On the Contrary

The magic word in the health care debate is “the public option”.  But does anybody really know what that means?  I doubt it, so lets examine it.  You have heard Medicare for people under 65.  Well that is not quite right.  Medicare is free and was and is paid for by your and others contributions.  I probably have insurance closest to what they are talking about.  I am a retired federal worker so the government offers a multitude of programs from various health providers and they subsidize my monthly costs along with the ability to negotiate very good rates.  Oh yeah, their administrative costs are minute compared to the insurance industry’s. Those that would qualify for the government program would get roughly the same program and the subsidy would be dependent on your ability to pay.  But it must take all comers and all the policies are not priced based upon the status of your health.

Now there are a couple of things to notice here.  First and foremost, there is no government bureaucrat between my health care provider and me.  The badly misused term in this discussion, and I should say prejudicial term is “government provided health care”.  The government does not provide the health care; they pay for it, or in my case subsidize it.  My health care is provided by a private health care provider who negotiates with the government for one price to provide the benefits I selected.  I select my plan and that plan and its benefits are charged to the government and my contribution is billed to me every month by the government.  It is very small compared to what most people pay for private insurance.

Second, who qualifies for the government plan?  The present options being considered in Congress have only a very small segment of the poor who will get these benefits.  So just how is this going to help small business or others who need a real choice?  How will this small segment, estimated at 10% of our population who will actually have access to a public option provide real competition to the insurance companies?  Why shouldn’t everyone have that choice?  That one is beyond me.  Additionally, the plan the President favors, because he thinks it is politically expedient, is one that will not go into effect unless some sort of trigger mechanism activates it.  This one is destined to failure.  It might be the most politically feasible among the dinosaurs who rule in Washington, but how long do we have to wait for it to kick in and how can the medical Insurance companies game the system to prevent it from ever happening?  It is truly a bad idea when you consider how many people will die while we dither.

Third there is this idea of “a level playing field”.  Just exactly what does this mean?  Well the industry is concerned that the government can price the same plans that they are providing at significantly less than they can, so they want either the government’s ability to negotiate or the rates they charge limited to provide them a “fair” opportunity.  Now think about this people.  If you end up paying higher rates so that private insurance companies can maintain their profits, that is money that is not going to treat a segment of our population.  The other side of this coin is that if we keep making an artificial level at which private insurers can earn money, where is the incentive for all that innovation that competition is suppose to foster?

So is it any wonder that this whole debate is really being carried out in a fog?  Please define public option and how it works; define who qualifies for it; and please define what you mean by a level playing field.  And within this, let’s not forget what we are trying to do:  Universal coverage at the lowest price without affecting the quality of the care.  Probably the best way forward is Medicare for anyone who wants to buy in.  Cost of the insurance in addition to what you already have withheld from your pay and earnings would be prorated on your ability to pay.  Let the private insurers compete with that.  No leveling, and no restriction of the government’s ability to negotiate.  Small business could then buy their plans directly from Medicare and we are off and running with a dual track system and may the best man/plan win.  You still have competition in that each plan would negotiate with the government or insurance providers for the services they provide and the onus would be on them to find ways to economize.  Additionally the government could partner with some of the providers to come up with innovative ways to reduce costs and increase the quality of care.

But all this is too simple and straightforward when you are trying to maintain the health insurance companies gouging our economy and our future for their well-being.  Just try to keep in mind that these health insurances companies have had years and years to compete and innovate and they did not.  And those second homes and nice cars that all those health insurances executives have are paid for by the 40,000 uninsured Americans who die for lack of insurance every year.  Then the discussion gets fairly simple.

In my mind we are not going to get anything anywhere near what I proposed above and therefore it is destined to fail.  If we do not get that robust public option in the final bill, then I would recommend they vote it down.  Putting a failed plan into effect will just make the next round that much more difficult after thousands have died.  If it isn’t right, then don’t compromise for failure.  Hold out for a real plan that gives us real relief and moves us forward instead of some holding action that could kill reform in the long run.