How To Argue For A Public Option On Health Insurance

The situation facing supporters of the public option going into this crucial month was made hilariously clear in this doozy of an anecdote from a recent Paul Krugman column. It seems that, at a recent town hall meeting in South Carolina, a man stood up and told Representative Bob Inglis to "keep your government hands off my Medicare."

OK, not knowing that Medicare is a government program is an extreme case but it highlights the ignorance factor on this issue -- which is huge. I count almost everyone among the (relatively) ignorant, by the way, which points to the reason Republicans are finding it so easy to shill for their corporate masters on health care. The complexity factor -- which is also huge. Only a few utter wonks have their arms around this sprawling monster. Which leaves us with:

High complexity + widespread ignorance = easy to scare.

That's the formula opponents of reform are deploying and, as Krugman's anecdote shows, you can scare people out of their wits, literally, with slogans about "government takeover." But the same anecdote points to what supporters of the public option most need, given the complexity -- a clear line of argument. That line of argument is rooted in the fact that the vast majority of Americans think Medicare is great. Ditto, Social Security.

So here's the way to go: in whatever public setting -- town hall meeting, around a picnic table -- whenever critics of reform start up about government bureaucracies coming between you and your doctor ask how they feel about Medicare. If they say, Medicare is fine then say, well, what's the difference? But if you are debating, as you likely will be, an ideological opponent of the public option then the chances are they won't actually like Medicare -- but won't want to admit that in front of people they are trying to convince. If they are caught in this bind, go on to ask if they supported W's effort to privatize Social Security. Chances are, they did.

The key is to keep the spotlight on them. No squirming out of it -- no "that's not the issue" or "Medicare is a done deal, we all accept it," none of that wiggling. Force the ideological confession. That will sway a lot of pragmatic citizens trying to make up their minds about a public option on grounds of workability.

Then there is this follow-up. Opponents of the public option like to say that government programs are wasteful and inefficient compared to private enterprise. They also like to say that the public option will drive private enterprises out of business and "limit your choices." Well, which is it? It can't be both....

Comments

[ThomasDoubting]

The reason why a Free, Universal, Single Payer,Not For Profit, Health care System works so well is because we throw all the money in one big pot, then if some people become ill, they will be cared for and for those who are fortunate enough to be well, they can enjoy their good health throughout their lives. They can also sleep better at night knowing that, if they become ill, it will not bring financial disaster too. Among the people who are fortunate enough to have employer health insurance, many of them are young healthy adults with no obvious health issues, otherwise they would probably not have been hired in the first place. When the employer pays, they are careful about who they hire. This contributes to discrimination, by age, weight, sex, etc. Whatever the employer saves, goes into the companies profits. What the employee sometimes forgets, is that the money paid for health insurance is part of their salary. In other words, if the employer no longer pays for insurance, does everyone get a raise, sounds fair to me. You know that any increase in the cost of insurance represents a pay cut or a missed raise for you, so why not a raise when it goes down. With private insurance, you don't know if you and your family are insured until you see that hospital bill marked "Paid in Full", and then you have to worry about next time. ,,,"Medicare For All"

[texanna]

Nice try, but the truth is that none of the people being whipped into a frenzy by the Americans for Prosperity and FreedomWorks and the other astroturf organizations are not willing to talk to you. Last weekend I tried to talk to a few that were in the lynch mob around Rep Doggett and I couldn't even get one of them to agree that the government does actually do several things pretty well -- roads, police, firemen, the Post Office, social security, medicare --- they just wanted to yell at the top of their lungs really violent things at Rep Doggett and scream at anyone that tried to talk to them. Your article, therefore, is pretty much a fairytale.

[TeeLolly]

I just discovered that my doctor's office manager did not know that people with individual coverage can be kicked off their insurance plans at the end of their benefit year if they are diagnosed with something expensive, like cancer. He honestly and truly didn't know that when you're not in a group plan, you can lose your insurance if you get sick. I spent some time educating him--but it all goes to show that there are a lot of seemingly knowledgeable people out there who need to be educated about the basics--and soon!

[noneIn2008]

Let the states handle health care. 50 different experiments so that when they make inevitable mistakes like Mass, not everyone gets hit. Then it is not too big to fail. Washington normally makes big mistakes with huge unintended consequences? The states will make better decisions on smaller scales so mistakes will be more easily reversed. The major insurance companies want one national plan because it makes lobbying much easier.

[vsign]

I agree.

[bethrorie]

But if our new superduper public option insurance is so great, why don't any members of the government want it?

[RRoadrunner]

So simple yet effective:

High complexity + widespread ignorance = easy to scare.

We need health care experts who can make High complexity + widespread ignorance = easy to unsterstand!

Goo read...

[Schneb]

A few questions:

The question of whether the government can be trusted to run such a huge program is worth discussion, but I don't see people discussing how awfully-run the private system(s) is/are.

I'm thinking of the scene in M.Moore's 'Sicko' when the list of pre-existing conditions scrolls on and on, and the former insurance company employees whose jobs were finding ways to deny claims described specific situations.

If we have a govt. run plan, it will have it's faults, but better those than a system that's built around the central, core, guiding fact that less service to 'customers' = greater profits for those running it.

(for a country that's supposed to be all about free enterprise, how is it that we're not 'getting' that fact?...'c­ourse such self-inflicted blindness somehow fits with the Congressional bans on negotiation for lower prices on meds')

ITEM #2: Those blue dogs, etc. who're so concerned about a ballooning federal deficits--how have they voted over the past 6 or 8 years? Given the Bush-era spend fest, I'm guessing these deficit 'hawks' have gotten that particular 'religion' rather recently..­.and rather 'conveniently' for their private insurance corporation sponsors.

[Rhetticent]

what country are you living in? Medicare is going bankrupt. My eligibility has already been extended. I anticipate having to do what my parents did, which is go to whatever doctor I can find that still accepts Medicare patients (tried getting anyone in to see a doc that still takes them? It won't be one with an established practice) and then pay a hefty premium for the co-insurance to cover the deductible. Then I can fight with Medicare over the billing errors and random, nonsensical refusals to pay claims. Yeah, can't wait for single payer.

You people really want health care run with all the efficiency of the postal service? All the careful thought of Cash for Clunkers? All the compassion of the IRS?

[noneIn2008]

It is interesting to listen to the Dr.s who say they support national health, yet while in their office turn down Medicare patients. "Sorry we are not accepting any more Medicare patients".

[Hopster1]

I find it funny that people try to relate the Healthcare issue to the Cash for Clunkers program in an attempt to say it's bad. Let's look at the Cash for Clunkers Idea. The government bails out the BIG 3 auto companies and then sets up Cash for Clunkers which essentially works when Americans with old fuel inefficient cars are given $4500 to trade in their old cars for new more fuel efficient and less polluting vehicles, thus increasing sales so that the BIG 3 can pay back the US Government the money they borrowed to keep afloat. All the while we get GREENER cars that make us less energy dependent on foreign oil and help spur the economy. The only problem with Cash for Clunkers is that it worked too well and additional fudning is needed for it to work even better. And some how this is a problem?

[JBoy]

Medicare and Social Security serve their purpose: to care for the elderly who cannot earn a living.

Public health care for younger citizens who are employable is a completely different matter.

Health care is a privilege, not a right!

[Vcubed]

Many of the employable cannot find work, or their jobs pay too little to afford health care. We let people rot?

[Samcat604]

So modify the system to let those who want it, but can't, have access it through vouchers or other means. Do not change the entire system and shoehorn everyone into the same system because of a recession.

Change COBRA to allow you to pay the same as when you lost your job.
Fix the economy so you can find work that provides healthcare.
Change the insurance so I take the same policy I have with me if I move to another job.
Give vouchers to legitimate cases of people not being able to afford and need it.
Make assistance TEMPORARY for able bodied people who should be working.

[noneIn2008]

Medicaid already covers 12 million of those listed as uninsured at the bottom. The people have just not used it, so they are listed as uninsured. The very bottom is covered. 20 million of those uninsured, choose to not buy insurance. So we then have 16 million who really need help. Maybe we should help them instead of redesigning the entire medical system?

[Emmory]

I thought Medicare was near or basically in bankruptcy?

Please explain how this isn't true...

[noneIn2008]

Very shortly it will be. But read the fine print in the bills. They plan to cut $622 billion from Medicare.

[Firbolg]

I came across this doozy of an anecdote on another blog.

“IF YOU ARE CURRENTLY AN EMPLOYEE WHO HAS HEALTH INSURANCE, BUT YOU WANT TO CHANGE JOBS, RETIRE, OR START YOUR OWN BUSINESS, BUT YOU CAN'T BECAUSE YOU WILL LOSE YOUR HEALTH COVERAGE:
You can now make your economic and career decisions on the basis of economic and career considerations, because regardless of your employment situation you will be able to acquire or maintain affordable health care coverage.”

If you are an employee with a large business your overall premium will be low relative to the benefits (as a result of your employer’s bargaining power) AND you will only be paying a fraction of the overall premium with your employer covering the balance.
So how can you expect to get similar coverage if you quit you job for anything approaching your current net cost? And remember your cost is pre-tax.
This is the kind of blind faith that people have in the phrase “public option”.

[jade7243]

Or let's use the consummate pitchman, Billy Mays. He can sell anything, even (apparently) from the Great Beyond:

"Hi! Billy Mays here for Public Option on Health Insurance Plan. Are you sick of paying high premiums for low coverage? Tired of getting the boot just because of pesky pre-existing conditions? Sick and tired of being sick and tired? Developed "cauliflower ear" from long hold times with your private insurance provider? Got no insurance at all? Well, it's time for you to try Public Option! It's the only affordable health insurance option good enough for the President. With Public Option, your insurance goes where you go! Move across country? You're still insured! Change jobs? You're still insured! Get Dengue River Fever? Don't fret... you're insured. No hard to read fine print. No long forms to fill out. No waiting for hours in the emergency room because you don't have a primary care physician. .And best of all, with Public Option, you'll never have to deal with private insurers again. Millions of Americans already enjoy Public Option in the form of Medicare, Medicaid, CHAMPUS, CHAMPVA, and Federal Employee Health Insurance. Why not sign up today? And if you're one of the first 47 million callers, your 30 waiting period is waived. That's a value worth more than ... heck, life itself. Take it from me, Billy Mays, if I were still alive, I sign up today. So call your Congressman right now and tell 'em Billy Mays sent you!

[Samcat604]

But like with all infomercials, you have to read the fine print.

Public option is not free. You still need a job to be able to pay for it.

[ThomasDoubting]

Part 1 The Health Care Industry as represented by the Insurance Companies have a plan for how they want this issue resolved. The Democratic Congress and President also have a plan, and although, we have heard bits and pieces of the government plan, most people have no idea what they are proposing. The fact that the proposed bill has more than 1000 pages is a bad sign. If the sponsors thought that the American voters would approve, they would be telling us all about it, with pride. Why are these "progressive" Senators, and Congressmen telling us about the need to go slow, and getting it past the right wingers. The first class, in Negotiation 101, teaches that you ask for more than you want, not less, and do it, with the confidence that you will win. They should be telling us, that we now have a Democratic President and a Democratic Congress and we are going to use this opportunity to something that the American people want. Not only give the people what they want, but do it cheaper. Recent polls show 70% of the Americans polled, said they want a Free, Universal, Single payer, not for profit, health care system. We don't need no stinkin, Insurance Companies, and people know it.

[Samcat604]

"Recent polls show 70% of the Americans polled, said they want a Free, Universal, Single payer, not for profit, health care system."

Of course people want something for nothing. However, no such system exists. NOTHING is ever free. If you have a job, you are paying for it twice. Once in taxes (the 'penalty' costs of your employer not provided their own) and once for the plan itself.

[ThomasDoubting]

Part 2 In the 1950s and 1960s, when medical technology began to keep people alive, longer than the Insurance Industry had planned, they refused to insure those over age 65, which was a common retirement age, at that time. If you left your job, that was the end of your health care insurance. That's why the government created Medicare. Medicare has covered seniors who are relatively high risk, while they left younger healthier people to the private companies. Now it looks like they want the federal government to insure the millions considered 'uninsurable'. Of course they don't want to lose their healthy young people, many of whom never even see a doctor, while their employer, pays a large percentage, of the employees' salary, to this insurance company. Only when the hospital says 'Paid In Full' will they be sure if they were really covered. I suspect that most of those 1000 pages tell us, what we are not going to get. When the right wingers have some input, of course they will make it even worse. "Medicare for All"

[Allthatglitters]

Isn't the US post office running a huge deficit and considering cutting out Saturday delivery? Of course, that's only a quasi-governmental agency ... sort of like a public option?

[TreesPlease]

So is your point that you prefer Fedex and UPS at more than 100 times the price - a stamp costs 41 cents, a Fedex package $20. Should we do away with the USPS and allow Fedex and UPS unfettered run of all mail?

[Samcat604]

a letter does not equal a package. The USPS has a specific contract to deliver mail.

If the USPS is so great why does EVERY company use Fedex/UPS/DHL for their shipping needs? Packages are cheaper to by non-government sources.

[disabledjim]

Actually,until slick willy came along,the post office was the only branch that was self supporting­.Willy then shifted the cost of health care of veterans employed by the post office,from the VA(veteran care is their responsibility) to the post office budget causing the once self supporting agency to become insolvant.­Just a little shell game to"balance the budget"

[gschear]

Since the advent of the telegraph, the act of writing words on paper, placing them in an envelope and paying some one to carry it to someone else has been doomed. The Postal service is a victim of technological advancements, not government inefficiency.
Your analogy is not analogous.
You appear to be among the minority that believe that Government is always bad.
OK, then kindly refrain from trying to Govern.
Honestly, it's like Flat Earther's volunteering to circumnavigate the globe.

[KrugnacTheMagnificent]

Although the root of the problem was technological, the USPS demonstrated government inefficiency quite clearly.

With the advent of UPS, Fedex, and e-mail over the past several decades, the post office was in steady decline. But that didn't stop the USPS from hiring. As their services plummeted, their labor force continued its inexorable climb year after year.

Any private business that so badly bungled their operations would have gone bankrupt. But with the USPS being insulated from the rigors of the market due to their government backing, they were able to add more and more union employees every year for the last 40 years, until 2008.

And now after utterly failing to adapt to changing demand and streamline their operations, they're looking at drastic measures and bailouts from Congress.

[Samcat604]

The government is not always bad.

It does serve a useful purpose. Defending the nation, providing essential infrastructure, things like that are necessary.

When the government intercedes, it causes many other problems. It should prop up doomed industries. Should the government have bailed out the Ice Delivery industry when refrigerators were invented? What about the wagon makers when automakers made them obsolete? No, creative destruction in this fashion is VITAL to make things better. The USPS should be allowed to die. Amtrak should be allowed to die.

Only when that happens will someone figure out a better way. If there is a need, someone will figure out how to do it. But as long as these are subsidized and propped up, that innovation will never happen.