People often forget, either due to distractions, blinding cynicism or a lack of education, how unique this country really is. The United States of America is a nation forged and grounded in a rich tradition of protest and persistent refusal to accept the status quo. In many ways this tradition has been in hibernation--recent decades will never be known as the years of particularly impressive citizen participation in government and policy. Indeed, the American people have become increasingly apathetic and stupid, but I believe that the spirit has remained alive--in fact, I predict that the drive to change our most negative aspects of society is building momentum; isn't it obvious?
Take the town halls on health care, for instance. Though CNN, FOX and MSNBC only cover the crazies, there is some remarkable dialogue going on--and not just by the supporters of health care. When it comes to the Public Option, there is a genuine philosophical debate to be had. Remember that the whole point of the American Revolution was to establish independence from an abusive and invasive government that taxed excessively and unfairly. We have come a long way since then, and have perhaps gone full-circle in many ways. I share many Libertarian concerns of the expansion of the U.S. government, excessive spending and the limitations placed upon civil liberties; not to mention our often tyrannical foreign policies. Indeed, the United States became the very empire its citizens died to defeat. People think I'm a big gov liberal, but the fact of the matter is that the federal government IS WAY TOO BIG! The War on Drugs is a fiscal and societal disaster, the Iraq and Afghanistan wars are squandering our treasure. The IRS ought to be torn down and replaced with a simpler tax code, and the Patriot Act ought to make every single American extremely wary of what leaders know about our personal lives. Not to mention the militarization of government that has seeped into the media and saturated our culture.
So when people say to me: "I just don't believe the federal government should expand! It's already too massive" I agree! The problem is that in this modern world, there are modern problems that require state intervention. Spying on Americans is not one of these exceptions. Drug abuse isn't either. Nor is Saddam Hussein or Ho Chi Minh! But to the people who believe the Public Option is some kind of government takeover and the onset of communism: should we not fight to end the excessive federal policies that actually hurt people? The War on Drugs fuels a culture of crime in the inner-cities. At least a million Iraqi citizens are dead because of the current conflict--not to mention the 4,339 dead American soldiers. But now you oppose a public health plan? A plan that will help your fellow citizens get the care they need? A report by the Institute of Medicine suggests that as many as 22,000 American citizens die annually due to the lack of an insurance policy--one that either could not be afforded or was cut by employers!
And let us not forget that the Public Option is an OPTION! While the true Left wing of this USA would really like a single-payer system, it is simply not going to happen with this legislation. Big Insurance is the most powerful lobby in Washington, and certainly has great influence on the bill--in other words, the argument that people will be forced to take the government plan is bullshit. The truth of the matter is that most people will keep their private plans; plans, by the way, made more consumer-friendly due to other reforms that will be in the final legislation (including the preexisting condition issue and the ability to choose your own doctors).
Though this is an expansion of government services, I want to tell you how the Public Plan is actually more economical and sustainable than the current system. You see, being private enterprise, Big Insurance seeks to charge as much as possible while providing as little as possible. I have no problem with capitalism (I am a Capitalist), but this is the reality of the basic operations of a firm. While this is perfectly acceptable in most sectors, health care is an entirely different beast. Since 2000, insurance premiums have nearly doubled! In 2007, the U.S. spent about $2.2 trillion on health care,* which comes out to approximately 16.2% of GDP--nearly twice the amount of the rest of the developed world! ** If you aren't worried yet, then you have read these numbers: by 2025, costs are expected to rise 25%; by 2082, 49% ! *** Oh, and did you realize that every GM vehicle is $1,525 more expensive because of employer-based health care coverage? Insurance is by far GM's biggest expenditure--even more than steel! ****
And the numbers go on and on. This is the financial argument, and it is all tied to the Big Insurance practice of driving up costs for higher profit margins, and making up for their clunky and inefficient administrative costs. Medicare costs are skyrocketing because they are subsidizing these inflating premiums, and this must be replaced. The Public Option must establish a much simpler and transparent system that injects competition into this stale and unsustainable market. It is fiscally sensical and it is moral.
But just any Public Option will not do. Next week I will tackle the question of "what must a Public Option look like in order to drive competition and cut costs?"
Absorb it, discuss it, and hopefully support it. Leave your comments below.
Check out my website: http://www.theskyewire.com
*Office of the Actuary, Centers for Medicare and Medicaid Services, National Health Expenditure Data for 2007. U.S. Department of Health and Human Services, available at: http://www.cms. hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage
**Organisation for Economic Cooperation and Development. OECD Health Data 2008.
***P.R. Orszag, Growth in Health Care Costs: Statement Before the Committee on the Budget, United States Senate, (Washington, DC: Congressional Budget Office, Jan 31 2008), available at http://www.cbo.gov/doc.cfm?index=8948
****R. Wagoner, Testimony before the House Financial Services Committee, December 5, 2008.
http://thinkprogress.org/2008/12/05/gm-health-care-reform/
This is a very impressive post. I'm libertarian in many facets, too (mostly associated with the way we handle and regulate small farmers, and subsidize the overproduction of one crop--guess which...), so it was excellent hearing from someone else who doesn't fit the stereotype.
Your argument is about the most rational I've heard about the public option.
my documentary...
"some folks say that a hippie won't steal,
but I caught three in my corn field"
--John Hartford
First of all, the various issues you mention drug policy, foreign wars etc. are fine ways that government could be trimmed back, but have nothing to do with the basic question of the 'public option.'
Nobody opposes anyone getting the care they need. Which makes that rhetorical question a 'straw man fallacy.'
Ah! so you do know what the 'left wing' which wrote this 'reform' intends to accomplish with this bill, but somehow you are still in denial.
Consider a few aspects of this mammoth bill:
1)No denial of coverage for pre-existing conditions.
2)yearly and lifetime limits on co-pays
3)A list of required coverages including drug treatment and mental health services.
All fine ideas which insurance companies sometimes avoid due to the fact that each one INCREASES the cost of providing coverage. But wait...this bill is supposed to REDUCE the cost of coverage!?!
There is only one part of this bill which seems to be aimed at reducing the cost of coverage. That is the REQUIREMENT that everyone must purchase coverage or be fined when they file their taxes. This, it is suggested in drafts of the senate bill, would also require that failure to file a return be made a felony in order to insure that compliance was universal. Government subsidy would accompany this mandate to buy insurance for those making less than 400% of the poverty level.
Now consider 'the public option' which Obama recently claimed would not be subsidized by the government. Is that entirely honest?
Since the poverty guideline for a family of four is $22,050 every family of that size making less than $88,200 would qualify for some subsidy, an individual making less than $10,830 is below poverty, so if you make less than $43,320 you would also be eligible. So most of America would be subsidized at some as yet undetermined rate, IF they applied for it.
So reform raises the cost of private care, while providing a new 'benefit' and 'public option' while we are all required to buy some form of insurance.
Obviously some of those seeking to qualify for this subsidy will one stop shop and buy into the 'Public Option' (PO) while they are visiting the Office Of Free Insurance Money (or whatever they call it). At the same time employers will be faced with an increase in the cost of private coverage, and an option to not renew their current plan since most of their employees can get Government Subsidized coverage from private or pubic sources.
The public option grows.
Government Employees are almost all given coverage as a part of their benefit package. When times are tight, as they are presently and cyclically, why not drop that coverage or opt for the PO as the provider?
So step by step private health insurance is eliminated or at least marginalized.
Now at a time about 3 to 5 years later more than half of coverage not provided by other Federal programs is under the PO. What would be more obvious and natural than to eliminate redundancy by rolling Medicare, medicaid, VA, WIC and several others into the PO?
Hold it! We have arrived at a 'single payer' which was our stated goal all along.
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Most of the opposition to this plan is from older persons that are on medicare or about to be. These same people have lived many years and never seen ANY government entitlement program removed once enacted. I may be wrong, but from their perspective the $600billion of savings from 'fraud and abuse' that Obama claims to have found in medicare (but for some mysterious reason cannot stop W/o this bill) look like cuts to the coverage they currently enjoy.
"It is only by risking our persons from one hour to another that we live at all. And often enough our faith beforehand in an uncertified result is the only thing that makes the result come true."
- William James
Good response. This entire blog is pure sophistry. There is a LOT to fear in the public option. As you point out, most of the arguments in the blog are pretty deceptive and disingenuous.
From my perspective, the entire healthcare bill is just one giant public option and that will not change even if the so-called public option is dropped. Almost everything about the way it has been marketed to the American people has been sophistry. How are we going to save money by spending a trillion dollars? How are we going to spend less and cover more people? If there is really 3 or 4 hundred billion dollars of annual fraud in Medicare that can be used to cover the cost of this bill, why is Obama not immediately going after these defrauders and recapturing this money for taxpayers? The list of questions goes on and the answers are not even close to satisfactory.
The public option is billed as a way of expanding choices. There are already hundreds of different insurance policies so there is an abundance of choice. One more won't make much of a difference.
In fact, this entire bill is about limiting choices. For example, to participate in the "insurance exchange", companies must all offer basically the same type of coverage. This is like saying to the consumer you can buy a house from any builder you want and then saying to the builders that they must all use the same blue prints and materials. Not much of a choice when all the houses look the same and are built the same. Really you have only one choice which is to buy the government approved house. It stinks of fascism where the resources of the private sector are co-opted to meet the will of the State.
To participate on the exchange, companies can't put limits on pre-existing conditions. But I am healthy with no health problems so I WANT to buy a policy that has limits on pre-exiting conditions because it meets my needs and is cheaper. How have my choices been expanded? I can understand how other people might want a policy that does not place limits on pre-existing conditions but clearly such coverage is more expensive. If people want more expensive coverage is it not fair that they pay more for these options? Why deny me my choice of the economy model?
To participate on the exchange, companies must cover certain conditions. Those of us who would like less coverage at a lower price don't get a choice. I personally would happily choose a policy that allowed me to choose my coverages on an ala carte basis if I got a discount for each disease for which I chose not to be covered (the shot of morphine and a clean comfortable bed in a hospice option). I would happily take a gamble and decline coverage for most very rare diseases and all cancers which required miserable therapies and had cure rates below 25%. I'm currently watching my brother go through radiation and chemo therapy and I want nothing to do with it unless there is a very good chance that it will cure me. It's not worth the suffering it if you are likely going to die anyway. I'd rather have the insurance discount which Obama wants to deny me. How is that an expansion of my choices?
And as you noted, the public option is designed so that over time it will become the ONLY option. How is that an expansion of choice?
There are actually good ways that actually would expand competition and choice for consumers but they are NOT IN THE BILL. One of the most obvious is to allow consumers to shop for insurance across State lines. Another would be to make insurance premiums tax deductible so that individuals could buy insurance on a level playing field with employers. This would greatly expand choice and have many other benefits because employees would actually have choices about insurance rather than being stuck with whatever plan their employer happened to offer. But it is NOT IN THE BILL.