‘Public option’ veers into fantasyland

August 20th, 2009 by ktrippe

As the purpose of this blog is educational, we will now be adding stories which we feel are worth reading and may get missed based on all of the activities we manage are part of our daily lives.

This is a recent editorial from USA Today on the healthcare bill.

Here’s a little secret: Government already pays more than insurers.

Depending on who you listen to, a central feature of President Obama’s health care overhaul — a government-run insurance plan known as the “public option” — is either dead or on life support. That it is in trouble at all reflects the Alice-in-Wonderland nature of the medical discussion.

In health care politics, down is up, right is left and the sun rises each morning in the West. When lawmakers try to be frugal with taxpayers’ money, their actions are labeled as Big Government intruding. When they try to bring some compassion to end-of-life issues, uncontroversial until it was included in a medical proposal, they’re accused of promoting euthanasia. And when they ignore the unsustainable amounts of public money pouring into a broken system, they call themselves pro-market.

This last illusion was illustrated in 2003 when Congress, then under Republican control, passed a Medicare drug benefit estimated to cost about $500 billion over a decade. Even though every dime was taxpayers’ money, the government was barred from using its clout to negotiate the most advantageous deals with pharmaceutical companies. Borrowing trillions from future generations was OK. Trying to get taxpayers the most for their money was not.

Something similar is happening with the public option. This entirely voluntary plan — that’s why it’s called an “option” — would bring some cost control to health care by applying government’s purchasing power as leverage against medical providers and insurance companies. Yet the idea is cynically cast as a “government takeover of health care” — rhetoric worthy of the Mad Hatter.

Even if tens of millions of people chose the public option, which is possible in some circumstances, tens of millions more would retain private insurance, which would get cheaper. And that could happen only if the program was wildly popular.

This is something to fear?

The dirty secret of our health care system is that it already is dependent on government or, more precisely, government waste. More than 46% of all medical service in the USA, about $1 trillion annually, is paid for directly by taxpayers. Private insurers cover 42%, and the remainder is paid out of pocket. In addition to what government pays directly, it pumps in more than $200 billion a year in tax subsidies.

If Washington does nothing, this government role will only get a lot bigger as the population ages, providers hike prices and private coverage becomes increasingly unaffordable.

The do-nothing critics avoid this reality through the strange logic that says government’s presence is harmless as long as it is dumb. It can mortgage the future. It can bankrupt itself. If everyone just closes his eyes, maybe no one will notice.

Senators opposed to the public option are promoting non-profit state cooperatives as an alternative. But such co-ops are likely to be too small, and take too long to establish, to provide competition to private insurers.

The public option is no boogeyman. It is a way to save taxpayers money while empowering people to make the choices Congress cannot. Without meaningful efforts to control costs, health care overhaul will simply turn into another exercise in sending trillions of dollars down the rabbit hole.

Posted at 12:22 AM/ET, August 19, 2009 in USA TODAY editorial

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