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Jennifer Brunner

Jennifer Brunner

Posted: July 22, 2009 12:55 PM

No More Delays: Pass a Health Care Plan With a Public Option


I'll be upfront with you. I'm a candidate for the U.S. Senate. Last weekend I spent a good deal of my Saturday reading and drafting position statements and reviewing plans and releases for my campaign. Our young neighbors, both of whom work for a large, hip retailer, had a housewarming party at their condo. They invited my husband and me to join them. So, after knocking off way too late, we wandered across the courtyard.

Now, I realize I am not exactly the "Abercrombie" type and much too old to even pretend. As I tentatively entered their home, with its door wide open and people spilling out into the courtyard, I encountered a young woman, Meredith, age 31, who is a physical therapist in Columbus. Meredith is originally from the famous Cuyahoga County -- that of long-line voting fame, but which came through last year's presidential election with flying colors. (I ought to know; I'm the Ohio Secretary of State who succeeded in getting the resignation of all four of its board members, Democrats and Republicans alike, and helping the new board successfully reinvent itself.)

Meredith had been told by a friend that I would be there and had wanted to engage me on political issues. She was glad I supported marriage equality but she thought that maybe marriage wasn't the appropriate term for same sex marriages. I went through the "separate but equal" argument with her, while our mutual friend, a lesbian, stood by nodding vigorously in agreement with me. We talked about the unwieldy task of modifying so many statutes, state and federal, to create a separate status that was like married but was not. As the conversation spiritedly progressed, she said she did not believe in universal health care, that it just wasn't possible to provide health care to everyone. She had me hooked for what turned into a wild and fruitful discussion.

I said, "Wait, you're a physical therapist at a retirement residence. What do you mean you think it's not possible for everyone to get health care?"

She said, "I just don't think it's possible." I went into a litany of health care options such as Medicaid and SCHIP for people in need, as well as Medicare for people 65 and older. I talked about how it's the rich and the poor who have an easier time getting health care coverage, but that the middle class is squeezed -- underinsured and lacking health insurance if they lose their jobs. Her eyes started getting bigger.

She countered, "Health care will be rationed like socialized medicine like in Canada; it will be substandard; people won't be able to get the treatments they want or see the doctors of their choice..."

I shot back, "You're believing those deceptive commercials you see on TV that try to confuse the American public that health care reform will be like socialized medicine. With a public option, the government will not provide services, just pay for them -- like with Medicare." Her friend, a family physician, quickly interjected, "Yes, but they've cut reimbursement rates for Medicare, and it's making it really tough for doctors. I said, "Give me some time and I'll work on that," and I smiled.

Then I asked Meredith, "Do you think it will hurt your work as a physical therapist?" She really couldn't say. So on I went about the need for a public option, because some people would prefer a plan that involves less paperwork, less layers of administration, less comparison of medical bills to statements from insurance companies, statements that have to be saved for months just to get them to match up and to still try to figure what you owe before you start getting collection calls that you aren't even sure are right.

By this time Meredith was trying to insist that she really didn't believe those commercials. I challenged her, "You need to do more research. Search the Internet for answers to your questions, for varying points of view."

"I'm sorry Meredith's pushing you so much on these issues," interjected our friend. "No, this is great, let's keep going," I urged. "Why do you think insurance companies are fighting a public option?" I asked without pausing. "It's because they are afraid that people will choose the public option because the cost is less, and they assume their business will be hurt or fail, so they're fighting what they're afraid of, even if it may not happen." Meredith and her friend agreed.

"Do you like the fact that an administrative person sitting at a computer screen makes the choice of whether or not a service you provide is covered based on looking at a key for service codes?" I asked. "That's your livelihood controlled by someone who isn't even a medical specialist," I challenged. "What about those people who have preexisting conditions and can't get coverage?" I tried to back off and make sure I wasn't overwhelming her.

Just last week, I talked with a building trades official from Northwest Ohio who worked within his union to start a nonprofit corporation that charges $4 per member to administer a plan that negotiates fees for medical services with over 1800 providers in Northwest Ohio. This nonprofit is its own "public" option that pays the providers directly and is staffed by nine people -- that's right, nine people. He is such an enthusiastic evangelist for a plan that has been tried and works, that he is retiring as a union official at the end of this year to work full-time on expanding the coverage and availability of the plan. This plan now employs a nurse practitioner who offers preventive services to plan members. Hundreds of members continue to join, allowing for greater clout in negotiating reasonable fees and costs for health care services. This is how a public option would and should work.

Many are afraid of the government operating this kind of plan. But the truth of the matter is that accountability would be required and built in because, instead of the union's dues and investment earnings, it would be our tax dollars at work for us -- the burden spread among many with the advantages of volume and the political will of the Obama administration to adopt best practices in preventive medicine.

The Obama administration is not pushing for true "single payer" health insurance, where there is just one health care payment system for the country. Instead, President Obama pragmatically recognizes that people should have the choice of the public option or private insurance, if they have or can obtain private insurance. There are, however, 50 million people without any health insurance, many of whom are ready to accept and embrace what is, as I urged Meredith, a basic human right. Giving them a choice and making the federal government directly accountable for that choice is what the public option means.

For the long-term economic health of our country, the public option will jettison costs from employers and from us as taxpayers, who pay the hidden costs of uninsured and underinsured Americans' health care now as it is. You don't cure a headache by beating your head against a wall, but that's what we've been doing -- and it's getting worse. Glenn Beck can scream all he wants about how leaders of other countries come to the U.S. for our excellent care, but he doesn't talk about how some desperate middle class Americans take enormous risks going to other countries to get health care, under whatever standards of care may prevail there, because they cannot get it here.

We are the United States of America. We are still, to so many here and abroad, that "shining city on the hill." We must step forward, recognize that the free market, by itself, as applied to health care doesn't make us free, but rather imprisons us in a vicious cycle of suffering, inequality, disparity and grief. The public option is the first step to stem the flood of loss and resulting damage.

I know we can do this. Each one of us must search out the Merediths of this country and talk until we can't talk any more, and then keep on talking. This will only happen when ordinary Americans like you and me get off the couch, turn off the TV, read all we can read, write and email our Congresspeople, and talk to our neighbors and friends. President Obama needs us to support what is a gargantuan task. He proved we can do it with his election. Now let's do it again.

Jennifer Brunner is Ohio's 52nd Secretary of State. After taking office in January 2007, she implemented enormous reforms to Ohio's election system, resulting in a record number of Ohioans voting in a presidential election, and a record number of Ohioans voting for the same presidential candidate -- Barack Obama. She is running in the Democratic primary to replace retiring Senator George Voinovich, a Republican. In 2008, she was awarded a John F. Kennedy Profile in Courage Award, the most prestigious award bestowed on elected public officials.