Congress and President Obama's plan must include a Public Healthcare Plan Option because it's the moral thing to do, because it is the financially prudent thing to do, and because all the arguments against are merely-fear mongering. In 2007, the USA spent over $7500 per person on healthcare -- almost double the average amount spent by other developed nations. That tab for the USA was nearly $2.4 Trillion -- yes, with a 't.' What we have to show for that money is a sad example of the failed efforts of every President since Truman to reign in the Health Care Industrial Complex.
The Myth of Choice in a Land of Plenty
Today we have 46 million uninsured citizens, 11 million of those being children. As a land of moral people, this is inexcusable, especially for the children who have no healthcare choice. Opponents of a single payer system want to make America believe that it will cost them more and have less services. However, when the uninsured need critical care they go to the local emergency room, and not being turned away, the cost to cover their care is passed on to the insured in higher premiums. When push comes to shove we will pay for this in every emergency room, and every unnecessary death, if not in ever insured persons' premium.
Arguments abound that a public option will lead to "socialized medicine, rationing, and the inability to choose your doctor." Besides, the 46 million Americans that have no health care, how many folks get to choose the doctor they want? My doctor is part of a pre-approved list of in-network doctors, and every time I change employers I have to choose a different doctor. As for rationing, I cannot see any doctor beyond my primary care doctor without a lengthy preauthorization process. If the doctor I want is not in that network, my insurance will only cover a small percentage of the "reasonable and customary" cost for my visit with that in-network doctor. Inevitably, that coverage ends up being a miniscule portion of a bill that I am forced to cover the difference.
Citizens with health insurance, whatever the coverage, in the end don't have as much choice as they believe. If we had choice, Americans would seek non-revocable and complete coverage with no exemptions. There would be no need for a long policy book explaining all the reasons why the insurance companies are not going to pay. Even amongst those of us blessed with employer-based health insurance, I would posit many of us are not thrilled with the extent of the coverage, the cost, or the fear that it won't be there when we need it most. For many employer-based policies, when you get so sick you cannot work -- your health insurance premiums become your own responsibility to pay. If the injury is long term, and/or debilitating, your work-based insurance may end, leaving the full cost to that individual least able to pay. Health care costs is a leading reason for the declaration of bankruptcy, contributing to over 60%.
Then and Now
It has been 16 years since President Clinton tried to pass comprehensive healthcare reform -- and while you may criticize his approach, you cannot assail his motive and compassion in identifying the need. Our new President, swept into office with similar ambitions, has fielded a dream team of sorts with Jim Messina (Senator Baucus's former Chief of Staff) now on White House Staff, White House Legislative Director Phil Schiliro (Congressman Waxman's aide for 25 years), and President Obama's Chief of Staff Rahm Emanual (former Congressman and Clinton White House Official). This team can get reform done with Congress.
This year, health care spending will top $2 trillion, and by some estimates, $2.3 trillion. Yet Obama must counter opponent's irrational fear, that over ten years, we might spend in excess of $1.3 trillion. To be clear, this year this nation will spend more than double the amount of what 10 years worth of coverage. For that, the USA will rank near the bottom on most healthcare outcomes, including one of the highest rates of infant mortality in the industrialized world.
The non-insured are seeking and receiving coverage -- and that cost is passed on to all of us in the form of higher premiums and costs. These costs will grow, like E.coli, until they bankrupt us individually and as a nation. Ultimately this intertwined relationship demands action to both control costs, increase access, and finally bring accountability (via competition) to the private insurance industry. In two decades time, if unchanged, health care costs will gobble upwards of 30% of GDP.
If Its Not Broke, Don't Fix It
The health care system is broken, and America must fix it -- and soon. The American healthcare system is the best in the world at developing new cures, at honest medical peer-reviewed journalism and has continually evolved leading the world in new discoveries. It now must continue to evolve -- and President Obama and Congress may argue about the details, but change is coming through reform, or moral and financial bankruptcy for America's inaction.
