In the health care reform debate, much of the opposition seems to be forming around the so-called “public option”, the idea that people should have the choice of a public or private insurance plan. It was precisely this aspect that made Hillary Clinton’s plan superior during the election period. The New York Times spells out the problem:
“But critics argue that with low administrative costs and no need to produce profits, a public plan will start with an unfair pricing advantage. They say that if a public plan is allowed to pay doctors and hospitals at levels comparable to Medicare’s, which are substantially below commercial insurance rates, it could set premiums so low it would quickly consume the market.”
But isn’t that exactly the point? Indeed, it is precisely why single-payer systems work so well– they cut out the middle-man, and take out the profit motive from health care. Combining a universal mandate with community rating means that insurance premiums become affordable and everybody gets covered. And no, there need not be long waiting lists and you get to choose your own doctor (it seems to be far easier to get same-day doctor’s appointments in single-payer countries, and they often even do house visits!). Right now, the insurance companies spend $50 billion a year trying to deny coverage. This is not an ideological point. If the private insurance companies started offering decent affordable coverage, and stopped excluding people, then fine. Until then, give people the power to choose.
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