Oct. 8, 2009 -- So vast is the majority in favor of a public option that even 70% of Republicans favor it. So, in order to turn us against it, the health insurance industry has to make us believe that it is something that it is not. Anyone who tries to tell us that support for a public health insurance option in the United States is weak or non-existent is either lying or seriously misinformed. As for Republican House Minority Leader John Boehner saying “I’m still trying to find the first American to talk to who is in favor of the public option”, what planet does he live on?
It is true that some opinion polls on the public option show support to be as low as about 55%. But that’s only because of the confusion that the insurance companies and its bought-and-paid-for politicians have sown about it. As a result of that confusion, a recent (August 27, 2009) poll by Nate Silver showed that 23% of American admitted they didn’t know what the “public option” is, 13% believe it is a network of health care cooperatives, 26% believed it to be “a national health care system like they have in Great Britain”, and only 37% correctly answer that it is “a government created health insurance company that competes with existing private insurers”.
Overwhelming support for public option when it is described in clear language
When asked a straight-forward question about the public option in a way that describes what it actually is, Americans routinely demonstrate overwhelming support for it. Here is a question that measures actual support for the public option because it asks about what people actually want, without giving it a label:
In any health care 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 – extremely important, quite important, not that important, or not at all important?
When asked that question in an August 2009 poll, 77% of Americans answered that it is either “extremely important” (58%) or “quite important” (19%). Here is the breakdown by demographic group, of the percent of respondents who say that a “choice of both a public plan administered by the federal government and a private plan…” is either extremely or quite important:
Party affiliation Democratic: 86% Independent: 71% Republican: 71% (!!!!!!!!)
So there you go. Even Republicans favor the public option when given an accurate definition of it. Undoubtedly, if Republicans were told before answering the question that President Obama favors the public option their support for it would plunge dramatically.
Requirements of a reasonable public option
It should be evident to most Americans by now why our country needs a public option: Private insurance companies, in their quest for profits, have failed to meet the health needs of the American people. It’s that simple. 47 million Americans are uninsured today. Just as bad, many of the 250 some million Americans who do have health insurance do not have the health insurance they need – as exemplified by research showing that health insurance companies operating in California alone denied more than 45 million health insurance claims (22% of all claims) over a 7 year period. Consequently, nearly one million Americans go bankrupt every year as a result of medical bills – and that number is on the increase.
Because government sponsored health insurance will be unhampered by the need for profits that characterize the private health insurance industry, it will be able to offer a much superior product. But the fact that it is able to do so does not mean that it will do so. It could very well turn out that our Congress, in an attempt to appease their constituents by passing legislation that contains a “public option” will offer a public option of little value. In this way they may be able to appease the insurance industry by offering a product so poor that few people will choose it over private insurance, while simultaneously appeasing their constituents by saying that they passed a “public option”. So, this is a tricky issue, and one that we need to watch out for. We need to consider the criteria for a public option that will meet our needs. Here are some of the most important:
Universality For obvious reasons, a “public option” should be an option for all Americans. In that regard, I was disappointed in President Obama’s September 9, 2009 speech to Congress, in which he proposed a “public option”, but one which “would only be an option for those who don’t have it” and for which “we believe that less than 5% of Americans would sign up.”
As I discussed above, it is not only Americans who currently totally lack health insurance who are in need of a decent insurance plan. Most of us who do have private health insurance are also in need of a decent insurance plan. If our government subsidizes the purchase of health insurance, and yet ends up providing a government plan to only 5% of the American people, such a system will turn out to be a massive gift to the private insurance industry at taxpayer expense.
Cost A major reason why so many millions of Americans lack health insurance is that it is too expensive for them. Many tens of millions of Americans are barely scraping by today from paycheck to paycheck. Having to pay additional money for health insurance would tip many of these people into financial ruin. For these people, government subsidies should cover the entire cost of whatever public option is available. For the rest of us, sufficient subsidies should be provided that, at a minimum, we are no more burdened in paying for health insurance than we are under the current system.
Health care is a necessity of life. Most people who lack health insurance do so because they cannot afford it, not out of choice. Meaningful health care reform means that health insurance will be affordable for all Americans.
Quality It is not easy to precisely specify a minimum acceptable quality for a health insurance plan. At a minimum, there should be no discrimination based on pre-existing conditions, and all reasonable health care needs should be met. It is of course difficult to say exactly what “reasonable” health care needs are. Since our society does not have unlimited resources, there must necessarily be some limit on the amount of health care that can be provided by government. Perhaps the health care needs that are met by Medicare would be a good starting point for comparison.
The politics of health care reform
We must keep in mind that the driving force behind opposition to meaningful health care reform – which must include on option to obtain health insurance from the government instead of through a private plan – is the health insurance industry. If our government offers us a superior and less expensive health insurance plan than we now obtain through private insurance, that would cut greatly into the business and profits of the health insurance industry.
So the outcome of the quest for meaningful health care reform in the United States boils down to whether or not the health insurance industry can convince Congress to either say no to all proposed plans or pass legislation that lacks a public option or one that contains a public option that is virtually worthless. Since Congresspersons are dependent upon their constituents to vote for them to continue in office, that means that the health insurance industry – and their lackeys in Congress – have to convince the American people that the provision of a government sponsored health insurance option is a bad thing.
But how can they do that when the vast majority of the American people favor a public option? So vast is that majority in favor of a public option that it is likely that not a single Congressional district in the United States opposes it. As noted above, polls show that even the good majority of Republicans favor it.
So, in order to turn us against it, the health insurance industry has to make us believe that it is something that it is not. They talk of death panels. They tell us that the option to choose government sponsored health insurance over the for-profit insurance that they offer us would not be an option at all, but a mandate. They tell us that we will have to give up our choice of doctor if some people – anyone at all – have the option of purchasing government sponsored instead of private health insurance. And that is why their bought-and-paid-for politicians, like John Boehner, make lying fools out of themselves by saying things like “The public option is as unpopular as a garlic milkshake” or that they’ve never met single person who was in favor of it.
We have to make sure that Congress understands that we understand this game and that we will not be happy about any Congressperson who votes against or otherwise obstructs the passage of health care legislation that contains a good strong public health insurance option.
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