Is a public health insurance option essential?
The debate over healthcare reform heated up this weekend when a top U.S. health official called into question the government-run health insurance option favored by President Barack Obama.
Health and Human Services Secretary Kathleen Sebelius said on Sunday a public option was “not the essential element” of any overhaul, and that non-profit cooperatives being considered by a Senate panel could also fulfill the White House goal of creating more competition on insurance.
Democratic dissenters of this view come out in full force.
“You can’t have reform without a public option,” Howard Dean, a former Democratic National Committee chairman and a vocal supporter of an overhaul, said on CBS’s “Early Show.”
“I don’t think it can pass without the public option,” Dean said. “There are too many people who understand, including the president himself, the public option is absolutely linked to reform.”
Democratic Representative Anthony Weiner of New York, who backs a public option, said in a statement “leaving private insurance companies the job of controlling the costs of healthcare is like making a pyromaniac the fire chief.”
Reuters.com asked a panel of experts to weigh in on the debate. Here are their responses:
(Updated at 8:15 pm ET)
Ted A. Okon is the executive director of the Community Oncology Alliance, a professional organization representing community oncologists. The views expressed are his own.
A government-run insurance program — the public plan option — is not essential to health care reform and could even be detrimental. The government should focus first on creating a consumer-friendly insurance exchange that provides transparency and easy comparison of private health care options. This combined with regulatory reform at the federal level will foster greater competition within the private insurance sector.
Proponents of a public plan want a low-cost, government-run insurance option that will force private payers to reduce premiums to compete. This would be achieved in large part by basing provider reimbursement on Medicare, or a nominal percentage above Medicare. Thus, between Medicare and the public plan, the government would have the leverage to virtually control provider payments.
Greater government control over provider payments would force practitioners to close their practices because in many cases Medicare rates are not realistic. For example, Medicare already pays for approximately 45 percent of cancer care at rates that are forcing community cancer clinics, which treat over 80 percent of Americans with cancer, to cut staff and close facilities. In 2010, Medicare is planning further payment cuts for the administration of life-saving cancer drugs by over 20 percent.
Extending the influence of Medicare pricing through a public plan offering would have catastrophic consequences on the cancer care delivery system in this country.
Dr. Steffie Woolhandler and Dr. David Himmelstein are both associate professors of medicine at Harvard Medical School and primary care doctors at Cambridge Hospital. They co-founded Physicians for a National Health Program. The views expressed are their own.
Even with a strong public option the president’s plan for health reform was far too timid, falling well short of the single payer reform that would resolve the health care crisis. Dropping the public option assures that reform will merely pump more money into private insurers’ coffers and reinforce their stranglehold on America’s health care system. The measure the president appears ready to accept would do little or nothing to help patients, and much to help the corporate interests who profit from care.
I’m hoping the comments from the White House over the past few days are part of a trial balloon to gauge the reaction to the possibility of throwing the public option overboard–and that the reaction from the president’s core supporters has been swift and clear.
There can be no meaningful reform without the public option. The suggestion that nonprofit co-ops can be created as an effective alternative to the public option is fantasy. The insurance industry would love to see the idea of co-ops included in the bill that reaches the president because insurance executives know co-ops would have no chance of ramping up to be competitive in any market.
Sen. Conrad should spend more time learning about what has happened to the insurance industry in recent years before championing an idea that would ensure the continued profitability of insurers at the expense of his constituents and millions of other Americans.
For full Reuters coverage on the healthcare reform debate, click here.