"public option that might have roared like a lion is becoming, at most, a mouse that barely squeaks"

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Mon Aug-03-09 04:08 PM
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"public option that might have roared like a lion is becoming, at most, a mouse that barely squeaks"

THE PUBLIC OPTION: DEAD BY PEN STROKES IN CONGRESSIONAL COMMITTEES
by John Geyman MD PNHP
July 27, 2009
John Geyman, M.D. is the author of The Cancer Generation and Do Not Resuscitate: Why the Health Insurance Industry is Dying, and How We Must Replace It, 2008

The so-called public option has emerged as the single most divisive point in the health care reform proposals being shaped in various committees in Congress. Republicans have risen up to demonize it as a government takeover of health care on the slippery slope toward socialism. Within the powerful Senate Finance Committee, it is being called a deal-breaker for any bipartisan bill.

The public option refers to a new public plan that would compete with private health insurers in an effort “to keep them honest”. It is a concept trumpeted by Jacob Hacker, now a professor of political science at the University of California Berkeley. His original idea, as first envisioned in the 1990s, was that a large public program, operated along the lines of Medicare, could cover as much as one-half of the non-elderly population by shifting all or most of the uninsured, as well as all Medicaid and SCHIP enrollees, into the plan from the start. Because of its size and efficiency, such a large plan would be able to keep its premiums much lower than private plans, thereby increasing its attractiveness to enrollees. In addition, all non-elderly Americans, whether privately insured or not, would be eligible to participate. Government subsidies would be extended to those unable to afford the plan. Private insurers would be required to offer the same minimum benefits as the public plan.

So the initial idea was premised on the idea that a public plan could bring needed competition into the financing of health care. Forget that dream. Although the current House and Senate bills both include a “public option”, it is in name only. What might have roared like a lion is becoming, at most, a mouse that barely squeaks. The details change every day, but already these kinds of changes from Hacker’s original concept make it a policy non-starter:

We are now being told by the Obama administration and many legislators that the public plan will bring competition into the system and will help to cut costs and make insurance more affordable. At the same time, they are trying to reassure the insurance industry that the public plan will not put them out of business. This is double-talk and snake oil of the worst kind.

As just another plan available to a small segment of the population, the public plan if ever enacted will further fragment the system, increase bureaucracy, and still not result in either cost containment or open choice of coverage. The playing field would remain tilted in favor of private insurers, and the public plan would likely become a dumping ground for poorer and sicker patients through adverse selection.

Please read the complete article at:

http://www.guaranteedhealthcare.org/blog/john-geyman-md-pnhp/2009/07/27/the-public-option-dead-by-pen-strokes-in-congressional-committee