Public Option in Health Care Reform

by Rich Beckman on June 29, 2009

Health reform with­out a pub­lic option is incom­plete reform. A pub­lic option will increase choice and reduce costs.

Oppo­nents of a pub­lic option cite the supe­ri­or­ity of a free mar­ket over “gov­ern­ment” intru­sion. The prob­lem is that 94 per­cent of the country’s insur­ance mar­kets are defined as “highly con­cen­trated.” A pub­lic option would increase com­pe­ti­tion and cre­ate a free mar­ket where there is not one cur­rently. Because of this, a pub­lic option will play an impor­tant role in bring­ing down costs (even George Will agrees the pub­lic option reduces costs).

The pub­lic option should not receive any tax­payer sub­sidy that is not avail­able to pri­vate plans.

There needs to be ele­ments in place that pre­vent pri­vate insur­ance com­pa­nies from skim­ming off the healthy and leav­ing the less healthy for the pub­lic plan.

I’ve seen the argu­ment against the pub­lic option that it will put pri­vate insur­ance com­pa­nies out of busi­ness. If the pub­lic option does not receive any sub­sidy not avail­able to pri­vate insur­ance plans, then this should not be an issue. In fact, a com­mon theme of con­ser­v­a­tives is the effi­ciency of the pri­vate sec­tor and the inef­fi­ciency of the gov­ern­ment sec­tor, so this shouldn’t be an issue at all.

Which brings us to the argu­ment that the pub­lic option will become a huge inef­fi­cient gov­ern­ment bureau­cracy. If it does, then it would be expen­sive and peo­ple would buy cov­er­age from pri­vate plans.

I keep hear­ing that such a plan would put a gov­ern­ment bureau­crat between me and my doc­tor. There’s already an insur­ance bureau­crat between me and my doc­tor (and that hasn’t always been so pleas­ant a situation!).

Finally, there is evi­dence that peo­ple with Medicare and Med­ic­aid are hap­pier with those pro­grams than peo­ple with pri­vate insur­ance are with those plans. (Hat tip TPMDC) And there is polling evi­dence that most Amer­i­cans want a pub­lic option.

The pub­lic option is wanted and needed. Write your Con­gressper­son and Sen­a­tors.

{ 3 comments… read them below or add one }

1 Rick Jr. June 29, 2009 at 10:41 pm

I have heard rumor — frankly I have no idea if what I ever hear is true or not regarding American politics — that one of the suggestions put forth for funding government health care would be a tax on employer or private health care.

No idea as to the truth of that, but if something like that were to happen, that could be the impetus which puts private insurers out of business.

2 Rich Beckman June 30, 2009 at 1:08 pm

I believe you are talking about the idea of taxing the health insurance benefits employees receive as part of their compensation. Effectively, a tax increase on anyone who gets their health insurance from an employer.

Since this tax would apply regardless of which vendor, private or public, the employer chose to buy the insurance from I don’t understand how it would lead to the end of private insurance.

3 Rick Jr. June 30, 2009 at 4:22 pm

Ah, well then that would make sense then. Thanks for clearing it up. :)

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