Overselling the Public Option, Continued
On WPRO radio’s (630 AM) John DePetro show this morning, Senators Jack Reed and Senator Sheldon Whitehouse advanced their position that “the public option” portion of healthcare reform, i.e. a government owned and operated insurance company, would be simply one additional insurance company added to the market, on equal footing with the already existing players.
However, in their answers to a Tim White question on Sunday’s WPRI-TV‘s (CBS 12) Newsmakers program on whether the public option is essential to the Democratic plans for healthcare reform, both Senators seemed to suggest that a public option was not just another choice, but an entity that could achieve goals that private insurers couldn’t…
Senator Jack Reed: What we’d like to do is have [the public option] there in place to provide the kind of integrated care, the kind of we hope sophisticated care that raises quality and lowers costsAren’t there are obvious problems with simultaneously claiming that the public option will be just like the other insurers, yet will also have impacts beyond those of “regular” insurance companies, having significant effects on the practice of medicine?
Senator Sheldon Whitehouse: I think that the success of healthcare reform over time, particularly in terms of improving the quality of care, driving down costs, getting rid of some of the unnecessary waste and conflict and duplication in the healthcare system will be driven by these different public options in 50 different states, finding ways to improve the way that they deliver care…
The idea of the public option being a new source of medical innovation doesn’t make immediate sense — and you don’t have to assume noble motives on the part of private insurers to see this. If the public option is truly just another insurance company, except for being owned and operated by the government, then the assumption that it will open the doors to cost-lowering quality-improving innovation is based on the idea that it will do things that private insurers could do, but won’t. Er, because private insurers have no interest in lowering costs? If there are ways for private insurers to significantly lower medical costs in the existing employment-based system, why wouldn’t private insurers already be doing them (if only to increase their profits, by not passing all or any of the savings along to their customers)?
The contradiction illustrates how much of the argument for “a public option”, right now, seems to be based more than anything else on the idea that the problems in American healthcare can be solved by an insurance company that tells doctors and nurses how to be better doctors and nurses — as long as the insurance company is run by the right people, of course. If the public is to believe that that desire for “a public option” is not driven by unrealistic expectations that government involvement can fix anything, and that it is not a stalking horse for much more intrusive government involvement into medical decision making, advocates for a “public option” need to start resolving their contradictory claims about its structure and the presumed impact it will have on healthcare practice beyond just the dynamics of the insurance market.