So what do critics on the left have to say about the public plan?
During this national conference call organized by MoveOn.org, Governor Howard Dean was asked whether or not he supports H.R. 676, the United States National Health Care Act (known amongst supporters as the single-payer bill).
His response was quite interesting, and perhaps illustrates where he hopes the public plan option will eventually lead.
He said that the public plan would essentially be a single-payer healthcare option, as the government would provide low-cost insurance much in the same way that it does for Medicare recipients.
Dean may hope that the public insurance plan will prove quite popular, thus allowing for its incremental expansion to an all-encompassing single-payer program later on.
Still, single-payer advocates are not convinced.
They believe that private insurers should not be included in the insurance exchange; they (correctly) believe that these providers squander precious dollars on unnecessary overhead.
Single-payer proponents would rather see private insurers cut from the picture entirely.
They are particularly opposed to coverage mandates and subsidies that facilitate, encourage and require the purchase of private insurance.
- As we showed in this letter, many of the concerns about private insurers, and their inability to control costs, are valid.
Take the situation in Massachusetts for example: Despite the fact that Massachusetts now mandates that all residents purchase “regulated” coverage through its insurance “Connector,” private insurance premiums continue to rise. This has led to an enormous financial strain for the state government, small businesses and individuals.
Supporters of the public plan would probably say that Massachusetts is missing one vital component needed for true cost control: a public plan option. Once such insurance is available, they claim, private insurers will be forced to reform. Whether that’s the case remains to be seen.
There is evidence that the public plan would be more effective than private insurance in controlling insurance costs over the long-term.
- Private plans’ spending per enrollee has grown much faster than Medicare spending per enrollee over the last few decades.
- Medicare’s growth rate per enrollee was 4.6% between 1997 and 2006, compared with 7.3% per enrollee in private health insurance.
We fully welcome the criticisms of single-payer advocates, and have been disheartened to see that they have been kept out of the decision-making process at the federal level.
That said, we believe that solving our healthcare crisis will ultimately require some trial-and-error, and that covering more folks today is better than waiting for an ideal solution to be passed later down the road.
What’s the likelihood that the public insurance option is included in a reform package this year?
President Obama and Dr. Dean have stressed their commitment to this option, and are already mobilizing folks to increase support.
At the same time, we can be certain that private insurers will wage an intense, drawn-out battle to keep the plan from going through.
The influence of this group is certainly not to be underestimated: many people remember the critical role that the “Harry and Louise” ads played in killing the Clintons’ healthcare plan in the early 1990’s.
There are those who argue that this is a new day, and that the American people are ready for substantial reforms.
But public opinion on this insurance option is not yet made up, mostly because the public lacks details about how the program would actually work, and about how much it would cost.
President Obama has called for a down payment of $634 billion for healthcare reform in his budget, which is only expected to be 1/3 to 1/2 of the total amount needed.
It is still unclear where this money will come from and what it will be used to pay for.
Private insurers will no doubt spread negative information about the public plan, and other reform initiatives, over the air waves in the coming months.
And some Democrats may be backing down as well, due to political pressure from all sides.
Senator Max Baucus (D-MT) recently commented that he was setting aside the public plan for awhile, although the option still remains on the table.
He has received large contributions from private insurers over the years and he is also facing pressure from conservative Democrats to focus more specifically on initiatives that will rein in long-term costs. (The irony is, of course, that several experts believe that the public insurance option would help to tackle the cost issue over time.)
We’ll keep you in the loop on the public plan, and we’d love to hear your thoughts.