Most people don't have the time to investigate every line of the health insurance reform bills currently in the Congress. But health insurers do. In fact, insurers have been getting major 'face time' with both houses of Congress and with President Obama ever since this entire issue began in May of 2009. At $1.4 million per day in lobbying fees, insurers have paid for at least 3 months worth of premiums for those currently uninsured. In that same timeframe, they've denied care in some form to as many as 15 million people that would have been delivered with reform. Talk about working it with a fine-toothed comb!
This is the same fine-toothed comb insurers take to the individual policy or agreement when it is time to look for a way to deny care. There's the cap (annual or lifetime), the exclusion, the denial, the deductible, the copay, the agreement omission, the preexisting condition, the arbitrary cancellation--all features of underwriting (means writing a check UNDER the amount requested) not very common before 1994, when insurers promised to cut costs and improve quality on their own if the Clinton Health Care initiative were canceled.
Without a Public Option, those combs will be repeatedly raking through the hair of the new bill before and after it becomes law, dividing parts on our collective scalp as never before seen. They'll be slicing and dicing us into new types of pools, figuring out all types of loopholes, creating every kind of strange ponytail and wild braid along with myriad new ways to cost us money and ruin our lives, destroying our businesses and the fabric of our communities in the process.
The only thing that protects the president (and us) from health insurers is the Public Option.
Mr. Obama has worked hard to put his mantra for health insurance reform into our heads: Affordability. Guaranteed Choice. Ensured Health Care for All. I'm sure many of his policy wonks are chafing at the bit, ready to move on to the next item on his legislative agenda; health care, now health insurance, has overstayed its welcome beyond the original July 31 deadline. Presidential politics is like that; solve the problem, move on. But the only way that the problem gets solved with health care and health insurance is if there is, at minimum, a strong Public Option.
Private, for-profit health insurance only works by finding ways to divide its customers into groups (called 'pools') that pit the sick against the well, the young against the old, the rich against the poor, and charge each group as much as possible for premiums while denying care at every possible opportunity. This business model destroys productivity (doctors on the phone trying to get approvals, patients fighting for referrals, employers and individuals scrambling for lower cost policies). The only way out of this byzantine morass is with a Public Option.
It would take a huge (read: expensive) phalanx of regulators to keep the collective death machine that US health insurers have become in check. Creating any such oversight agency would not only be counterproductive, but the group would be at a severe disadvantage against the well-oiled analytical machine that health insurers have become, and the line of defense could easily be eviscerated by a future president, much as the SEC and banking regulators were left unmanned during W's administration. Regulation is a fait accompli with a strong Public Option.
What does it take to reduce or eliminate unbridled profit-enhancing 'pool' practices? Public Option.
How does the bill stop insurers from identifying specific patients to employers during rate increases? Public Option.
Why has the lobbying been so intense, with legislators owned by the insurers fence-sitting? Public Option.
First, it was Single Payer. This optimal solution, the one that would have enabled the United States to reenter world markets as a powerhouse manufacturer, a workforce to be reckoned with, was shot down before anyone really even knew what it was or how it could work. Single Payer would have divorced health insurance from employment, encouraging new investment in US business development. Single Payer would have sucked 90% of the waste out of the insurance and pharmaceutical markets, providing money for salary raises, new hiring, and upward mobility for those now stuck on Medicaid (they can't leave public insurance to take a job; there's no solution for them to pull themselves up by their bootstraps.) Single payer would prevent the HIZs (health insurance zombies) between age 48 and 64 who can't get insured at any price. We were left with the Public Option.
The Public Option, while not taking the employer out of the health insurance equation altogether, at least created a level playing field. It provides the only real competition for the insurer and an opportunity to maintain the privacy guaranteed by HIPAA but completely undermined by collusion between health insurers and employers. Yes, if you or your family develop a major illness, your insurer will make no bones about informing your employer through swift rate increases. They might even 'help' the employer identify the offending party so that 'somehow' the rates can be made to come back down if the person is 'no longer employed.' Government insurance doesn't use 'pools' to divide people into insurability groups. Rates wouldn't sharply rise sharply to dizzying heights without pooling. There was hope that personal privacy would be honored and worries about becoming an insurance burden would cease--but only with the Public Option.
The Public Option provided a case (albeit a weaker one than Single Payer) for reviving US employment levels to postwar levels. Small businesses, entrepreneurs, people suffering from disabling or debilitating conditions (but still productive) would have no health insurance worries. No underwriter with a profit motive would seek to disrupt their health care security in order to meet a profit goal. The best way to consistently nurture the leading edge of US GDP and business regeneration is through including with the health reform legislation a strong Public Option.