Thursday, October 01, 2009

Healthcare and the Public Option

I like the public option, because I like what it is supposed to do. That, however, does not mean this is the only route we can take. The problem is both parties are not participating in shaping the future of healthcare. The idea is that the public option* would provide a means of containing cost in medical treatment. One would assume that they (the public provider) would limit what they'd be willing pay out and utilize a cost vs. overhead ratio that is more similar to Medicaid (around 7-10% for overhead) instead of that of private insurance (around 30%). This bargaining muscle would control costs because they'd control what is paid. This is the exact way that Wal-Mart uses its purchasing power to control the costs of the market.

If something else can control this cost inflation, I'd be fine with it. No matter if it be a co-op (like a public option but a privately run non-profit), a public option, or whatever. it just has to be something that actually exists. what it cannot be is a tax break that ignores the increase in cost and tries to paint over the problem by subsidizing the outrageous growth in cost. I've yet to hear many ideas dealing with this issue, but does not including a public option or a co-op. Other than the 'single payer', I've not heard anything. The Republicans have not even been in the room for the most part, let alone submitting ideas, which isn't helpful. There has been talk by Sen. Olympia Snow (R-ME) about not doing a public option at first, but having a 'trigger' that activates it if the 'other' ways don't work. I'm fine with this if it gets the job done, but I honestly think that's more about political expediency rather than actual sound policy. while i know that the public option has a cost (which seems to be/not be deficit neutral based on how much of a subsidy you give to poor-er people to offset the expense of buying in). I, however, think the real cost calculation is "what is the cost of full(er) coverage with the public option AND the longer term price controls it brings vs. no public option, no expense of such a program but also no alternative governor on the growth of medical expense and the half-assed care we get for this level of expense over, say...10 years.

Some things simply have costs. This is one of them. we have to figure what can give us the most bang for the dollars we are trying to spend. the only thing i don't approve of is an option that covers fewer people at a more steeply increasing rate. if there are other leading options beyond the public option, the co-op, or the triggered public option, i'd really like to hear it. I'm quite tired of the misguided notion that the price of the various plans are simply too if doing nothing were cost free. or less expensive.

It isn't.

*NOTE: Just for clarification, my understanding of the "public option" is that if you meet certain criteria, people who need coverage would be put into an "insurance exhange", in which a public option would be one of the choices. the others being private insurers. if someone speaks to you about the public option being a stand alone item, not as part of a group of available policies in this 'exchange', then they most likely don't know what they are talking about.