Debate Out of Control: What is Healthcare Reforms’ Public Option Anyway?

November 3, 2009 | | Comments Off on Debate Out of Control: What is Healthcare Reforms’ Public Option Anyway?

We’ve all heard the, “You lie!” and “die quickly” quotes in the media. The 2009 Healthcare Reform Debate will go down in historical archives as a contentious battle royal. One small piece of this debate has garnered far more attention than it actually deserves. Described as a “sliver” of healthcare reform even by supporters – the Public Option has taken a center stage in the debate.

A recent headline, however, suggests there is broad support for a public option included in the overall healthcare reform package. Another news source showed polls swinging wildly based on how the questions were phrased. For example, in a Wall Street Journal/ NBC News poll if you asked, “In any healthcare proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government, and a private plan for their health insurance?” 72% of the people said “Extremely or Quite important.” If you change that to, “Would you favor or oppose creating a public health care plan administered by the federal government that would compete directly with private health insurance companies?” the support fell to 48%. The truth is that the public option debate has become entrenched in scary and false images of government death panels, people facing terrible diseases with no insurance to pay for their treatment, and partisan competition to be as rude, controversial, and divisive as possible. What are they fighting about and what does it mean for Americans?
The Public Option would entail a government run insurance plan to cover people not covered by other health insurance plans – state or private. The plan would compete directly with private insurers. The current House Bill would allow healthcare providers to negotiate their reimbursement rates. A public option would require the government to provide money for the initial set-up, which in the proposed Senate bills would require to be repaid over the next ten years. The insurance plan would then be self-sustained by member premiums. The current bill proposed by the Senate includes an opt-out for states; that means that states can choose for themselves not to offer a public option. Support is divided mostly along party lines with Democrats in favor and Republicans against.

Supports of the Public Option Pros:
Provides coverage for some of the estimated 46 million people without insurance in the United States. Recent estimates, however, say that only 2 percent of the population under 65 would take the public option as laid out in the current House Bill.
Provides choice of plans so people can select the better of either their employer’s or the federal option.
Intended to drive down industry-wide premiums by encouraging competition especially in markets with local monopoly providers.
Intended to provide people who lose their coverage through unemployment with an affordable option.

Healthcare Reform Protests Cons:
Some claim that competition with the government would cause the health insurance industry to collapse. According to Aetna’s CEO, “when you have a government plan, you have in essence a player in the industry who is a participant in the market, but also is a regulator and a referee in the game. And we think that those two roles really don’t work well.” President Obama and other proponents state that the reform would include rules to level the playing field between the government and the insurance companies. Others claim this is just the response of insurance companies that don’t want to compete.
Some people against the public option believe that this would encourage employers to stop providing health insurance benefits for employees. Proponents claim this would just provide a less expensive option for small businesses and the self-employed.

No matter what side of the debate you fall on – one thing is clear. “The public option is a significant issue, but its place in the debate is completely out of proportion to its actual importance to consumers,” said Drew Altman, president of the nonpartisan Kaiser Family Foundation. “It has sucked all the oxygen out of the room and diverted attention from bread-and-butter consumer issues, such as affordable coverage and comprehensive benefits.”


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