Thursday, June 11, 2009

The "Public Option" is a Generous Offer to Health Insurance Companies

So much to talk about, and so little time after the work day to do it. Have you been following the debate about the "public option" as part of healthcare reform?

It looks like Republicans and Industry are making opposition to a public plan that competes with for-profit coverage their hill to die on. They say that allowing people to choose a public plan, as President Obama proposes, will inevitably lead to insurance companies going out of business and universal, single-payer, government-provided healthcare. Actually, that sounds pretty good to me. But really, if "socialized medicine" is so backwards, why are conservatives worried that Americans will flock to it and abandon the insurance companies if given a choice? After all, it's an option. If you're happy with your private insurance, you can keep it. But under the president's proposal, everyone--especially the 46 million Americans without health insurance--would have the choice of the public option.

The president's proposal is really pretty modest. If it were up to me, we would not have for-profit health insurance companies at all. Some things are too foundational to society, too sacred, to be up for sale. Americans used to think more along these lines. But war, disaster relief, public infrastructure, basic education, etc., all of these things have been up for sale in the recent years of conservative dominance. We've had to re-learn that when corporations who control these things they inevitably have the profit interest instead of the public interest in mind. It's wasteful. The corporations constantly drive up costs and reduce quality of service in order to increase profits. And then our public institutions spend enormous resources to police the corporations and enforce tax laws.

Why not simply place these "pillars of the economy" under democratic control? If that sounds radical, consider how much of the economy already is under democratic control and how nobody's really complaining. No one wants to utterly privatize the Army, elementary schools, or the interstate highway system. These are basic, foundational things that ought to be their for everyone, kind of like healthcare.

This is the direction in which the health care debate should eventually go. But for now, the insurance companies should be happy that they're allowed to exist at all and that they will still exist under President Obama's plan. They will still have the enormous privilege of profiting from providing as little health coverage as possible to sick people. I do think we will eventually take that privilege away from them. After the Bush years, the public seems to have decided that disaster profiteering and war profiteering are wrong, but we haven't quite gotten their on health profiteering. Give it time.

For now, Republicans and the insurance companies should take this exceedingly generous offer from President Obama and the Democrats and accept the public option.


Sara said...

Seems pretty elementary to me. It is hugely wasteful and designed to make money.
Bugs me that it really, really seems to be set up to keep people in treatment, keep them on medications-which then give you side effects that require more medication ad infinitum, and people accept this as the norm. Among other things.
I don't know whether private should still get the opportunity to operate, but a change here would be good.
Have a good weekend!

Elizabeth said...

But if everyone DOES flock to the "government provided" healthcare, how will all these poor politicians (unfortunately, on both sides of the aisle) raise millions of dollars to get reelected???? You're so mean, BTM. What did the politicians ever do to you?

delaine said...

Amy and family are getting excellent, affordable medical care in Australia. There are NO unreasonable waits for service or needed tests. Hospitals are modern and well managed. The Repubs will cite a smear campaign against medical care in Canada, for example, but they do not tell the truth. I do not hold out much hope for this country to ever have universal coverage for its citizens. Big money and powerful politicians( who are in the thrall of big money) will not let it happen. Am I just a pessimist?

Becky said...

I am kind of enjoying watching the anti-change factions try to position themselves on this issue--it's like they're realizing that they're just in the way of an inevitable shift. Example: the AMA came out against Obama's plan and then twelve hours later said they were before it before they were against it. Or something.