Corporate Profits Muscle Out The Public Opition

We're headed into the end game for health care reform. The president has put himself in the arena. The insurance lobby is unleashing the scare campaign. A strong bill will pass the House. But at this point, too many senators are still standing in the way.

The reform includes a broad range of measures to extend and improve care and help curb rising costs, but the epicenter of the debate is over what is called the "public option." Health care reform will mandate businesses provide insurance or pay into a general fund. Individuals will be responsible to get health insurance, with subsidies for those who can't afford it. We'll be able to retain the insurance we have, or have the choice of a range of plans, including a public option, modeled after Medicare. A strong public option, competing with private insurance, is key to helping to get costs under control.

And costs must be brought under control. We now spend nearly 50 percent more on health care per capita than any other country, with mediocre results. We ration care by price, with some 47 million Americans uninsured. It costs the rest of us about $1,000 a year to pay for the price of their care when they are forced finally to check themselves into emergency rooms.

Tell stories, not statistics, the pollsters tell us. But after adjusting for inflation, health care costs have soared by 58 percent since 2000; while wages for most Americans were stagnant or lost ground. As the auto companies showed, businesses increasingly can't afford health care. Families find it unaffordable. Virtually the entire long-term debt challenge facing the U.S. government is from the projected rise of health care costs. Get health care costs under control, the U.S. has no long term fiscal problem. Fail to get them under control, the costs will bankrupt the federal government, state governments, businesses that offer health care (and increasing numbers won't) and families. Reform that gets costs under control is imperative. There is no choice.

A key to getting costs under control is the public plan. It can take advantage of its purchasing power to gain cost reductions. It can model best care practices. Private insurance—which in most localities translates into a couple of dominant providers that don't compete on price—will be forced to measure up with greater efficiency, innovation, and cost savings techniques.

Yet the debate in the Senate has been fixated on how to weaken or abandon the public plan rather than strengthen it. Republicans, for the most part, have taken themselves out of the adult conversation. Like first generation robots, they endlessly repeat the exact same words crafted by Frank Luntz: "government takeover," "no choice of doctor," "bureaucrats, not doctors, prescribing medicine." It's frankly pathetic. We have no choice as a society but to figure out how to fix this—and Republican leaders have chosen simply to peddle lies and scare stories and absent themselves from any serious discussion.

A gaggle of Democratic Senators—led by Sen. Max Baucus and the so-called "moderates"—have publicly thrashed around for ways to weaken or gut the public option. Outside groups like the Third Way have provided guidelines for disemboweling it. Some have suggested putting it off until private insurance competition proves it can't get costs under control—as if that hasn't been proven over the last decades. Baucus suggested decentralized local "co-ops" would serve as the public option —an idea notable for being both unmanageable and ineffective. Even if a network of coops somehow arose to insure that people had an option, they wouldn't have the clout to hold costs down and force private insurance to compete.