Katrina and the public option

KATRINA AND THE PUBLIC OPTION…. Congressional Republicans went after the public option in the Democratic health care plan with some of the rhetoric we heard during the presidential campaign:

“The federal government would run a health care system — or a public plan option — with the compassion of the IRS, the efficiency of the post office, and the incompetence of Katrina.”

That’s a cute little phrase, and I’m sure we’ll be hearing it again and again in the coming months. That said, is it me, or is it strange to hear Republicans use the government response to Katrina as the quintessential example of incompetence? Isn’t that the Democrats’ line?

What’s more, as Brian Beutler notes, the substance of the argument doesn’t stand up well to scrutiny: “[T]he government fully runs one health care system — the Veterans Health Administration — and it’s considered to be just about the best system in the country.”

Quite right. In fact, the GOP talking point is as much an argument against the federal government doing literally anything as it is against a public option. (Look at the sentence again and replace “run a health care system” with “protect Americans’ national security interests” to see how lazy this thinking is.)

For that matter, Republicans have learned the wrong lessons in response to the Katrina fiasco. The 2005 breakdown wasn’t the result of flawed reliance on government support, it was the result of incompetent government. FEMA used to be extremely well run and fully capable of helping areas in need of disaster assistance. To hear the GOP tell it, government can’t respond to a hurricane, so it certainly can’t bring access to quality healthcare to Americans. In reality, it can do both with competent leadership in positions of authority.

The entire approach to attacking the public option is misguided. Matt Yglesias had a good piece on this yesterday.

The proposals currently before Congress would not, of course, create a government-run health care system. There is, however, a proposal to create a health care system that would include a widely available public health insurance option. The point of this would be to try and see if private industry actually can do better than a government-run insurance plan. After all, if the public option offered rationing and low-quality care, why would anyone sign up for it? Nobody would. That kind of low-quality public option would give private insurance nothing to fear. But what they really fear isn’t that a public option would be bad, it’s that it would be good — putting effective cost-controls in place without compromising patient care, thus threatening private industry’s business model.

That, however, is one of the best ways at our disposal to make health reform really work. A public option that strives to achieve public goals — quality care at an affordable price — will challenge private industry to do a better job. Then competition between plans will drive improvements in quality and efficiency. Without a public option, the risk is that private plans will compete by trying to screen out sick patients. That’s a viable root to private sector profits, but it does nothing to improve quality or control costs.