Public Option

Commentary July 05, 2009 at 08:00 PM
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If you're a driver, then it's likely that the only time you pay attention to speed limit signs is when you spot a cop car parked on the side of the road or when (even more inconveniently) the cop is on the road doing the speed limit and no one dares go faster, meaning you have to go that slow until the cop gets on an exit ramp and out of the way. Then, as if all the drivers were a bunch of lemmings, everyone picks up the speed they were going before or maybe even faster to make up for lost time.

Speed limit signs, in other words, are pretty ineffective at controlling drivers and are treated by most of them as mere suggestions.

This insight, I believe, is what is behind the administration's and other Democrats' insistence that any health care reform needs to include the so-called "public option" as a way of making sure health insurers obey the speed limit, as it were.

The health insurance industry's reaction has been unenthusiastic, needless to say.

Here's what a spokesman for AHIP said in response to the one Democratic package unveiled recently: "A government-run plan would dismantle employer-based coverage, add additional liabilities to the federal budget, and turn back the clock on efforts to improve the quality and safety of patient care. A better approach is to pursue reforms that can achieve broad bipartisan support, including strengthening the health care safety net, overhauling existing market rules, promoting shared responsibility, and transforming the delivery system to reward quality and value."

Now, who could possibly disagree with those noble goals? But the devil, as they say, is in the details or, in this case, how to get from the present unsatisfactory point A to a point B where the health care system works for everyone.

The reality of the situation is that you're not going to do it without the cop.

Any idea that's put forth that would dramatically change the status quo is jumped on by Republicans as leading to a government-run health system.

Public option? Socialism!

A tax on rich health benefits? Socialism!

Individuals being required to have health insurance? Socialism!

This last really gets me because the people spouting this nonsense don't believe health care is a right but they don't want to make it a responsibility either.

So much for the "broad bipartisan support" so nobly wished for by the AHIP spokesman.

The reality is that something major in the current way we insure people is going to have to change in order for the system to get better. Tweaks are not going to do it.

President Obama made a telling point about the public option in his press conference on June 23. "If private insurers say that the marketplace provides the best quality health care, if they tell us they're offering a good deal, then why is it that the government–which they say can't run anything–suddenly is going to put them out of business? That's not logical."

Shortly before Mr. Obama's press conference, Karen Ignagni, president of AHIP, and Scott Serota, president of the Blues, wrote a letter to the Senate that said, "We do not believe that is it possible to create a government plan that could operate on a level playing field. Regardless of how it is initially structured, a government plan would use its built-in advantages to take over the health insurance market."

This is pretty lame and the industry really should be able to articulate its case backed by evidence instead of simply resorting to jejune arguments.

The fact is that when the cop is on the road, everyone else is on their best behavior. And if they're not, they should be ready to get pulled over.

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