Why the Public Option is an Absolute MUST for Health Insurance Reform

First of all, I don't believe Kent Conrad,'s contention that there aren't enough votes in the Senate to support the public option. In reality, we only need 51 votes, and there are only six Blue Dogs. I'm even betting at least 2-3 Republicans can be brought to the public option side, especially if we can show that it will be paid for without huge tax increases on the masses.

contrary to the consternation shown in the media, I personally think President
Obama knows exactly what he's doing. He's not confused about what he wants at
all. His aim is to rally the troops to support the public option. But he's also
trying to get us to focus. One thing that killed the Clinton Health Care Plan
15 years ago was progressives' tepid response to it, and lack of enthusiasm for
it. It's wasn't Harry and Louise who killed health care reform then; it was
apathy. Republicans didn't like it, because they were told not to, and liberals
didn't get behind it enough.

are in danger of repeating that this time, as well. And President Obama knows

Until recently, a large group of liberals has been tilting at windmills, and demanding that a single payer system be passed in one bill. It's time to abandon that for a while, and put all of our efforts behind the creation of a public health insurance option. If the Obama Administration seems wishy washy on the health care bill, it's because its support has been wishy washy. It's time we focused and got this done, people. Thank goodness for one thing; there will be some reform this time. Even co-ops will be an improvement over the crap we're stuck with now; in fact, if you look at the co-op plan, it looks very much like the Clinton plan 15 years ago. But  that's not good enough. We are a hair's breadth away from finally passing a bill that will create an insurance system that could eventually bring us closer to an ideal system than we have ever been, and it's time we on the left stepped it up a bit. Get enthusiastic.

As we discuss health care reform, here are a few
things everyone should consider:

— The United States is
the only industrialized nation in the world in which a citizen can get sick and
lose everything they've worked for their entire life. More than half of all bankruptcies list health care bills as a cause.


— The United States is
the only industrialized nation in the world in which people die because they
can't afford a doctor.


— The United States is
the only industrialized nation in the world in which those most
likely to need medical care are currently actually forbidden pay into it. People who actually need health care are actually refused coverage.

— The United States is the only country in the world in which a private, for-profit insurance company can overrule a doctor-patient treatment decision, and leave both doctor and patient with no recourse.


— The United States
pays far more per capita for health care than any other country in the world,
even though nearly a quarter of the population is not covered at any given
time. We spent $2.4 trillion on health care last year; that's 17% of our GDP.


— The United States
has been regressing in recent years when it comes to major health statistics.
According to the World Health Organization, we are ranked 37th in major health
statistics, such as mortality, infant mortality and life expectancy. There are actually pockets in this country
with health statistics that rival the worst third world toilets.


— On an economic
level, companies operating in the United States are at a major competitive
disadvantage, because we are the only industrialized nation that doesn't
provide its people with basic health insurance.

So, let's recap. We live in the second-richest economy in the world, spend far more than any other country in the world, and yet, thousands of people die every year because they can't see a doctor. As a result, while most other industrialized nations are seeing improvement in their health care outcomes, we have been sinking.


We should be ashamed
of our status in the world.


Why is this
happening? We have many of the best doctors and medical personnel in the world. Many of
the best medical facilities in the world are located in the United States.
People from all over the world come here to train as medical professionals. We
have great hospitals, with the most advanced technology available.   How in the hell have we dropped to 37th in
the world in major health statistics with such great medical facilities and
professionals to choose from?


There's really only
one thing wrong with our system; one thing that has to change, and that is health

There probably need to be
subtle changes in other aspects of health care, to drive prices down, but the
biggest, most fundamental change must come through health insurance


Now, let me begin by saying that I don't think
we can rush into a single-payer plan, as many have called for — at least not all in one step. Even though
there's a huge problem out there, and our system is about to hit critical
mass, keep in mind that between 75-80% of the population currently have some kind of
coverage, and most have private coverage. It would be economically
daunting and wholly unfeasible to simply yank everyone out of private
health  insurance and into a public pool.
Millions of people would suddenly become unemployed, as private insurers lose a
significant portion of their business, and the cost of such a transition could
well $2-3 trillion or more in the first year alone.  In my opinion, the economy simply can't handle such a shock, at least on the short term. But that doesn't mean we shouldn't migrate the system into the direction of single payer.


What the economy can
handle, however, and in fact absolutely must handle, is a mechanism for covering the 47 million people currently without insurance as well as
the millions who are about to find themselves without it, even as the economy
recovers from the current recession. The best and most cost-effective way to cover all of these people is through a public health insurance option. While there is a lot of concern over a
"public option," the fact of the matter is, it's the only thing
that can work. In a capitalist system such as ours, it's simply not feasible for private insurance to cover absolutely everyone and still make a profit. But if we're to control costs in any significant way, everyone's bill must be paid.

The public
option picks up the slack for the time being, and it will force the health insurance
industry to migrate into something more realistic and feasible. Perhaps that's single
payer, but it could also be a hybrid between single payer and private insurance. Contrary to the crap you've been hearing lately, most countries with a single payer plan also have a relatively healthy private insurance system, as well. Anyone who thinks there's a perfect solution
hasn't looked at this issue from all sides before.No country's system is ideal; while we're 37th on the WHO's list, there are also 150 countries below us, many of which have single payer systems. But we're supposed to be world leaders. We know our system is failing; we have to work toward fixing it.


A public option will
do two important things right away, both of which scare the bejesus out of private insurance
companies. First, it would seriously reduce inflation in the health care
industry. Though it seems counter-intuitive, private insurance companies love high inflation. See, the main reason there is so much inflation in health care is
because so many people aren't covered and can't pay. Health care providers have
billions of dollars in unpaid bills every year, and they make up that shortfall by increasing their premiums every year. Insurance
companies love this, because the 12% increase in medical care gives them cover
when they increase premiums by 15-20%. Not only that, but think about this;  at the same time private health insurance companies are raising premiums, they're dropping people from the rolls who might actually may need those procedures for which prices have been raised, and they're denying claims for as many insured as they can get away with. In other words, they're raising premiums ostensibly to cover costs that they will then spend the next year trying NOT to pay. 

A public insurance system would immediately cover almost everyone, which would greatly reduce, if not eliminate, the unpaid bills for health care delivery, which would drop inflation in the health care industry to almost nothing; at most, it would be even with the inflation rate in the rest of the economy. No more year-over-year 15-20% premium increases. Everyone would be able to budget for health insurance; imagine the effect on almost all businesses, large and small.


Not having a
national health insurance plan is both morally wrong and fiscally
stupid. Whether you realize it or not, if you're married and have a
family, your employer is paying upwards of $1100 per month for your health
insurance on average. That's in addition to the nearly 3% of your pay that is
being paid in Medicare taxes on your behalf. That's a hell of a lot of money.
And it goes up every year, because the people most likely to be denied care are
those most likely to need it. 


Anyone who doesn't
want a national health care plan and thinks the current health care system is
just great should be certified insane.  What we have right now is absolutely
unsustainable and fiscally irresponsible, but is also morally repugnant.

Think about this; if you're walking down the street and see a guy having a heart attack, you call 911, and if you have the skills, you administer CPR, if necessary. You watch the ambulance pick him up and take him to the hospital. You're a good person for doing that. But think about what happens after that. How good do you feel about a society in which there is a better than one-in-five chance that the victim of that heart attack will be faced with a bill that he won't be able to pay, and which will cause him to go into financial ruin? How do you feel about the fact that he's thrown into financial ruin AND you're forced to pick up the cost of his bill through higher premiums? How do you feel about  being part of a society that will allow the insurance policy into which he has paid a quarter of a million dollars of his own money over the last 30 years to lapse, as his insurance company DROPS HIM because he had a heart attack? How do you feel about living in a society in which a hospital will be encouraged to discharge him before he's ready, because his insurance insists upon it, to save a few bucks?

If any
person in this country dies because he or she is denied medical care due to an
inability to pay, that is one too many, and it's a violation of the principles  contained in our Constitution. How free are we, if we are one illness or
accident away from losing everything we have worked for our entire lives? How
free is someone if they are working three jobs just to keep a roof over their heads and
food in their stomachs,  and one health episode puts those out of their reach? And what does it say about a country, when
a parent who's working one job gets health coverage for their kids, but if they
take two or three jobs to try to get ahead, they lose their health coverage?

Like I say; if we allow our representatives vote to keep the status quo, we should be ashamed of ourselves.


And if you want
confirmation that the anti-health insurance reform people are certifiable, check out
their most common arguments.

  • It'll cost
    too much
    — Ok,
    this is just insane. One third of all health care money comes from the
    government, anyway. And the 75-80% of Americans with insurance are already
    paying the bills of those who can't afford to pay. That's why your
    premiums go up every year. On the other hand, if everyone is
    paying in to the system, and they're then covered, and the bills are paid,
    how will it cost those with insurance MORE? In fact, they'll likely pay
    less. May I also point out that a significant component of car insurance,
    boat insurance and homeowners insurance, among others is medical, and if
    everyone's covered, your liability under those will be significantly less.
  • The
    government can't run anything
    — This is a Golden Oldie, isn't it? Forget the fact
    that no private insurance company in the world could handle Social
    Security. Don't give me those awful stories about the DMV — the last
    several times I had to go to the DMV, I was in there for less than 30 minutes and walked out WITH my license or my plates, thank you very much. And
    forget the reality that there is no way a private corporation could take a
    letter from your home and deliver it to your brother on the other side of
    the country for 44 cents. No, this is about money, and who's
    better at handling it? I have one question for you; WHO is bailing out
    WHOM here; isn't it THE GOVERNMENT bailing out PRIVATE banks, and not the
    other way around? Was it the GOVERNMENT who forced all of those PRIVATE companies to invest in derivatives, to their own deteriment? General Motors is in bankruptcy right now, not the US Treasury.
  • Obama wants
    "socialized medicine."
    — ooohhhh…. Scary term, that "socialism" huh? I mean, that's a frightening concept, isn't it? Well, let me be
    the first to break it to you, folks. Health insurance IS socialism. No,
    actually, that's not true. It's really not socialism; it's communism. In
    describing communism, Karl Marx famously said, "From each
    according to his ability, to each according to his needs." That's the
    essence of insurance, really. A large group of people pays money into a
    large pool of cash, and as people need health care (theoretically,
    anyway), the money to pay for it comes from the pool. You know, each
    person who can pays into the pool, and people take what they need.
    Insurance = communism. The difference between private
    and public insurance 
    is that private insurance has to make a profit, and the profit has to
    increase every year.  Public
    insurance is not concerned with profit, so they simply have to make sure
    they take in enough money to cover expenses.
  • The
    government will make medical decisions for you.
    — this is my absolute
    favorite, because it ignores the realities of today. Most people know someone, or at least know of someone, who had to jump
    through hoops in order to have treatment covered by the insurance company.
    Private insurance companies routinely deny coverage on any procedure over
    a certain dollar amount, and count on a certain percentage of their
    customers to go along with that decision and not fight it. And why not;
    insurance companies work at cross purposes with health care delivery
    companies as a natural course of things, which is what makes the AMA's
    disapproval of a public option particularly galling. The doctor's main
    purpose is to make you well. The hospital's main purpose is to provide you
    with the means for you to get well. On the other hand, a for-profit
    insurance carrier (or a non-profit carrier with a shitload of highly paid
    executives) makes its money by denying coverage, and by providing as few
    procedures as possible. In other words, private insurance companies already make medical
    decisions all of the time, because they don't want to pay for the results of decisions your doctor makes. Not only that, but how often have you had to
    change doctors in the last 20 years, because your physician isn't included
    in your plan's network, or because one that used to be there isn't there
    anymore? Doesn't your insurance company have to approve your referral to a
    specialist? Don't they dictate which drugs they'll cover for you and how much
    they'll pay for them? And ask any hospital or medical administrator whose
    paperwork is easier to deal with; private insurance or Medicare/Medicaid.
    Public insurance couldn't possibly be more cumbersome than the system we
    have now.
  • A public
    option would kill private health insurance
    . — Okay, this is my second favorite, because
    it usually comes from the same people who offer most of the other
    "arguments" above. It's that infamous right wing cognitive dissonance. The next time one of these people presents this argument, ask them how such a thing is possible,
    if the government is incompetent, it costs too much, and will take decision-making
    away from doctors? How are these boobs supposed to kill private insurance? Private
    insurance won't die. Public insurance should only cover the basics, with private insurance filling in the gaps. It
    shouldn't cover medically unnecessary surgery, for example. They can also sell dental and vision insurance. But for basic
    medical care, it only makes sense that one group watch over and negotiate
    costs, hand out the money and monitor fraud. It's a hell of a lot cheaper
    for everyone involved.

Face it, folks; we
need a new approach to health care. And while diving whole hog into a single
payer plan is neither feasible nor fiscally responsible at the moment, a public
option for people is the only way to go. That is, unless private insurance companies
are willing to:

  • Cover everyone, regardless of
    their age or medical condition, at a reasonable price;
  • Not drop anyone due to their medical condition.
  • Promise to cover every
    procedure that is a result of a rational medical decision by a doctor;
  • Pay every claim except those
    proven fraudulent;
  • And limit their profits to
    5-10% overall.

And you know they'll
never agree to any of the above.

However, HR 3200 would cover everyone, it would make insurance — public or  private — cover everything. It would force them to do pay all claims, and by providing competition, it would limit profits somewhat.


The current system
is immoral, it's shameful, and it needs to go away. It's time to ease into a
new system, where we the people make our own decisions regarding our health
care, along with the doctors we choose to help us. Anything less is

Now, call or write your Congressperson and both Senators — even if they're Republican — and let them know that nothing less than every American covered by health insurance is acceptable, and that you will no longer tolerate living in a country where people die because they don't have enough money. That's not what our country is about, and never has been.

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