RIP Public Option?
Well, if you watched Meet the Press yesterday, you were either understandably concerned about the death/demise of the public option provision contained in the president’s wish list on health care reform. In reality, a public option would have been the first step toward a single payer system—one in which all Americans are covered. But Obama appears to be backing off. So, those of us interested in real reform are shaking our heads in disbelief—Obama has the votes in both chambers of congress to pass whatever he likes—because now it might be a generation before we once again have a chance at real progress towards a single payer system.
But rather than being upset and deflated, I decided to look a little deeper into why the public option appears to be dead–which is not to suggest it is completely and absolutely dead, we’ll know this in September. For one thing, it seems like Ross Douthat, a conservative, nailed it in today’s New York Times: “If the Democratic Party’s attempt at health care reform perishes, senior citizens will have done it in, not talk-radio listeners and Glenn Beck acolytes. It’s the skepticism of over-65 Americans that’s dragging support for reform southward. And it’s their opposition to cost-cutting that makes finding the money to pay for it so difficult.”
Did you hear that? In essence, taking from current recipients of Medicare to give to everyone else will not fly. Fair enough, let’s raise taxes (an added expense, likely offset for most people given the corresponding decrease in premium payments). Or let’s end a war: pick one. Iraq is a mess whether we are there or not, we might as well not be there. Perhaps we could create a tiered system of health insurance? Diabetics and other persons with chronic issues covered 100%, while otherwise healthy people are mandated to pay a reasonable premium for catastrophic coverage? Maybe we should base tiered coverage on age groups? Maybe we should ban the insurance lobby?
No. Greed is the problem. Paul Krugman: “To have a workable system without the public option, you need to have effective regulation of the insurers. Given the realities of our money-dominated politics, you really have to worry whether that can be done — which is a reason to have a more or less automatic mechanism for disciplining the industry.”
Competition is the only solution. Quoth Robert Reich: “There’s no way to push private insurers to become more efficient and provide better value to Americans without being forced to compete with a public option.” He’s right, and for reasons that should be fairly obvious.
Finally, do yourself a favor and keep your ears open to the musings of the conservative intelligencia. The Douthat’s and Brooks’ of the world tend to be well-meaning thinkers—shutting them out of the debate is probably unwise.
