No One's Falling for Big Health's Bogus Promise to "Reform"

By Joshua Holland, AlterNet. Posted May 13, 2009.

The Public Option 

The creation of a public health insurance option is what the insurance industry fears most. The idea is to allow businesses and individuals to continue purchasing coverage from private insurance companies if they desire, while also establishing a public insurance program modeled on Medicare as an alternative. The government would subsidize the premiums paid by low-income families, but anyone could buy in. "Choice" is the key word.

With a very large pool of insured, a greater emphasis on prevention and a reduction in paperwork and administrative costs, advocates contend that the public option would prove more attractive for most employers and families, and its membership would grow, leading in turn to greater cost reductions. Eventually, gradually, most people would switch from private health insurance, and we would end up with a national insurance plan. 

The idea of creating a choice of a public-insurance plan is a bit of political jujitsu intended to get the U.S. to something approaching a single-payer system incrementally and without taking on the powerful insurance lobby head-on (Over the past 10 years, the insurance industry has ranked second in dollars spent lobbying Congress and the White House. The top spot is held by the pharmaceutical-and-health-products industry. Big insurance is one of the most influential lobbies in Washington, and it has trillions of dollars at stake in the health care battle.)

Although the proposals put forth during the primaries by presidential candidates Barack Obama and Hillary Rodham Clinton differed in the specifics, both had a public-insurance option at their hearts; it was one of the promises that helped get Democrats elected. And this is where the fight will be -- a coalition of "free-market" advocates led by the Heritage Foundation put a public insurance option at the top of its list of six health care "deal-killers." And all of the health care lobbyists behind this week's "proposal" have signalled their intention to fight against the inclusion of a public health option. Again, from the inside.

On the outside, we can look forward to the corporate-right's network of media outlets, think tanks and PR firms calling any substantive reform "socialism." The New York Times reported that Rick Scott, a veteran of the Bill Clinton-era health care fight whom the Times describes as a "conservative investor willing to spend freely on a political cause," started a group called "Conservatives for Patients Rights," which has already launched a multimillion-dollar campaign attacking the Obama administration on health care before the White House even endorsed any specific legislation.

Scott is a controversial figure; the former CEO of Columbia/HCA, then the world's largest health care company, was "ousted by his own board of directors in 1997 amid the nation's biggest health care fraud scandal." According to the Times, Scott's new group hired the right-wing PR firm behind the "Swift Boat" attacks on Sen. John Kerry, D-Mass., in 2004 to scare the public about the "perils of socialized medicine." 

The ideological stakes in the fight are high and go far beyond the bottom line of the insurance industry.

In an op-ed in the Wall Street Journal, Rep. Paul Ryan, R-Wis., and Peter Wehner, a former deputy in the George W. Bush administration, argued that a public option would make the conservatives' one-size-fits-all economic policy -- tax cuts -- more difficult to enact.

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Joshua Holland is an editor and senior writer at AlterNet.

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