The fact that keeps getting dropped in the healthcare reform debate is that a strong public option—a government-run insurance option designed specifically to provide competition for the corporate insurers—was the compromise the US political left made in abandoning a demand for the universal, single-payer, Medicare-for-all model. All three leading Democratic candidates—Obama, Clinton, and Edwards—actively campaigned on a strong public option.
The strong public option was the healthcare reform compromise.
President Obama has failed miserably to rally support for the public option. Failed because he hasn’t; miserably because he hasn’t even tried. According to Rahm Emanual’s political strategy, passing anything is a victory, a victory is imperative, so passing anything will do.
If there’s another way to reduce the growth rate of health insurance costs—not reduce costs, but rather the growth rate of those costs—everyone I’ve talked to is open to discussing it. But it has to be a viable option. The co-op model proposed by Senator Kent Conrad (D-North Dakota) and others isn’t viable except to provide cover for the centrists. And, as Jim Hightower articulated so well, there’s nothing in the middle of the road but yellow stripes and dead armadillos. No one’s been able to answer the simple question: How do you propose to have real, honest competition between a state-based co-op and the megalithic insurance corporations? And the limp-wristed notion of allowing people to buy health insurance across state lines does nothing except raise premium rates, reduce benefits, and eliminate the minimal power the states currently have to regulate corporate insurer behavior. And a trigger? Well, that’s just laughable. How much more of a trigger do you need than 30 million uninsured US citizens? You know it’s wrong if it’s what the corporate providers want.
The corporate insurers and healthcare providers don’t want a strong public option because it will allow the US government to negotiate fees for service at significantly lower rates than the corporate insurers. Obama isn’t pushing a strong public option because he doesn’t want to give up the lucrative flow of money to the Democrats from the health insurance, pharmaceutical, and medical provider PACs. The power of the public option comes in the numbers: The numbers of subscribers under a true public option—one open to the entire citizenry—would drive the costs of both services and pharmaceuticals down to a true market cost. Because there would be only one payer for these services and pharmaceuticals, the fixed overhead costs would similarly be driven lower.
Conservatives who fear this is the “camel’s nose under the tent” to socialized healthcare are—let’s be honest—absolutely correct. If you have the option of keeping your current insurance plan, or a public option that offers the full backing of the US government along with lower premiums, co-pays, and deductibles, which would you choose? Anyone on the left who doesn’t admit the clear consequences of this is, well, lying.
There. I said it. Single-payer healthcare with universal coverage is the only viable resolution to both the problems of costs and access. I believe that good quality, universal access to healthcare is a human right. Or, taken from a different perspective, universal access to affordable healthcare is part of the true mission of any real homeland security effort.
The vast majority of US citizens agree. The majority of Americans want the option of being able to choose a government-backed, government-negotiated health insurance policy. A strong public option gets us to a single-payer system in an orderly fashion, giving those in the private insurance industry at least a decade to wind down and find a new line of work.
Any healthcare reform policy without a public option means a big, wet, sloppy kiss along with a very large check to the health insurance, pharmaceutical, and medical provider industries. A big fat thank you for all of the rate raising, claim denying, and preexisting condition excluding bad behavior that came before. Especially if mandated insurance is part of the policy, but a public option is not.
The challenge to those on the right is to simply acknowledge that they believe healthcare is not a human right, but rather a privilege afforded only to those who can afford it.
It’s time to strip away the circus bullshit and have that simple, clear-cut debate. Does every US citizen have a right to adequate healthcare, yes or no? It should take less than half a day. Then move on to the vote. Then a month, maybe two, to craft a policy. Don’t think it can be done? Start by suspending the healthcare benefits of members of the US Congress until it is done.
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