119 Million Americans Must Be Wrong

As the health insurance industry and its defenders in Congress lay out
their case against permitting a public option in a reform bill, perhaps
their most curious argument is that some 119 million Americans are
ready to dump their private plans and jump to something more like
Medicare - and that's why the choice can't be permitted.

In other words, the industry and its backers are acknowledging that
more than one-third of the American people are so dissatisfied with
their private health insurance that they trust the U.S. government to
give them a fairer shake on health care. The industry says its allies
in Congress must prevent that.

The peculiar argument that 119 million Americans must be denied the
public option that they prefer has been made most notably by Sen. Chuck
Grassley of Iowa, ranking Republican on the Senate Finance Committee,
which is one of two panels that has jurisdiction over the health
insurance bill.

"As many as 119 million Americans would shift from private coverage to the government plan," Grassley wrote in a column
for Politico.com. That migration, Grassley said, would "put America on
the path toward a completely government-run health care system. ...
Eventually, the government plan would overtake the entire market."

Grassley's logic is that so many Americans would prefer a
government-run plan that the private health insurance industry would
collapse or become a shadow of its current self. That, in turn, would
lead even more Americans entering the government plan, making private
insurance even less viable.

Rarely has an argument more dramatically highlighted the philosophical
question of whether in a democracy, the government should represent the
people's interests or an industry's.

But Grassley said he is simply upholding "the promise that if you like
the coverage you have, you can keep it. ... That's why I'm concerned
about a government-run plan that forces people out of private

counter-argument, of course, might be that if the health insurance
industry hadn't dissatisfied so many customers - indeed forcing many
sick people into bankruptcy because of excessive fees, denial of
coverage and gaps in permitted medical treatments - there wouldn't be
so many Americans eager for a public option.

So, now to protect the health insurance industry, Congress must stop
119 million Americans from leaping into the arms of a government plan.

Grassley is joined in his position by nearly the entire Republican
contingent in Congress. It also appears a few key Democrats,
particularly Senate Finance Committee Chairman Max Baucus, D-Montana,
agree at least in part.

has kept a single-payer option "off the table" during the debate even
as he claimed "all options are on the table." He also has suggested
that Congress might have to "sculpt" any public option, presumably to
make it less appealing to Americans if some version survives in the
reform bill.

President Barack
Obama, whose mother had to fight with her health insurance company
while dying of cancer, says he continues to favor including a public
option in the bill as necessary to keep the insurance industry honest.
Sen. Ted Kennedy, chairman of the Health and Education Committee which
also has jurisdiction over the bill, also favors a strong public plan.

However, there is the additional fact that executives from health
insurance companies and related industries are major campaign
contributors to members of Congress on both sides of the aisle.

For instance, since 2005, Grassley's various political action
committees have collected nearly $1.3 million in donations from the
industries related to the health insurance debate, according to OpenSecrets.org.
Grassley's top four donor groups were Health ($411,956); Insurance
($307,348); Pharmaceuticals ($233,850); and Hospitals ($197,137).
Eighth on Grassley's donor list were HMOs at $130,684.

On the other hand, the health insurance industry appears about as
popular with Americans as the tobacco industry, with both considered
highly hazardous to your health. Except that Americans can choose not
to smoke, while they run enormous risks for themselves and their
families if they don't have some form of health insurance.

Health insurance companies do negotiate rates with hospitals and
doctors that are far below what is charged to people who don't have
insurance, sometimes as low as one-tenth what the uninsured patient
might be charged.

disparities, in effect, force many Americans to sign up for private
insurance even if the insurance fees are excessive, padded with
handsome profits for investors and unproductive bureaucratic costs
(including investigations into whether people can be denied payments
because of undisclosed "preexisting conditions").

If the health insurance industry had its way, Congress would produce a
bill that simply required Americans (or their employers) to buy health
insurance from private industry. That way, the government would compel
citizens to become customers while denying them a choice of the public

To avoid such an
outcome, proponents of the public option - including those 119 million
Americans who are ready to sign up - will have to overcome opposition
from Republicans and some Democrats who are determined to protect the
interests of the private health insurance industry.

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