Public Option in Health Care Reform

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 thoughts on “Public Option in Health Care Reform”

  1. 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. 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.

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