The public option

THE PUBLIC OPTION…. The New York Times has a good editorial today on the public insurance health care option. It’s the kind of piece I hope the paper is prepared to publish again and again in the coming months, as the debate over reform continues.

Already one of the most contentious issues is whether to include a new public plan option to compete with private insurance plans. Many Republicans deride it as “government-run health care” and a step toward “socialized medicine.” Democrats find the notion appealing — even of vital importance.

A new public plan — to offer consumers greater choice, keep the private plans honest and, one can hope, restrain the relentless growth in health care premiums and underlying medical costs — seems worth trying. […]

Many reformers suggest that a public plan be modeled on Medicare. If crafted correctly, it would provide a valuable option for people who don’t trust private insurers to have a patient’s interest at heart and would offer a safe haven should private plans abandon a market, leaving their subscribers stranded. It would also serve as a competitive yardstick for measuring the performance of private plans.

A public plan might do a better job of slowing the growth of health care costs, although Medicare has not been notably successful in that regard. The public plan would almost certainly have lower administrative costs. And it could probably force doctors and hospitals to accept lower reimbursements than they negotiate with private insurers, allowing the public plan to charge lower premiums and attract more customers.

The principal conservative fear is that Americans might actually like the public option. And why would that be so awful? Because if private and public insurers competed for consumers’ dollars, and Americans decided they prefer to give up on private insurers, we might move towards (cue scary music) government-run health care.

The goal for conservative critics isn’t to put an effective system in place; the goal is to make a system that satisfies their ideological wishes. It’s not about pragmatism, it’s about political philosophy — a philosophy that only occasionally embraces competition.

The Times concluded, “A new public plan is neither the cornerstone of health care reform nor the death knell of private insurance. It should be tried as one element of comprehensive reform. If, over time, a vast majority decides the government plan is superior, so be it.”

Congressional Republicans don’t see it that way. They’re wrong.

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