The Public Option Is Nothing To Fear

Republican opponents of a public option for US healthcare are defending the insurance industry, not conservative principles

Back in the good old days, the
conservatives were the folks who favoured individual choice. Not any
more. In the current healthcare debate, the top priority of the
so-called conservatives is to deny people choice. They want to make sure that Americans do not have the option to buy into a Medicare-type public healthcare plan.
These alleged conservatives have come up with a variety of arguments
against allowing people the Medicare-type option, but the only one that
makes sense is that they work for the insurance industry.

The argument against a Medicare-type option always begins with the assertion that the government can't do anything. This is a peculiar claim given the popularity of Medicare,
but it also makes no sense as an argument against giving people a
buy-in option. Suppose the government gives people the option to buy
into its really bad plan. Everyone would just stick with the good
private plans we have now, right?

The so-called conservatives
then tell us that people will end up buying into the bad Medicare-type
plan instead of the good private insurance options because the
government will subsidise the Medicare-type plan. A little bit of
arithmetic is sufficient to dismiss this argument.

How much
money would be needed to get people to choose a bad healthcare plan
rather than a good one? This would have to involve some serious subsidies. People are not going to sacrifice their health and the health of their families for another cup of coffee at Starbucks.

it took a subsidy of $1,000 a year to get people to choose the bad
Medicare-type plan over the good private sector plans. With a
non-Medicare population of more than 250 million, this would imply
government subsidies of more than $250bn a year, if the Medicare-type
plan was to fully replace private sector plans, as the so-called
conservatives warn.

Is it really plausible that Congress will
approve $250bn a year in subsidies ($2.5tn over a 10-year budget
window) for a Medicare-type plan that everyone thinks is awful? Is
there another altogether wasteful programmes that gets public subsidies
even one-tenth of this size?

This one just doesn't pass the laugh
test. If conservative politicians don't think they can prevent such an
enormous waste of taxpayer dollars being perpetuated year after year
for the indefinite future, they should probably consider another line
of work.

In short, there is no genuine conservative argument
against allowing people the option of buying into a Medicare-type plan.
If the plan proves to be inferior to private insurance plans, as is
often argued, then the consequences will be relatively minor. Some
number of people who choose to sign up with this plan will find that
they don't like it, and then will switch to a better alternative. In
time, a bad public plan will soon flounder, since few people will buy
into it. There may be some effort to provide subsidies to even a bad
public plan, but it is not plausible that the subsidies could be large
enough to displace private plans.

It is also clear that the
opposition to a Medicare-type public plan does not stem from
townhall-type mass opposition. A recent New York Times poll found that
by an overwhelming majority, 65% to 26%, the public favours giving people this option.
If there is a member of Congress that risks defeat by supporting a
public plan, it is not because of their constituents' views.

opposition to a Medicare-type option is not based on public sentiment
or the fear that the plan will be bad. Rather the opposition is based
on the fear that the plan will be good and that people will choose to
buy into it. This will cost the insurance industry tens of billions of
dollars in profit over the next decade and could mean the end of big
paycheques for the industry's CEO's and other high-level executives.

the people who oppose giving the public the opportunity to buy into a
Medicare-type plan should not be called conservatives. Honest
conservatives would have no objection to giving the public a choice.
The people who oppose a Medicare-type plan are doing the bidding of the
insurance industry - there is no conservative principle at stake. And
we all know what Joe Wilson has to say about people like that.

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