The great debate about healthcare in America invokes some of the deepest passions from people across the ideological spectrum. On the one hand, there are people who are content to treat any commentary that does not assert that the US has the most advanced, successful, ideal healthcare in the world, as a kind of treason, and on the other, you have people who are all too aware of how much suffering is induced by the failure of the current insurance system to provide care to everyone who needs it.
There might be a few ideologues who actually want the government to run healthcare, but they are not part of the debate in Washington. No one in the healthcare reform debate is arguing for “socialized medicine”, where government bureaucrats would have the power to select among treatments or deny care. In fact, the entire purpose of the reform is to bar private insurers from doing just that.
Every year, between 22,000 and 200,000 people die due to lack of coverage, or mistakes and delays in treatment related to confusion over what is or is not permitted or covered by a given insurance plan. Hundreds of millions of dollars are spent by insurers to find ways to avoid providing coverage for paying customers.
The so-called public option that is currently under consideration would be nothing more than a not-for-profit insurance plan aimed at competing with private insurers… to “keep ‘em honest”, as the president has said. Every time a politician, or a political pundit or lobbyist begins talking about socialized medicine, and the wait-times, and undertreatment associated with that system, in the UK, for instance, they are talking about something entirely unrelated to healthcare reform in the US.
It cannot be said firmly enough: there is no plan of any kind whatsoever under consideration that would include socialized medicine. There is not even a single-payer option being considered. The Obama plan is specifically oriented toward capitalizing on the efficiencies of the marketplace, while protecting consumers against discriminatory and unfair practices or denial of treatment.
The goal is to make sure that no one goes without coverage, that doctors decide best care, that best care is available and is provided, and that costs come down for everyone. The only group that might be negatively impacted in the short term are the insurers, but the stabilized, more affordable system would benefit them in the long term, as efficiencies generated by the reforms would reduce preventable deaths and medical error, increase quality of care, and expand the pool of insurees by somewhere between 47 million and 60 million individuals.
While some of the most advanced care is available in the US, anyone who suggests reform is not necessary is apparently unwilling to recognize the value of the lives of those people who die as a result of the system’s flaws. And that is precisely why a public option is being contemplated, because people of the mindset that would argue that all of those deaths are not a problem (or that the fear and hardship people live with who can’t get medical treatment are not a problem) would not make the adjustments without one.
So the public option is about competition. Ironically, the argument that it would “undermine the free market” can only be made by people who don’t believe in and don’t want a free market. There is no reason why a not-for-profit insurance plan should not compete with the vast array of for-profit plans, in a free market. What those who argue against the public option are saying is: they want a market rigged in favor of those who put profit before people, and they don’t want to have to compete to make quality care more affordable.
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Comments
At bottom, insurance is the craziest gamble to "invest" in, because the majority of stakeholders have a right to take out far more money than they will ever put in. Any and all profits taken at any point are taken with full knowledge that this only diminishes the existing fund of cash (always insufficient) to cover all the payable policies.
Insurance as a way of funding paid services (i.e. healthcare) only works if the pool is UNIVERSAL. Otherwise, the entire logic of the system is undermined, and the private firms who have promised to pay for insurees medical bills have an incentive to hoard the money that rightfully belongs to those people once they become sick.
We are dealing with a perverse system where the reason for being of the insurance industry, to provide payment for services needed due to illness or infirmity, is turned on its head, and insurers claim the legal right to withhold payment and/or invest heavily in ways to block insurees' access to the funds they have a right to access.
That's not to say I don't think this plan is a major step in the right direction for the US. But it doesn't resolve the many inefficiences that make a single payer plan, among other things, cheaper.