Chicago Sun-Times Editorial: Public option essential to health-care reform

Chicago Sun-Times Editorial: Public option essential to health-care reform
Copyright by The Chicago Sun-Times
September 18, 2009
http://www.suntimes.com/news/commentary/1776914,CST-EDT-edit18.article


Health-care reform without a robust public health insurance option won't be much reform at all.
We're talking about all Americans having the option to buy health insurance through a government-run nonprofit program, one that's subsidized, in part, by businesses that don't provide good insurance for their own employees.

There has been a lot of criticism of what's known as the public option.

Opponents say there's already too much government in people's lives.

They fear the government will mess it up -- when it can be a matter of life and death. They worry it's a radical idea that will bankrupt private insurance companies.

Amid those concerns, Sen. Max Baucus, a Montana Democrat and chairman of the Senate Finance Committee, on Wednesday released his long-anticipated plan to remake the American health-care system -- without a public option.

While it's far from a done deal, it would be a terrible outcome to lose the public option, even if other critical changes do go into effect, such as eliminating an insurance company's ability to deny someone coverage because of a pre-existing medical condition.

The public option is the only way to provide true, much-needed competition in the insurance industry and drive down health-care costs.

Understand that our health-care system doesn't need a makeover.

It needs a gut rehab, fast.

It should be clear why we need radical reform, but in case it isn't, here's a quick rundown.

In Illinois alone, average health insurance premiums for families have shot up nearly 90 percent since 2000. Last year, more than 1.5 million Illinois residents had no health insurance.

And the largest health insurer in the state -- BlueCross BlueShield of Illinois -- holds more than 50 percent of the market, hardly the best competitive situation.

Far from being anti-business, we think the public option is good for business, small ones in particular.

Right now, small businesses pay up to 18 percent more in premiums for the same health coverage as big businesses do.

"It's just not fair," said David Borris, president of a Northbrook catering company and spokesman for a small business group backing health-care reform. "It's not fair to us. It's not fair to the employee."

With the real competition that a public option would bring, small businesses would get to compete on a level playing field with the big boys when it comes to one of their most significant costs.

Without the public option, health-care reform will amount to a bonanza for private insurance companies -- because everyone would have to buy insurance, but the insurance companies would have no motivation to keep costs low.

Some politicians, shying away from the public option, have suggested setting up a trigger to unleash the public option down the road if insurance companies don't do a better job of offering affordable insurance to everyone.

At first glance, that sounds reasonable, but insurance companies have had decades to figure out how to provide better service at lower cost.

They haven't, so it's time to pull the trigger, not just threaten to.

We have every confidence private insurance companies will find ways to compete with a public option program and still thrive, because the Congressional Budget Office estimates that the vast majority of Americans won't sign up for it.

Other critics have suggested creating smaller co-operatives across the country to handle a public insurance option, but the size of a nationally run nonprofit would give it the bargaining power with health-care providers and drug companies that the smaller alternatives would lack.

Those smaller co-ops could do little to financially motivate doctors and caregivers to give the most effective care, rather than just the most care, which is what we have now.

A public option could do just that, and that's why it's so critical in any reform.