For those feeling down about the public option, Robert Creamer, in TruthOut:
“Hasty headlines to the contrary, it is very likely that a strong public option will be part of a final health insurance reform bill when it finally passes Congress this fall. There are three reasons:
1). A Public Option is the most elegant and politically viable solution to a major practical problem.
Three basic models have been adopted by Western industrial nations to provide universal health care to their populations.
The government can directly employ doctors and hospitals to provide service
That is the system they have in Britain where they spend 40% less per person on health care than in the U.S. and get pretty good reviews from their citizens. It’s the same system that we use to provide health care to veterans through the Veterans Administration.
The government can provide heath insurance for everyone as it does in Canada – or as we do in the U.S. with Medicare. Medical practices and hospitals are in private hands, but the health insurance fund is managed by the government. Again, that system seems to work quite well and also does a good job at controlling costs.
The third approach is to require individuals and businesses to purchase insurance and leave it to private insurance companies to provide that coverage. The problem with this approach is that requires some mechanism to control costs. That is particularly true in the United States where insurance companies are one of only two industries (Major League Baseball being the other) that are excepted from the anti-trust laws that are aimed at insuring competitive markets. In fact, most major health insurance markets are dominated by two or three companies so there is no real competition – particularly with respect to price.
Once everyone is required to buy insurance, the companies can have a field day raising prices and profits using the government to guarantee they are paid – either through subsidies or the imposition of fines. You can see why, from an insurance company perspective, this would be a great deal.
But from the point of view of the taxpayers – and the insurance ratepayers – it would be a disaster. It would be like giving the insurance companies a license to take your money – with no regulation – all enforced by government edict.
This, of course, is basically what happened with the prescription drug benefit – Medicare Part D. But there is a big political difference. A huge percentage of the money used to pay the insurance and drug companies in Medicare Part D comes from the taxpayers (or deficits). Most of the money that will go to pay for health insurance in a new system will come from ratepayers – individuals and companies who will feel the sting of rate increases directly…There are only two real practical solutions to this problem. On the one hand, you could set up a public health insurance option that does not have the same incentives to increase profit or CEO salaries and would compete against the private insurance companies and keep them honest. That is what President Obama has proposed. Or you could regulate health insurance rates…
That’s why the President and his top advisors support a public option.
2). The politics of Congress and the White House. There are a couple of political givens:
• Both the White House and Democratic Leadership understand that they must pass health insurance reform. Defeat is simply not an option. Both the Carter and Clinton administrations foundered because they proposed major policy initiatives and failed to achieve them…
3). Inclusion of a public option is necessary to assure a mobilizable base to counterbalance a highly-motivated right wing and make passage of any health insurance reform possible. The public option has become an iconic symbol for Progressives. Without it, many would lose the passion that sends them to town meetings, phone banks and demonstrations. Without a public option to fuel this passion, the forces for reform would likely be overwhelmed by the shock troops of the right wing.
When you put all of these factors together, it is very likely that later this year President Obama will sign a health insurance reform bill into law that will indeed include a strong public option – not simply because the President clearly supports it, but also because of the practical policy and political considerations that make it critically necessary to success.
THANK YOU BOB!