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Casting the feature as a bug

The AMA is opposed to a public option in the health care bill. (It has since tried to soften its opposition, but only rhetorically). The AMA agrees with some Republicans, if there is a public option, people might prefer it:

But in comments submitted to the Senate Finance Committee, the American Medical Association said: “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”

If private insurers are pushed out of the market, the group said, “the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.”

One of the arguments I’ve never understood against public health plans is the one contained in the second quoted paragraph. The last time I checked the taxpayers were already absorbing exploding health costs. They were and are doing it in their capacity as consumers of health care. Insurance companies act as de facto taxing entities, with the disadvantage that consumers don’t get to vote for their overlords, and corporations demand exorbitant profits, something governments don’t do. Nor do governments tend to spend more than 20% of their budget figuring out ways to deny benefits. Added to the direct premiums we all pay are the indirect premiums they pay through their employer and the costs of expensive ER they absorb in one way or another because the uninsured do, in fact, have half assed but costly health care under the current system.

Most people (excluding doctrinaire right wingers) don’t really care where their health care dollars go. What they want is to get good health care for the least amount of money. If a government plan can get them there, then that’s what they want. At this point, most people have concluded that a government plan is the most likely route to that end. Judging by the experience everywhere else in the civilized world, they are, no doubt, correct.

By the way, for all those that would argue that Medicare is in financial trouble, recall that it is an insurance program for that slice of the population that requires the most health care. It’s costs are still rising more slowly that those of private health insurers. Medicare for all would no doubt require more money, but it would be more efficient than the system we have today, and overall it would be cheaper.

It is to be hoped that the public option passes, and that the dire predictions of the AMA and the Republicans are realized: that it drives the inefficient, deny-at-all-costs private companies out of the business. Then we can have decent health care at reasonable cost for everyone. In the final analysis, there are certain goods and services that are so vital that no private company can be given the right to control their distribution. Everyone is comfortable with the concept of public water companies, for instance. Here in Groton we have a public utility, that delivers electricity, cable and internet cheaper than its private competitors. A good argument can be made that in this day and age, all three of those commodities are so vital that government should be at least a player, to keep the corporations close to honest. We have seen the result of leaving health care to the corporations. We spend huge amounts of money for a horrible health care system, though we are constantly propagandized with the baseless claim that we have the best health care in the world.


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