@christine215 I’ve just read the sources you cite and I don’t find any support for your two basic arguments which, so far have been 1) the government can’t do anything well, and 2) a public option is going to result in loss of personal freedom (I am paraphrasing here). They make a number of different arguments, which I boil down as follows:
1. A public option poses unfair competition.
2. People will be forced to make choices against their will.
3. Its really all just a sneaky plan to impose socialism on Americans.
_ a. Anyone who says different is a two-faced socialist liar.
_ b. You are going to lose your current insurance
4. Its going to result in lower levels of service and/or rationed care.
5. Employers are going to “dump” their insurance on the public sector.
6. Wages and hiring are going to stagnate as businesses lay off employees.
7. Costs and taxes will rise.
At the end of his summary the anonymous blogger says, “There is no good faith negotiating [with anyone who advocates a public option]. This plan must be defeated, and those who push it kicked out of office and run out of D.C.”
Unfair competition The government has several inherent cost advantages: it has economies of scale; it has transparency and accountability which keeps waste, fraud and abuse to a minimum; it doesn’t have to divert a large percentage of the health care dollar in order to turn a profit to meet shareholder’s high expectations; it doesn’t have to pay its CEOs $200+ billion per year, or maintain fancy corporate jets and other lavish corporate perks. Because of its purchasing power, the public plan can negotiate the best possible with every vendor in the system—like Medicare used to do before the Republicans put a stop to it. It doesn’t have to pay taxes, and it is in a better position to control malpractice claims. It can therefore offer any given level of service for a lower cost than the for-profit system.
The only thing unfair about any of this is that the American people don’t have the opportunity to choose this lower cost option. It is only “unfair” from the point of view of corporations who consider that their right to make a profit off of sick people outweighs the right of Americans to get the most cost effective health care.
Forced choice This argument is ludicrous: If your insurance company jacks up your premium and you can’t afford to pay it, you are “forced” into the lower cost public plan. “If your provider drops you or goes out of business, or if your employer drops their coverage, you’ll lose that insurance.” (Duh.) To keep people from rushing to the public plan and overwhelming it (as happened in Hawaii), there is a stipulation in the plan that people who have insurance now keep it for the next five years. They argue that this will prevent companies from shopping around for the best deal. If your company tries to shift you into a plan that has a lower premium and a higher deductible, or fewer covered services, there will be none of that. “You have to keep your current insurance, or you’re under the new plan, with new mandates.” That assumes that the new mandates will be onerous and oppressive, but in fact those mandates will define minimum levels of coverage so all your bases are covered, and they will restrict the new plan’s ability to deny coverage for things like pre-existing conditions.
California State and Local employees have a cafeteria style plan where the plan must meet certain decent standards of coverage, and the plans compete on the basis of price and options. For example, if you would rather pay a higher co-pay or deductible, in exchange for being able to go to any doctor you want to, you may do so. If you would rather have less out-of-pocket expenses and are willing to see a more restricted panel of doctors (as you would if you belonged, say, to Kaiser or an HMO) then you can go that way too. I have it, and it works just fine and everybody is very glad to have it.
To argue that people are “forced” by because they are presented with no-brainer choices between high-cost, undependable coverage and low-cost, dependable coverage. Is sheer Orwellian double-speak. Choice has suddenly been redefined as “coercion.” (Typical Rovian spinmeister fare.)
Sneaky road to socialism It is true that nobody is calling the plan “socialism” even though it technically is. All “socialism” means is government-funded, meaning that the costs are “socialized,” or spread across the whole society (which happens to create the broadest possible risk pool). This isn’t sneaky or deceptive, it is simply a matter of letting the program speak for itself, rather than hanging a label with a lot of baggage on it.
The fact is, the American public loves it’s socialized programs. Public education is a socialized program, meaning that it is government-organized and tax funded. So is Social Security, Medicare, the Post Office, PBS, the Public Health Service, the IRS, the FBI, the police, the military, homeland security, immigration, FDIC, the FDA, the EPA, OTIA, unemployment insurance, Food Stamps, AFDC, Student Loans, the GI Bill, Veteran’s Administration, the Justice Department, the courts, the prisons, the National Institutes of Health, NASA, DARPA, Family Planning Clinics, EEOC, HUD, Fanny Mae, Freddy Mac, Food and Drug Administration, etc., etc., etc. It is the Republicans who are being disingenuous when they persist in confusing socialism with Communism or totalitarianism or, just lately, Nazism. This again is more Orwellian double-speak.
The real liars in this debate are the corporate shills that are hiding behind grass-roots-looking websites that are getting people all upset by telling ABSOLUTE LIES, like the plan is going to have “death panels” who are going to kill old people; that there is going to be a government “takeover” of health care, and the “birther” nonsense that Obama “really” isn’t President (and therefore nothing he does is legitimate). The real deception here is the attempt to deny Americans freedom to choose between these two types of systems.
Its going to result in lower levels of coverage and/or rationed health care First, we already have health care rationing now: 47 million people don’t get any care. A large fraction of these are non-white, who are poor and disenfranchised due to centuries of Jim Crow, discrimination and economic disinvestment. Somehow this seems perfectly acceptable when the burden is born mainly by blacks, Hispanics and poor white women—hence, the implicit racism in opposing universal health care.
Any system is going to have limits. If France can spend $3,000 per person and achieve the best level of health care in the world, we should certainly be able to have an acceptable level of care with the $6,000 we already pay. The commentators cite Hawaii and Massachusetts as counter examples. In the former case, there was a big rush to the public system, shifting the 80% of the children who had private insurance over to the public side of the ledger, creating a sudden shift in costs that the state couldn’t immediately cover. The reason they couldn’t cover it was that in 2008, the economy was in a free-fall and, and it simply wasn’t feasible to raise taxes during such a downturn. In Massachusetts, another tiny state, there was a similar fiscal crunch, so they cut back dental services, and services to immigrants. The benefits will no doubt be restored when the economy improves.
It is much less likely that the entire United States be subject to a crunch of this sort, but if it does, what is fairer having everybody tighten their belt a little bit, or throw the poorest among us overboard? If you said the latter, you are a racist. The fact is that once you’ve got everyone in the same system, there are lots of things you can do to rationalize the system that aren’t being done now. Some years down the road there will very likely be very expensive services that we won’t be able to easily provide to everyone, but that is fundamentally a question of how willing we are to be taxed. If the French can do so much more than us with so much less, then certainly we can do a whole lot better. You get the health care system you are willing to pay for in any case, only in the present case you get a whole lot less because what you pay for goes to corporate “overhead.”
Employers are going to “dump” their insurance on the private sector So what? You are paying for it either way. Letting people vote with their feet in no way constitutes a government “takeover.”
Wages and jobs are going to stagnate. This is the same old argument that gets trotted out every time they propose raising the minimum wage. “Small businesses are not going to be able to afford to hire people, so there will be massive unemployment.” It never materializes. In fact, there is always a boom after a raise in the minimum wage because people have more cash to spend, and it stimulates the economy. Shifting over to a more cost-effective system will, in effect, put more cash in people’s pockets which will more than offset the squeeze on business.
Costs and taxes will rise There is simply no evidence that costs will rise. The experience of every other country with universal health care bares this out.
Taxes might rise for some, depending on who actually gets stuck with them after cost shifting; but your premium payments, which are a kind of privatized tax, will fall when you move over to the public system. If it costs 19% less to administer a public system, those savings will be realized either in the form of expanded coverage, or rebated back to the consumer. The real benefits, however, will accrue in the future, when doctors can start practicing preventative medicine again instead of practicing risk-averse defensive medicine in order to avoid malpractice suits. With everybody in the same system, it will be very inexpensive to do do things like put people’s medical records on smart cards they can carry with them or organize clinical trials that are cost-prohibitive under the kludgy medical information systems we have now. It will also become possible to link medical records with genetic information, opening up new frontiers of gene-based treatments that are difficult to research now.
If you want to keep your bloated crappy private health insurance, go ahead and do so; but don’t tell me I can’t have a public option if I want one. As a matter of fact, I do have Medicare and I like it just fine. I’m pretty sure you will too if we can make it available to everyone.
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