Why the "Public Option" is ABSOLUTELY Necessary (9/9/09)
President Obama is going to make a speech about health care tonight. I don't know what's going to be in it. I hope he will express his newfound recognition that compromise with Republicans is pointless and that he now has decided to go for a PROPER health care reform and will hang it around the necks of Republicans and Blue Dogs if they choose to obstruct the public's will, but I somehow doubt that he will please me on this point.
I myself will NOT support any health care reform proposal that does not include a public option right from the get-go, and I will do whatever little I can to the best of my limited abilities to help to scuttle any reform that is proposed without it, because I feel strongly that "reform" without the public option will not only bankrupt our government, it will create tremendous hardship on working men and women and will fail to provide the comprehensively universal coverage that we need.
Let me explain. All of the reform bills I hear about, whether they include the "public option" or not, mandate that insurance companies end their current practice of refusing to issue policies to anyone with a pre-existing condition and cease and desist in their particularly despicable policy of scouring policyholders' initial applications for coverage once they become ill or injured, combing those forms for any inadvertent omission that they then use to justify terminating or rescinding their policies, leaving the individual without coverage when he or she most needs it.
But, of course, these policies, as cruel, greedy and heartless as they may be, save the insurance companies a very great deal of money. It helps them to limit what they call their "medical losses," meaning their payment of legitimate claims. Curtailing these practices will have an immediate effect on their balance sheets, which they will then use as justification to raise their premium rates for ALL their policies, probably by significant percentages. They will be able to make the unarguable point that the increased costs caused by these "reform" mandates make it necessary for them to raise their rates, and these increased rates will take place for all forms of insurance, whether provided by employers or purchased privately, and whether the policies are with traditional insurers like BC/BS, with PPAs, or with HMOs.
These increased premiums of course will fall most heavily on those businesses that provide health care coverage for their employees. If they continue to provide the same level of coverage to their employees that they provide today, it will directly and adversely impact their profits. They will either have to decrease or eliminate coverage for their employees, decrease the amounts they pay their workforce, downsize, or raise the prices for the goods and services that they produce. Whatever their choice, it will have a serious negative effect on their business prospects or on their employees, at a time when both businesses and workers are hurting plenty already.
But couple this with the oft-mentioned mandate that all Americans obtain health insurance and you have a real problem. Most Americans not currently covered by health insurance are in this situation because they can't afford it now. The mandates in these reform proposals will make health insurance even MORE expensive than it is today. Indeed, it is likely to SUBSTANTIALLY increase the percentage of our GDP that is now represented by the health INSURANCE industry, and the already tremendously too-high percentage of our GDP consumed by health care overall. Where today health care accounts for around 18% of GDP, under these proposals without the public option it is likely to rise to 25% or perhaps even more. From a macroeconomic standpoint, this is the precise OPPOSITE direction that health care reform should take.
This will have a TREMENDOUS impact on Medicare and Medicaid expenditures, because the price of everything related health care will rise sharply. This threatens to cause a very real budget crisis at both the Federal and state levels, requiring a Hobson's choice between cutting medical care coverage for our elderly and poor or raising taxes painfully.
With a public option, however, if it has teeth, it will be able to set reimbursement rates and cap coverage costs, and the rest of the health care and health insurance industries will have to fall into line. This is the ONLY WAY to provide universal coverage and control costs, and if the public option proceeds to grow because it provides better service at lower cost than private insurers do, and it swallows up the entire health insurance world, well, that is as it should be. We call it "single-payer," and that's what I've wanted from the git-go.
But now comes this weird new proposal for a public option "trigger" in 2013, 2015, 2016 or whenever. What a total crock! Whatever the criteria might be to pull such a "trigger," this will give plenty of time for the health insurance industry to change the terms or eliminate the trigger altogether before it would ever be pulled. This is a meaningless provision intended to trick the supporters of real reform into submission, and it is nothing but a subterfuge intended to engineer the defeat real reform in a death by a thousand cuts.
Without the public option, all reform will be is an enormous taxpayer subsidy to the health insurance industry and a mandate that we all become customers of these profit-making enterprises. I find this to be UTTERLY UNACCEPTABLE, a disaster for our country and for our people. Unfortunately, the entire Republican Party and a number of pitifully, indeed shamefully, frightened Democrats seem more interested in doing the bidding of the health insurance moguls than in protecting the interests of the American people.
Obama and the more courageous Democrats in the congress that we were elected to control need to fight for PROPER health care reform and hang it around the necks of those representatives and senators who choose to obstruct it in 2010. It will be better for the country to have NOTHING now than the things that now seem possible, and go for REAL reform two years down the road.
We need to oppose sham "reform," and make those who have made it a sham pay dearly for their foolishness.
The private health insurance industry needs to be phased out. It is not necessary.
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