Howard Dean:Why The Public Health Insurance Option Is Worth Fighting For

[cal04]

http://thinkprogress.org/2009/08/19/dean-public-option-pearlstein/#comments
by Guest Blogger

Our guest blogger is Gov. Howard Dean, former chairman of the DNC and the author of Howard Dean’s Prescription For Real Health Care Reform.

In today’s Washington Post, Steven Pearlstein argues that Democrats should just give up on the public option. “Enough already with the public option!,” he writes. Pearlstein thinks we should drop one of the most popular and effective aspects of health care reform simply because the fight is too politically difficult in Congress. I think such an approach would ruin health care reform and devastate the Democratic party.

Pearlstein is confusing health insurance reform with health care reform. If we only get reform that requires insurance companies to provide coverage to everyone who applies, charge everyone the same premiums, and end their discriminatory practices, that would be great insurance reform, but it’s not, as Pearlstein writes, health care reform.

Real health care reform that includes a new public health insurance option would give Americans a real choice and not reward for-profit health insurers with 47 milllion new customers. Real health care reform that includes a new public health insurance option would cut out the administrative waste of private insurers and begin changing the way health care is delivered. Real health care reform that includes a new public health insurance option could adopt the kind of payment reforms that would start to “hold down long-term growth in health spending” and encourage providers to deliver care more efficiently. We know that premiums in the public option would be about 10 percent lower and that a real robust plan that piggy backs off of Medicare’s infrastructure could save us somewhere between $75 billion and $150 billion over 10 years.

Just because the public health insurance option is “new,” moreover, does not mean it’s not worth fighting for. Pearlstein points out that I did not propose a robust public option in 2004 election. The measure of good politics and policy is the ability to accept and identify new ideas. My 2004 plan may not have included a new stand-alone program, but it did allow Americans over 55 to enroll in Medicare and everyone under 25 would have been eligible for Medicaid.

I believed that government could help expand coverage and control costs then, and the overwhelming majority of Americans believe it today. If the August recess has taught us one thing, it’s that Republicans have ended all serious conversations about reform and will oppose reform whether it includes a public option or not. They want to make the choice for the American people instead of letting Americans have their own choice of coverage. And if Democrats follow their lead, they will have to face the voters’ choice come November.

[Mr Generic Other]

1. thank you for the post cal04.

dr. dean brings up many good points and is our best advocate for health insurance reform to date yet even his defense could be stronger. here he mentions that a public option would save perhaps 10% on administrative costs. fine, but most examples of single payer systems save closer to 30% over our for profit model. this should be pointed out as we continually push for the plan that provides the most for the least cost. these savings can be passed on to consumers, 10% or up to 30%. in the private sector any savings are considered profit and get divided up among the administrators.
dr. dean and others engaged in this debate also need to point out that even those who are employed their whole adult lives lose coverage if they ever change jobs for periods between 6 months and a year. this has proved to be a flaw with the employer provided insurance model. no one deserves to be penalized for changing jobs or be tied to a job they would prefer to leave just to keep health coverage.
it is also true in america today that more than half of personal bankruptcies are the result of medical costs. and to highlight this situation we need reminding that almost half of those bankruptcies were filed by working people with health coverage.
if this economic concern is not enough then defenders of universal health coverage need to talk about the effect that universal coverage would have on those in our society who are marginalized or among the dispossessed. all of these people would feel better about themselves and do better in life if the community (universal health coverage) valued each individual equally in regards to health care coverage. we could demonstrate our commitment to inclusiveness and equality.
small business owners and those who would like to start a business would benefit from the single payer model too. currently they pay higher costs for medical insurance than corporations who have larger pools of buyers and can bargain for better prices.
there are many other positive things that might result from solving the problems associated with for profit health care insurance. that is if we do this right.
i fear that a "public option" will be constrained by the continued efforts of the insurance industry and their supporters to weaken it until it appears to be a failure to everyone.
the "public option" was and is a compromise made in good faith so that opponents would work, with that same good faith, toward solving perhaps the biggest domestic issue facing americans.
since the right wing has not bargained in good faith i believe the offer of public option should be withdrawn and the democrats should do the right thing and enact a single payer model.
if we begin to see information about other aspects of our economy that impact our ability to provide basic health coverage for all citizens, such as the insane amount of money spent on the military each year, even those who are presently opposed to government insurance for health coverage will begin to see that making some changes in our system can benefit all americans.
after all some of the concerns that the rabble shouting town hall meetings are based in real life experiences. they, and we pay too many taxes that aren't used to make our lives better. no one wants to pay more when their experience is that they always get less. right wingers believe that the status quo exists by divine decree not by policies set in place by our government.
it is well within our grasp to make positive changes in america that would benefit all of us.
democrats are at a disadvantage here because they believe in the process and including all voices. republicans on the other hand tell us what's good for us and expect us to accept it. since it is not in the nature of democrats to be so autocratic they must be sure to educate us all so we recognize that all of us regular citizens have common concerns and that elites will stop at nothing to divide us.