Notes on the Status of Health Reform- "Public Option" Posturing

[Orwellian_Ghost]

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"Public Option" Posturing

The "public option" refers to an idea that people and employers should be allowed to purchase insurance from a public program along the lines of Medicare. Proponents believe this would pressure the entire insurance market to reform itself. On moral grounds, supporters of the public option advance arguments similar to single-payer proponents: insurer profits amount to blood money, for every penny earned by the company is a penny's worth of care cheated from the effort to make a human being healthy. In comparison, a public program with the lowest possible overhead, its finances open for scrutiny, presents a morally defensible means of paying for care.

But the public option amounts to a moral posture, not a workable reform. Single payer would eliminate the insurance industry from health care; a "public option" cannot. A "public option" won't liberate the resources squandered by the private insurance companies. Instead, it adds duplicative waste in administrative overhead to the system.

The most relevant evidence comes from the state of Maine. Maine has offered a "public option" since 2003. In six years this program has managed to cover only 10% of the uninsured and has not forced its competitors to lower costs.

Perhaps the idea of a "public option," as a clever market-based scheme, reveals something about popular ideological illusions, for it relies upon a crude kind of "free markets equal low costs plus high quality." Of course this is not the way the market works. The laws of the health insurance market, in particular, dictate that the successful competitor will avoid insuring people who are sick and/or poor while recruiting customers who are healthy and wealthy.

Does it really make sense to believe that a "public option" tossed amid the heavily monopolized insurance market in the U.S. would stand a chance at competing for the healthy and wealthy patients? In the best case scenario, wouldn't such a program instead drive the system toward officially sanctioned disparities in care?

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http://www.monthlyreview.org/mrzine/coates050909.html

[eridani]

1. If a public option allowed buy-in to Medicare it might n/t

[Orwellian_Ghost]

2. bump