Four Reasons Why the Public Health Care Option is Irrefutable

I'm not a healthcare wonk. Of course, I want the 46 million uninsured Americans to get coverage, but they have not been my primary concern in healthcare reform (even though I have been among the uninsured many times in my life). I have to admit I'm being a bit selfish here because I mainly want to have less expensive health insurance that still gives me decent coverage.

Why? Because these healthcare costs are killing us. It significantly impacts our family's life. We're just like everyone else, getting crushed under these bills. And what drives me crazy is that after paying more than any other country in the world, we get the 37th best coverage. That's unacceptable. We need to change this system.

This is why I'm in favor of the public option. I need lower bills. Republicans are saying that the public option is unacceptable because it will be too cheap and too efficient, so private companies cannot keep up with it. Great!

Frankly, I don't give a damn what happens to private insurance companies, I just want less expensive coverage that does the same job (or better). And that's what the Republicans are telling me is going to happen.

Mitch McConnell literally said this weekend on Fox, "The private insurance people will not be able to compete with a government option." Doesn't this prove that the private insurance companies will not be able to do as good a job as the government? Then step aside, Butch.

Here are four indisputable reasons why the public option must be part of the healthcare proposal:

1.    The government doesn't have to advertise. No marketing budget means less costs to pass down to the consumer.

2.    The government will not take a profit. That is about 10-30% of costs wiped out immediately. Private companies by their nature will add a certain percentage to the product for their own profit. That comes directly out of our pocket. An option that doesn't take profit also doesn't take as much money from us.

3.    The government will have enormous negotiating leverage with drug companies and health care providers, so they can drive down the costs to the consumer even more.

4.    It is an option! If it turns out that the government option does not work as well or costs more, no problem, just use the private insurance you have now. This is only an option you have in a more competitive market. Who can argue with that?


There are legitimate concerns that progressives have with the public option. It is not single payer. The government does not pick up the tab. You still have to pay a premium and the current system is largely maintained. But I think this is better than single payer. It gives us a choice and allows the market to dictate which system works better in the healthcare industry - public or private.

If in the end, more people choose the public option, then obviously it worked. If they don't, we've lost nothing because they can still get private insurance.

Another important point to remember is that the doctors, drug companies and medical providers are still private entities. They can compete with one another for more business by producing better products or making them cheaper. The base of healthcare services is still the same. It's just how you pay for it that would change a little.

And no one is getting between you and your doctor (unless it's your current provider who won't let you go out of network). You can pick any doctor you like under the public option; you just pay him from your public insurance rather than your private insurance. And it costs less. So, where's the harm?

Well, some would argue that the costs of the public option might be more than we realize. For example, the government will cover pre-existing conditions, and that could add to the costs of the plan. No problem, if you can find a better private plan, take it! If you want to add on to the coverage the public plan gives you, do it! Nobody is stopping you from getting more or different coverage from a private insurance company.

Plus, there are even more savings that are likely from the public option because the government has proven to be more efficient in how they run healthcare insurance policies. Medicare has 2% in overhead, while the average private insurance plan has about 10-25% of their costs in overhead. That's an enormous difference. But even if you think the government can't run an enterprise as efficiently (though the evidence clearly shows otherwise), you would be hard pressed to think they couldn't at least cut costs significantly because of the first three reasons stated above.

So, given all of this, it is absolutely clear that the public option must be included in any real healthcare reform plan that comes out of Congress. Otherwise, it's a joke and the lobbyists have won again. The public option is the whole enchilada here. Politicians who talk about compromising on it have no policy ground to stand on. They are simply doing the bidding of their benefactors, large healthcare corporations who feed their campaign coffers. Don't believe any sweet talk about necessary compromises. It is a deception meant to kill the heart of the bill.

It must be the public option or bust. There will be many things to negotiate in the final bill, but this cannot be one of them. Otherwise, there will be no real reform.

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Granted, I'm for single payer and I'm less optimistic that a public option plan here would be serious enough to actually compete and put private insurers out of business, as explained in a good Huffington Post comment:

"...Most seem to imagine it would be some kind of Medicare clone that would be so attractive that it would wipe out the private insurers. Well . . . guess again. It's likely to be a clone of the private insurers with a phony "public" branding designed to gull the credulous while achieving it's real objective: keeping most of the system in the hands of the rapacious private insurers.

The first inkling of the details of the public option came about a month ago from AHIP shill Chuck Schumer, who devised the scheme at the behest the HMO-owned Max Baucus. Here are the devilish details, according to The New York Times:

�The public plan must be self-sustaining. It should pay claims with money raised from premiums and co-payments. It should not receive tax revenue or appropriations from the government.

�The public plan should pay doctors and hospitals more than what Medicare pays. Medicare rates, set by law and regulation, are often lower than what private insurers pay."

In other words, a guaranteed-to-fail farce that would replicate all the worst features of private insurance and offer none of the cost-savings or coverage expansion of the single risk pool of true single payer..."

by Tom Hanc on 06/11/2009 02:43:36 PM EST

I forgot to include the CEO Roundtable Report on healthcare since it's the perfect time for it.

"...It compares statistics on life expectancy, death rates and even cholesterol readings and blood pressures. The health measures are factored together with costs into a 100-point "value" scale. That hasn't been done before, the authors said....

The United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France. The five nations cover all their citizens, and though their systems differ, in each country the government plays a much larger role than in the U.S.

The cost-benefit disparity is even wider -- 46 points -- when the U.S. is compared with emerging competitors: China, Brazil and India..."

by Tom Hanc on 06/11/2009 02:48:49 PM EST

[ Parent ]
I do not know how the comparison between different countries is acutally calculated but I would guess that there are many sources for errors.

For example in Germany (and Austria) all of the public insurance companies make deficits. The actual costs are much higher than the money payed by the insurants, the difference is thrown in by the government. The positive side effect of this is that the government cares about costs very much. As a result, drugs are much more cheaper in Europe than in the USA - obviously it is not so easy to milk the people when this results in a greater budget deficit.

Another characteristic of the public insurance in Germany is, that the amount of money you have to pay is coupled to your income. You have to pay a percentage of your income rather than a fixed amount of money. The private insurance companies have fixed fees and so people with higher incomes are trying to get private coverage.

All physicians I know are whining about how few they get payed by the public insurance companies for their patients. Usually you have to wait longer for operations too. There are studies that even the probability to get an operation at all is higher if you got private coverage. Ironically in some cases operations are serving the wealth of the surgeon better than the health of the patient.

Public insurance companies in Germany are heavy bloated - oh - may be that must be mentioned explicitly: There is not ONE public company, there are many of them. Everyone responsible for another occupation group, no competition at all, may be that is the reason why they are so bloated.

I am curious how the public option will evolve in America, I am sure it will be pretty different than in Europe, basically because there are some characteristics in the european way of handling the issue that are someway socialistic and therefore not very attractive for Americans in general I guess.

by snoewchen on 06/11/2009 07:38:03 PM EST

[ Parent ]

(I know you spoke of Germany, but I figured I'd post this because it has a lot of great information and touches on some of what you mentioned).

10 Myths About Canadian Health Care, Busted

I don't want to repost the whole thing here, so I'll just post the 10 myths and the first sentence or two of each response:

1. Canada’s health care system is “socialized medicine.” False. In socialized medical systems, the doctors work directly for the state...

2. Doctors are hurt financially by single-payer health care. True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions...

3. Wait times in Canada are horrendous. True and False again — it depends on which province you live in, and what’s wrong with you...

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few...

5. You don’t get to choose your own doctor.
Scurrilously False...

6. Canada’s care plan only covers the basics. You’re still on your own for any extras, including prescription drugs. And you still have to pay for it.
True — but not as big an issue as you might think...

7. Canadian drugs are not the same.
More preposterious bogosity...

8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true...

9. People won’t be responsible for their own health if they’re not being forced to pay for the consequences. False...

10. This all sounds great — but the taxes to cover it are just unaffordable. And besides, isn’t the system in bad financial shape? False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we’re not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we’re actually money ahead....

by Tom Hanc on 06/11/2009 08:00:36 PM EST

[ Parent ]
You should have left out reason 4. You would give that reason to someone who wants the current system to stay, while the other 3 appear to be for people arguing for the single payer option.

Moreover, reason 4 projects a win-win scenario when it's really a lose-lose one. That is for people who can't afford to go to the doctor in either case.

by Tansul on 06/12/2009 12:58:48 AM EST

the most convincing piece of evidence that americans are incapable of thinking sensibly about health-care reform is their continued focus on "health insurance" instead of "health care". only this obsessive focus on "insurance" leads to the lunacy of secondary talk about "marketing costs" and "overhead".

 

"insurance" is about the mitigation of risk, and "risk" implies uncertainty.

having someone else pay for your regular 4 times a year visit to your own personal favorite dentist to have your teeth cleaned, and to have your children fitted for braces is not "risk" since there is nothing uncertain about it.

 

if americans are worried about being uninsured, they need to first understand why "out of the pocket" health care costs so much in this country, especially when compared to the quality of care in other countries vis-a-vis their per-capita spending.

without a proper, evidence-based answer to that question (doctors paid too much, hospitals are greedy, malpractice costs are high, drugs are needlessly expensive, patients demanding unnecessary diagnostics, whatever), trying to sweep the cost problem under the proverbial rug by claiming to provide "insurance to everyone" is just a waste of money.

 

if the government really had as its ultimate goal the good-health and well-being of all its citizenry, and wanted to achieve this goal most efficiently, all it is has to do is this:

  • start a bunch of government-owned, government-run hospitals.
  • these hospitals are funded through general tax revenue.
  • they are located in all major metropolitan areas in country, thereby ensuring that they are within the reach of an overwhelming majority of the citizenry (just start with every place in the country that has some sort of "federal building" and build a hospital in that city/town).
  • staff the hospital with doctors, nurses, technicians that you hire and pay reasonable market wages---if market wages are really reasonable, you should have no problem staffing the hospitals.
  • equip the hospitals with the best medicines and diagnostic tools you have at your disposal---the fda and nih will happy tell you all about the latest medical research.
  • provide treatment to any and all comers at subsidized, or means-tested, or zero-cost.
  • there is no talk of insurance or hmo or any other bullshit.
  • a citizen walks into the hospital, asks to see a doctor, gets a diagnosis, possibly medicines/therapy/surgery, etc.

people are free to go to the "government hospital" or to a private hospital, based on the quality of care provided by these two institutions.

at private hospitals, they get to see their personal favorite doctor but they pay whatever amount (and through whatever agency) the private hospital administrators demand.

at government hospitals, they pay nothing or write a check or swipe their credit card when leaving the premises. however, they get to see a doctor that has already worked on their case or someone who happens to be working at the hospital.

do this, and you will find out that either (a) you have solved the supposed "health care crisis" in the country without any bullshit talk of insurance, or (b) figure out that running a hospital and providing inexpensive care to whiny fatty american fuckers is ultimately a thankless and wretched job, and breaks the treasury.

 

what about the american dumfucks who want to make frequent visits to their favorite personal doctor in their favorite private hospital but have someone else pick up the tab---these dumfucks can pay for this privilege by themselves.

what about rethuglicans who will claim that this turns the u.s. into cuba. well, if you have already started down the road of deciding long-term public policy based on the rantings of rethuglicans, you deserve the hell you get.

by neo on 06/12/2009 02:32:40 AM EST

Poll: Health care costs too expensive, Americans say


by Chinese Democracy on 06/12/2009 09:29:12 AM EST

Common, what you describe is the actual system. Last time I checked, it didn't look like that favorite image of yours. And U.S.P. vs private transport companies: there are legacy costs (e.g. pensions and healthcare of the retired) that the start-ups, being private, avoided in the first place. Face it: treating human beings humanely is more costly for a company than treating them as expendable material (of course if you look at it in the long run, it is more cost efficient for the society most of the time).

Some rare OT from me:

1. Ken, seriously consider seeking help. Even if that is just your internet persona, it will take a toll on your RL psyche if it has not already. Just try to take a break and then look at what you do here from a distance.

2. Please everybody just ignore every single one of Ken's accs. Just look at the above post and you have 4 of them.

3. Yturks, Dave, seriously consider banning (or suspending) Ken's Account (Membership being a different issue and i don't advocate anything there if you can separate the two). First, it will be for his own good, but secondly he also openly undermines the rating system with his sockpuppets and rarely if ever provides any substantial points and he is certainly not open to debate. If he feels he loses he changes the subject, gets inflammatory or stops responding and later declares victory because many posters simply get annoyed with him.

This will be all I'm going to post about that (oligoword posts excluded), Ken simply being no match for me anyway, so I win. 

by eborujion on 06/12/2009 11:55:47 AM EST

There is always the option of ignoring him completely.


by Chinese Democracy on 06/12/2009 12:10:35 PM EST

[ Parent ]
According to eborujion, I should be ignored, shunned, banned, and maybe even jailed for posting such comments.

How about being waterboarded? I remember faintly that some KenTx promissed he'd get waterboarded on tape...

I've been getting exactly this kind of response for the five years I've participated on this board, and that's why I'll never leave. I get tremendous satisfaction from posting simple, common sense ideas, and having liberals react with outrage and vitriol.

That's why I advocate expelling you. You'll never learn how to behave properly. What happens to the moron who starts fights in the wrong neighborhood? He'll get beat up. If he doesn't understand that, he gets a restraining order (I purposefully skipped the step involving guns). Note: this has nothing to do with dissenting opinions, but with the fact that you are an asshat who doesn't have any opinion most of the time. Stop masturbating over your posts or I'll tell your mom!

Notice that neo posted nearly the same proposal, using many more words. But my post generated the reactions, because I employed an old picture, and much fewer words.
Lol, have you read what Neo wrote? Same proposal, my ass! I may not agree with him, but he presented many valid points and posed some good questions in his rant whereas you have exactly one statement: "I don't care about anything but myself and I don't have a solution for the crisis! So fuck the poor people!".

by eborujion on 06/14/2009 08:37:01 AM EST

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