Thursday, October 1, 2009

The Two Faces of the Public Option

Clive Crook writes:

My view on the public option has always been that I'll know whether I like the idea when I see it explained. The problem is that the idea has been pitched as all things to all men. Centrist voters are told it won't make much difference. Progressive voters are told it will make so much difference that the entire project is a waste of time without it.

. . .

The public option cannot be both an ordinary competitor, leaving your circumstances unchanged if you choose not to take it up, and a force that can balance the budget by squeezing hundreds of billions out of public health-care costs. It can be one of these or the other, but not both.

Democrats have been debating whether a "strong" public option should pay Medicare reimbursement rates, something an ordinary competitor could not do. If it did, this would drive down costs and have many other (not necessarily intended) consequences. It would be a big step towards Medicare for all. As I have argued before, there are worse things than Medicare for all, including in my view the present system. But this outcome is one of the things that the administration is saying it does not want.

If you want Medicare for all, do what some Democrats do and make the case. If you don't, stop proposing a public option that would push the system towards it.

I couldn't agree more.

Update: According to Gallup, the majority of Americans (61%) believe that it is not the responsibility of the federal government to guarantee health insurance to all its citizens. (The sampling error is +/- 4%.)

No comments: