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rant

health insurance

I just heard a radio interview with Senator Jon Kyl (R-AZ), who stated his objections to the "public option". In a nutshell,

1) "it's intended to compete with the private sector, and a respected research firm has predicted that 120 million Americans could be covered by the public option, 80 million of whom already have private employer-based health insurance but would switch into the public option because it was cheaper."

Excuse me -- isn't that what a free market is about? People choosing to switch from one provider to another that gives them better service and/or prices? And I thought that was supposed to be a good thing. How is it suddenly a bad thing if one of the providers happens to be government-run?

In fairness, Senator Kyl actually said "their employers would dump them into the public option because it was cheaper" [with the unspoken assumption that this would provide inferior service, and would be against the wishes of the employees]

Employers already have a choice of more-expensive, more-complete plans vs. cheaper, less-complete plans for their employees, and they haven't all chosen the cheapest, presumably because, in the market for good employees, the quality of health insurance plans is a bargaining chip. How would this be any different if they had one additional choice that happened to be run (but not funded) by the U.S. government?

Regardless of whether there's a public option, I'd rather the individuals were making the decisions rather than their employers. That's something to discuss: getting rid of the employer-based insurance system, which forces people to switch insurers when they switch or lose a job.

2) "it's the first in a two-step process leading to a single-payer system." [With the unspoken assumption that that would be bad]

Even if so, how can it "lead to a single-payer system" through free-market competition unless it works, which as a government-run program it can't possibly do?

3) "when you compete with the Federal government, you lose. They're not only the referee, they get to make up the rules."

OK, this is a substantive claim worth considering. The rules should be written in such a way that the public option and the private companies truly compete on a level playing field. This means

  • any customer who's allowed to buy from a private company should also be allowed to buy from the public option, and vice versa

  • if private companies are allowed to negotiate for prices, the public option should also be allowed to negotiate for prices, and vice versa

  • any procedure that can legally be covered by a private company should also be allowed to be covered by the public option, and vice versa

  • private companies and the public option should both be funded by premiums, and should have the exact same access (ideally none) to Federal subsidies

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