11/26/2009 05:12 am ET | Updated May 25, 2011

Health Care Reform: It Boils Down to Four Words

Next week, the Senate Finance Committee will vote on the public health insurance option. There will be two versions of it, one offered by Senator Rockefeller; the other by Senator Schumer. Regardless of the outcome, health care reform today comes down to four simple, words: accessibility, affordability, choice, and competition. For good measure, there is also perhaps a fifth word, and that is the word, right, as in Americans should have a right to health care as part of being a United States citizen.

In order to be healthy, we need care from our doctors, hospitals, and other health care providers. In other words, we must be able to access (the first word of reform) that care. We should all be astute enough to know how to call a doctor, or get over to a hospital emergency room. And if we do not, surely we have a friend, colleague, or loved one who can assist us. Recently, the major drugstore chains, like Walgreen's and CVS, have established in-store "clinics", staffed by licensed and certified nurse-practitioners, to treat garden variety ailments for less than it would be to visit a private doctor. But even though we know where to go for care, if we cannot afford (the second word of reform) it, it does not matter if the doctor is next door or down the block.

So, to pay to sustain our health means we need to find quality for the least expensive price. Typically, that can be obtained through health care insurance policies. After all, rarely, if ever, does anyone pay the "retail" rate for health care services; everything is always negotiated between provider and third party payor. But premiums for these policies cost lots of money, and millions of Americans cannot afford them. Those of us who have insurance are no doubt paying way too much for them as well.

In order for premiums to come down, either the private market has to voluntarily drop the cost, or there must be some outside pressure to force them to do so. We know the former does not work, since insurance companies in the private market are in business to be as profitable as possible. Shareholders would not want it any other way. The other way is for a "new kid in town" to make premiums come down. This kid is the public option. After all, the American way is to compete. By those who wish to compete, we have sufficient choice (our third and fourth words for reform) among the insurance being offered to us. The more choices, the better the price and the product.

Another reason a public option is critical is that insurance companies have been exempt from our antitrust laws for over 60 years. The opposite of competition is monopolization, which antitrust laws are designed to prevent. This includes monopolizing prices insurance companies charge as insurance premiums. Senator Leahy (D.-Vt.) introduced last week S. 1681 (H.R. 3596) to lift the exemption that the insurance industry has had since 1945. We should all get on that bandwagon to ensure its passage.

Parenthetically, if we do get a public option, let's ensure that insurance companies do not have the ability to hike premiums or reduce coverage before it (public option) goes into being. Remember what the credit card companies did with interest rates before recent regulations limiting interest charges went into effect? We shouldn't be taken as fools once more.

So, to all those on the Senate Finance Committee, before you cast your vote on the public option, think of the four words put forth in this post. That should not be a difficult thing to do, unless you really are unconcerned about carrying out the will of the people you swore to follow upon becoming an elected representative.