OPINION | Health reform with a public option: Yes, but…


We need health care reform. Comprehensive reform. Health care that covers everyone, for all of their medical needs, including dental care, prescription drugs, mental health, and chemical dependency treatment. And we need to deliver it in a wise, more efficient manner so that it is affordable. The public is pleading for this.

President Obama has made clear that the status quo is not acceptable, and it’s great to hear the President’s vocal push for reform. The legislation in Congress will cover tens of millions of people who have no access to healthcare. For people without any health insurance, gaining coverage is not a minor thing. Providing them with access to care is a matter of life or death. Literally. Eighteen thousand Americans die every year for a lack of access to health care. We cannot wait any longer to change that.

In order for the Obama proposal to reach many of the most sick and vulnerable people, a “public option” – a public health insurance plan that people can select as an alternative to private insurance coverage – is an essential part of this legislation. People with serious mental or physical health challenges don’t stand a chance against a private insurance plan that is challenging their need for care day after day.

While the federal legislation will require insurance companies to cover people regardless of preexisting conditions, insurance companies will find ways to deny them needed care, effectively pushing them onto the public plan. Of course this means that the public option may eventually cost much more than the private plans, making it unsustainable, despite attempts to shift funds from insurance companies to adjust for it. But for now, people who are unable to advocate for themselves need a public option in order to get appropriate care.

This legislation will be life changing for millions of people. I want to underscore the need to fight for its passage. But…

Even with a public option, the proposals fall short. The bill that passed a couple of House committees is promoted as providing “universal coverage” though it will only reach 94% of the population, according to congressional estimates. That is better than the 81% of the public that currently has some sort of insurance coverage, but far from universal. And the benefits offered by insurance companies under the proposal will not be comprehensive because they leave out needed services and medications.

Also, despite congressional attempts to slow the growth in health care costs, the legislation will do very little for the tens of millions of people who already have insurance coverage, but still cannot afford the care they need.

The United States spends about twice what other countries spend for health care, yet the proposals under consideration will add significantly to what is already being spent, with a price tag reaching a trillion dollars over the next decade. When health care reform is done right, it will cost less, not more.

Other countries have found a way to provide health care for everyone, yet the reforms being pushed in Washington – even before the compromises are negotiated – would only reach 94%. That’s not good enough. Why can’t congress push for universal care? President Obama said that “the truth is unless you have what’s called a single-payer system in which everyone’s automatically covered, you’re probably not going to reach every single individual.”

So why isn’t single payer on the table? Senator Max Baucus, the chair of the committee putting together the Senate legislation says “it’s not on the table…because it cannot pass. It just cannot pass.”

Baucus’ lack of enthusiasm for a single-payer health care system might be better understood after one hears that Baucus has received hundreds of thousands of dollars from the health insurance lobby. Is it any surprise that he wants to require people to buy insurance instead of offer health care for all?

I want us to treat health care the way we treat police and fire protection. If you call the police because your home is being burglarized, the police dispatcher doesn’t ask, “Do you have police insurance? Does your plan cover home burglary?” They don’t waste time and money having you fill out forms so your insurance company can be billed. The police response does not depend on your insurance status. Everyone is covered. It’s the American way.

We have a chance to deliver health care to all in Minnesota. The Minnesota Health Plan (MHP) would provide health care to everyone for all of their medical needs, cradle to grave. It lets people choose their doctors, and leaves medical decisions to them and their doctors, instead of insurance companies or government. And it would be delivered in a wise, more efficient manner costing less than the current system, not more.

The MN Health Plan has many co-authors, and it has passed through two Senate committees. While health insurance companies and the pharmaceutical lobby will go all out to defeat the MHP, it is time to stand up to the special interest money and deliver health care for all. It may take three or four years, but we must do it.

I am deeply disappointed that people in Washington take the insurance lobby’s campaign contributions and settle for a very costly plan that doesn’t cover everyone. Congress and the administration should not promote the legislation as if it is a solution when millions of people won’t be covered and health care still won’t be affordable to many of those families who have insurance. Nevertheless, for the sake of the millions who would gain access to care, we have to fight hard for the most comprehensive reform that they will consider in Washington. Our work for a real, long term solution is no excuse for ignoring current needs.

To make both immediate and long term progress on health care, we should push for congressional passage of a bill with a robust public option, even as we press forward here in Minnesota for systemic change. A new Minnesota health care model, built on the Minnesota Health Plan, will provide high quality, affordable care for all Minnesotans in a sustainable manner. And it will, at the same time, show the rest of the nation the way out of our health care crisis.

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