Public Plans: Pro and Con

I’ve just about beaten this subject to death, but it’s worth responding to the tissue of lies being thrown up in defense of a public plan. The WSJ had editorials today — con by John Calfree and pro by the Smuggest Little Marxist in Washington, Robert Reich. Just to tackle a few of Reich’s deceptions (most are addressed in Calfree’s piece).

No other issue in the current health-care debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course, they don’t want it. A public option would squeeze their profits and force them to undertake major reforms. That’s the whole point.

Yes, just as public universities have made higher education so efficient and cheap. Just as the public option for seniors made their insurance so efficient and cheap — oh wait, there isn’t any private insurance for seniors anymore — except that created for government employees. Carry on.

Can anyone name for me an industry that has benefited from having a “public option”? I’m genuinely curious about this.

Critics say the public option is really a Trojan horse for a government takeover of all of health insurance. But nothing could be further from the truth. It’s an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal — more and better health care for less.

As I noted yesterday, this is the Big Lie. People don’t choose their insurance — their employer does, thanks to a nonsensical tax code that makes employer-provided insurance tax deductible, but not self-insurance.

But, say the critics, the public plan starts off with an unfair advantage because it’s likely to have lower administrative costs. That may be true — Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs — but here again, why exactly is this unfair?

Because Medicare doesn’t administer Medicare. It farms out that job to the eeevil insurance companies. Because, as we’ve seen with the Post Office and Amtrak and Fannie Mae, government-created corporations are often exempted from the regulations and taxes that private corporations are saddled with.

Critics charge that the public plan will be subsidized by the government. Here they have their facts wrong. Under every plan that’s being discussed on Capitol Hill, subsidies go to individuals and families who need them in order to afford health care, not to a public plan. Individuals and families use the subsidies to shop for the best care they can find. They’re free to choose the public plan, but that’s only one option. They could take their subsidy and buy a private plan just as easily. Legislation should also make crystal clear that the public plan, for its part, may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans must not favor the public plan.

There’s more than one way to subsidize a trojan horse. Will these public plans be subject to the exact same rules and regulations and taxes that private plans are? Will they have to create their own infrastructure or be able, like Medicare, to borrow someone else’s? And perhaps the greatest subsidy of all would be Ted Kennedy’s plan to make participation mandatory. There is no greater subsidy than forcing doctors to participate in the plan.

Finally, critics say that because of its breadth and national reach, the public plan will be able to collect and analyze patient information on a large scale to discover the best ways to improve care. The public plan might even allow clinicians who form accountable-care organizations to keep a portion of the savings they generate. Those opposed to a public option ask how private plans can ever compete with all this. The answer is they can and should. It’s the only way we have a prayer of taming health-care costs. But here’s some good news for the private plans. The information gleaned by the public plan about best practices will be made available to the private plans as they try to achieve the same or better outputs.

We’re not even finished with the article and we already have the first subsidy of the public plan. Ever heard of HIPAA?

Robert Reich is not in favor of healthcare competition. He doesn’t really believe most of the shit he’s peddling in this article. As I pointed out at the other site, many on the Left are openly acknowledging the slow poison that is the public plan. This is nothing but window dressing to lull us into thinking everything’s going to be OK.

But pay no attention to that. Look at the shiny watch. You are growing sleepy. Very sleepy. Did you hear Michael Jackson died? Don’t pay attention to the Marxist behind the curtain.