(Blog Post) Without a public option, the other parties that comprise America's non-system of health care -- private insurers, doctors, hospitals, drug companies, and medical suppliers -- have little or no incentive to supply high-quality care at a lower cost than they do now. Full Story »
Posted by Kaizar Campwala
I like and respect Robert Reich's opinions, but this article makes one argument repeatedly that is subject to question. He insists that the public plan option will put pressure on the other plans to clean up their acts and improve their efficiencies. He also notes that the public "Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs", and this after many decades of its existence. Where, then, is the pressure on the private insurances to match the Medicare efficiency? This is the weakest part of the argument he makes for the public plan option. He ignores entirely the question of whether insurance, public or private, is an effective method of delivering health care services to the population. In this, Mr. Reich joins with the rest of the industry, Congress and White House in dismissing the option that truly strikes fear in the hearts of the insurance and pharmaceutical industry: a universal coverage single payer plan.
The insurance model is actually at odds with the general delivery of health care. The theory of insurance posits relatively rare payable events among a large population. When only catastrophic care is covered, this theory fits and the insurance model works. When all of health care is covered, however, the payable events are not only not rare, they are experienced by EVERY member of the population, so the theory no longer fits and the model fails. The insurance industry response is to seek to inhibit utilization of services so as to restore the payable conditions to rare status and restore the model, but this is NOT the health care anyone wants. There is no application of health insurance, public or private, that is going to resolve this problem. The only solution is to eliminate insurance as the model, and establish some form of universal coverage single payer system.