'm sick of hearing this argument that we need to be fair to the insurance industry, or that a public option isn't fair to insurance companies. Well aren't paybacks a bitch. Poor insurance companies, oh my hearts bleeding for them. What a crock! Health insurance industry be damned. I thought my government already purchased AIG, the largest provider of health insurance in America, so we already have the health insurance industry by the balls and our government is already in the health insurance business. It seems nobody wants to bear the failure of awful policies as long as they can use the taxpayers for chumps. I say let the insurance companies be the chumps, and go down with their own failure. I'm not going to loose a second of sleep over a bankrupt and failed insurance industry. The whole world knows the failure of our health care system better than the average corporate brainwashed American. I'm not sorry to see the American insurance racket come to an end. They don't give me any lobby money.
I can see three hurdles that must be jumped before the healcare plan can succeed.
1. The word "socialism" will be used extensively by the RIght to describe this plan. I fear that to too many Americans "socialism" has no other meaning than "bad". So a little education is needed here.
2. Racism. There are still too many Americans that would prefer exclusivity. That is, not walking into a waiting room filled with black and brown people.
3. Lobbies, Congessional lobbies, and damned Congressional lobbies.
Some comments on Canadian Health Care have been posted here. I think this article clears up so many misconceptions about our system:
http://www.denverpost.com/opinion/ci_12523427
The irony is that the author is a Canadian living in the US of A
Whatever system that is finally adopted by the American people will have growing pains. Please have patience - your government actually appears to care about serving you, its people.
I wouldn't be surprised that this "public option" would morph into a single payer system if the people like what they get. The trick is to make that initial hit to private insurance profits, which this public option will no doubt do. Once insurance companies take that hit, it will be easier to move in the universal direction. Everybody holding their breath for a one-payer system should consider Voltaire's observation, "the perfect is the enemy of the good." [Of course he's French and thus has proto-socialist tendencies.] I too favor a one-payer system, but we are coming at this with a huge, entrenched insurance industry that has tons of influence. Other countries put their systems together before insurance companies became behemoths, after large scale social upheaval. We are coming at this knowing full well that insurance companies are going to lose money. Of course they are going to put up a fight and that means they are going to call in their favors in the legislature. This "public option" strategy is really quite ingenious. It very much neutralizes the standard GOP complaint, which boils down to, "I am wealthy and want the best medicine money can buy." In my lifetime I've never seen any positive motion on this problem. Here we may actually get something. Have at it Senators.
I want a public option so that I can change jobs without having to limit my employer options to large companies that provide health insurance.
There have been times in my life when I've wished I could join a start-up or small company. But if I had to shop for insurance on my own because a small-sized employer didn't offer any, I'd surely get turned down due to pre-existing conditions or the premiums would be so high I couldn't afford them.
Public option = greater freedom to move around the job market!
Public option also equals onerous premiums and deductibles. It's a phony reform--see my posts below for additional details.
Onerous? I'm a 45 year old Canadian, and my healthcare costs me less than $60 a month. With NO coverage ceiling, no HMOs looking over my shoulder and second-guessing my doctors, and no co-pays. I have never had to pay for any medical service at my doctor's office or a hospital.
And BTW, my city has the second-highest life expectancy in the world, so this price is not coming at the expense of quality care.
Onerous premiums? I pay Regence of Washington $600.00 a month, have a $1500.00 a yearly deductible and my prescription benefit end at $3000.00 a year. That might sound like a lot until your Dr orders Blood Glucose test strips $100 a box, Avandia $300 a month, Topamax $250.00 a month. (The manufacture of Topamax fought release of generic for months in the courts when the patent expired.) When you don't and cant have routine preventative test done like a colonoscopy ($2000.) because if will go on the deductible and you have to pay 20% of what is left. I can't go get me teeth cleaned because I am paying so much for medical insurance. Why should insurance companies be siphoning off profits from health care dollars. I am 61, and struggling to pay these horrible rates. I have worked all my life, never been to travel to Europe, the East coast, Washinton DC, New England, the Carribean or many places I have dreamed about. It is all going to health insurance!
No, actually it doesn't mean greater freedom. The "public option" as it's being discussed is neither public nor an option. First it only applies to poor people, the public at large can't sign up for it. Second, it's part of mandatory health care. You have to have health insurance and if you can't afford it then this will be provided for you.
This is a scam to avoid real health care reform. It will force the public to cover excessive costs (sicker, poorer people) while driving the paying customers to private insurers for their profit. There is no cost control in this mechanism so it doesn't help hold prices down.
It 100% stinks.
You are correct, Sir. The public option (if there is one) will be a repository for the infirm and chronically ill, thus relieving the private insurance companies of a substantial drain on their profits. It all depends on whether or not insurance companies will be allowed to pre-screen those who apply with authority to decline inclusion or charge more for coverage than they would for a young healthy person. It's hard to believe that the public option would be cheaper than private insurance with better benefits otherwise no one would choose private insurance. As you say, jmpurser, it's all a scam.
Some links and evidence for this would be nice to back up your opinion with.
What piece of legislation are you reading from to get these ideas? Is it a house or senate bill. If is from one of those Rick Scott adds. he defrauded medicare in the past and belongs you know where. We need to read the actual house and senate bills which you can easily find on their websites. HR676 is a good place to start. I like you have the guts to use your name!
At the core of any government funded health care plan should be an emphasis on personal responsibility. You cannot eat, drink and smoke yourself to death and expect others to pick up the tab. Ever wondered why any application for health or life insurance contains questions about your (over)eating, drinking and smoking history? The insurance industry is a business of calculating the risk. The more risk you pose, the more you pay. If you think it ain't fair, move to Canada.
The more you work in a stressful environment, the more you drive, the more you take part in sports likely to inflict injuries the more you pay?
The more your family health history and your DNA analysis makes you sseem likely to develop certain conditions the more you pay?
You have twisted what I said or you don't understand the difference between preventable causes and inherited ones. You are using inappropriate examples. Stress is a subjective category and cannot be quantified. What may stress you out, may be a sheer pleasure for me and vice versa (like what you do, do what you like). No insurance company ever considers something like that in their formulas. Same goes for the exposure to injuries, but keep in mind that some insurance companies, especially those selling life policies do ask questions about extremely hazardous activities. Majority of sports are not among those (unless you're a bull fighter). Be reasonable, use common sense.
That's nice but probably not a huge driver of costs. I mean who thinks "well, I was going to quit cigarettes but now that I know my chemo will be on Uncle Sam I think I'll start chewing too!" Anyone who thought like that should probably be in a mental ward.
However I saw on "Sicko" in I think France, the Doctors were paid extra depending on how many of their patients lost weight or stopped smoking. Now THAT made a lot of sense to me.
Yeah, and what about a seemingly normal child who suddenly develops leukemia? A 27-year-old vegan with no known health problems who goes into sudden cardiac arrest? A responsible adult with good diet who develops colon cancer?
Why don't you think before you hit the keyboard.
Canadian experience has been that with single-payer coverage, it costs more to operate a system of variable pricing than you can save by doing so. Instead, the healthcare system gets more benefit from spending on general 'public health' programs that aren't tied to insurance price.
A 'personal responsibility' system like the one you propose makes ideological but not economic sense.
Yes, YerRight and while we are at it tax the manufacture and sale of evil products like CANDY, POP, CHIPS, ROASTED AND SALTED NUTS, ETHANOL FOR CONSUMPTION, PURE FATS FOR CONSUMPTION, REFINED SUGAR, WHITE FLOUR, ANY GRAINS THAT ARE NOT WHOLE GRAIN, ICE CREAM AND ALL SWEETENED MILK PRODUCTS, ALL MIXED FROZEN MEALS THAT CONTAIN OVER 500MG OF SODIUM, UNNECESSARY HIDDEN MILK PRODUCTS, UNNECESSARY OTHER HIDDEN FOOD PRODUCTS THAT ARE NOTORIOUS FOR CAUSING ALLERGIES. PUT A HUGE TAX ON AMMUNITION! Gun violence costs our health care system enormously. Of course law enforcement agencies would be exempt from paying the ammo tax as well as the military. We can start this slowly like a small tax on junk food, pop and alcohol, then gradually increase these taxes like the story of the frog in the boiling water. Most people know they really should not buy this junk anyway These taxes will pay for health care.
"The government will have enormous negotiating leverage with drug companies and health care providers, so they can drive down the costs to the consumer even more." - Not necessarily. How come this "enormous negotiating leverage" does not work for defense procurement (single payer by definition) which is a scam that even beats our present health insurance system?
Excellent point.
This is because of the corrupt revolving door between the Pentagon and the defense contractors. This is not the situation that would obtain under single payer, in which the plan would be staffed by health-care professionals with no ties to the HMOs or Big Pharma.
It works in the VA--it pays much lower prices for drugs than we suckers who are victims of the private insurers.
Remember the power to be that were in running Washinton up to 6 months ago liked giving out no bid contracts to there former employers.
Because it's set up much like the Medicare Part D plan was set up, where negotiations are not allowed. When they are allowed, cost overruns are paid, generally in a cost plus circumstance. Further, many of the contracts the DoD is paying for were given to them as no bid by the bush administration!
I "public option" is unlikely to get you those lower bills. The only proven approach to health care reform is single payer and the "public option" isn't even a down payment on that. There is nothing in the "public option" that contains a mechanism for holding costs down.
The "public option" is not a "public plan". It is in fact yet another way to foist the costs of a system (poorer, older, sicker people) off onto the government while driving the healthier, wealthier, patients to private companies. The "public option" as it is currently being discussed would require the poor to submit to a financial audit to prove their need, only to be taxed additionally in order to get health care. The rest of "the public" would have no option but to buy from one of the private plans currently at the heart of America's Health Care Crisis. This is neither a "public option" nor a "public plan".
A real public plan is universal single payer health insurance run by the government. This is a proven plan that can achieve all the stated goals of health care reform. The only thing it doesn't provide is massive profits for the health insurance industry and bribes for congressmen which is why it's "not on the table" now.
If you would like a REAL public plan then contact your congressional delegation, state governor, and the white house and tell them this nation NEEDS single payer health insurance!
Single Pay insurance is obviously the best option. But guess what we will not get it because we did not make enough noise. We did not make it a condition or a litmus test for our vote. We have not placed enough pressure on Congress while crafting the bill.
It's hard to "place pressure" when you're denied access to the room which is exactly what happened both at the congressional and presidential levels. They don't WANT health care reform.
The glaring problem with a public insurance option as opposed to single-payer. If you are a self-employed independent contractor, as I am, when you don't work you don't get paid. Therefore, if you get sick or you the work load goes down suddenly -- as a legal transcriptionist this has been the worst part of my job, although in the last few years it's been rock steady -- you can't pay the premium. And when you can't do that then the mandates come in -- assuming Obama and Kennedy wins on that one -- and you get fined a small fortune for not being able to carry the premium because you're sick. And what is affordable. I've said many time that as an individual I can't afford the premium for Healthy New York at $259 a month and $25 co-pays, no prescription coverage, no dental, no eye care, huge deductibles for hospitalization. It's a bare-bones policy. If this is the type of policy they're going to be offering all Americans as the public option it's a joke.
Why can't the Public Option be single-payer plan as outlined in HR676? If one does not want it one does not have to participate.
Insurance companies don't want the public option because they know that once people get a taste for the quality the government can provide at less cost, the next step will be that most people will leave their insurance plans well behind forever. It's a stepping stone toward a single-payer system, perhaps the closest we can get at this point in time. And the sooner the better.
The "public option" is not a steppingstone toward single payer. At best, it is a step sideways, at worst, a step into the abyss. Part of the problem is that there is no clear conception of what the public options would entail. The only publicly floated version--proposed by Schumer at the behest of Baucus (both owned by the HMOs)--is farcical: the pub-op would have to charge premiums and impose deductibles and would essentially be no different from an HMO--except that it would be saddled with the oldest/sickest cohort and thus would incur unmanageable costs; the youngest/healthiest/most profitable cohort would be aggressively marketed and snatched up by the HMOs.
The public option plan would leave most of the system in the hands of the rapacious HMOs; therefore it would neither control costs nor achieve universal coverage. It's a sham designed to gull the public into thinking they're getting "reform" while leaving the system essentially unchanged.
For a good summary of the pitfalls of the public option plan, see the following:
http://www.pnhp.org/facts/singlepayer_faq.php#public-option
A "public option" will never compete with the insurance companies AND you probably won't be allowed to take it. It's not really either public or an option.
The author is right about one thing, he is no healthcare wonk and, clearly, makes absolutely no effort to understand both sides of an argument. The reason that republicans say that private companies cannot compete with the government option is because the government option is more efficient, but because the government option is subsidized by the taxpayers. So, even if you go with a private health insurance plan, you are still paying for the public option.
Also, the 46m uninsured number is a total farce.
First, you're right, that 46 million uninsured is a farce now, because it's closer to 50 million.
Second, the government plan will not be subsidized by taxpayers, it will BE taxpayers. The reason that they will not be able to compete is because the government plan spends 3% on administration, whereas private insurance pays between 25 and 50 percent for administration!
You forget that the government wastes 42% of the money it collects. Add that to the 3 % administration fee and you are at the upper edge of what private insurance pays for administration.
Second the government plan will be taxpayers. Just not the same ones that get the service. That is socialized medicine.
So do you want a doctor with the compassion of the IRS and the efficiency of the DMV?
Let me get this straight - a government subsidy tips the balance, thereby squashing competition in the "free market", therefore we shouldn't do it.
So why is it okay to give subsidies to oil companies, energy companies, telecom companies, agricultural companies, pharmaceutical companies, etc.?
Funny how these "no government interference in the market" types will allow so much of it when it benefits their interests.
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