Got Health Insurance? Fighting for a Public Option Might Just Get You a Raise!

By Joshua Holland, AlterNet. Posted June 29, 2009.

And while the whole point of a public option is to compete with private insurers -- using the same efficiencies and economies of scale that big corporations employ all the time to cut costs -- the notion that a public option would kill off private insurance is nonsense.

Harrop points out that, "Contrary to the propaganda, a government plan doesn't tell you what you can have. It tells you what it will pay for. You can buy whatever you want with your own money. And any well-designed plan would allow people to purchase private insurance to cover things the government plan doesn't."

In France, where they have a "single-payer" system, 9 out of 10 people buy supplemental insurance from the private sector.  

More broadly, they frame the debate as a question of whether hard-working folks will pay higher taxes to cover the uninsured (a large majority of Americans say they're willing to do so, but it tilts the whole debate to the free-marketeers' advantage nonetheless).

The reality, though, is that health care is one of those areas where the individual, even the individual with decent insurance, only stands to benefit from the savings that come from genuine competition with a very large insurance pool that doesn't have to turn a profit for its shareholders.  

But I Have Insurance! 

Part of the conventional wisdom in the national conversation over health care reform is that if there are around 50 million Americans who lack insurance -- give or take -- then there are also 250 million who are covered (around 160 million through their employers).

And while Gallup tells us that Americans in general are ranked 18^th among citizens of industrialized countries in terms of satisfaction with their health care -- while spending more than twice as much per person as top-ranked Ireland -- those 160 million people who are covered by their employers are vulnerable to industry-sponsored messages suggesting they could lose their current coverage.  

So, it's important to talk not only about how systemic health care reform might help the 47 million uninsured, but also about what's in it for the 160 million who have coverage through their jobs.  

First, we have to understand that the numbers for the uninsured paint a rosy picture of the depth of the problem. Just consider a few additional points: 

• While an estimated 47 million lack insurance today, the number of Americans who have been without coverage at some point in the last two years is almost double that -- 87 million, or about 1 in 3 adults under Medicare age.

• And just because you have insurance now doesn't mean you'll have it tomorrow.  According to an estimate by the AARP, over a quarter-million American companies stopped offering coverage to their employees between 2000-2005.

• And just because you have insurance now doesn't mean you can afford it -- in recent years, the average amount insured employees have had to shell out for premiums has gone up eight times faster than their wages.

• And just because you have insurance doesn't mean you're adequately covered. According to an analysis by the Commonwealth Fund, 25 million Americans were underinsured (defined as "people who have health coverage that does not adequately protect them from high medical expenses") in 2007, up 60 percent since 2003.

Stuck in Dead-End Jobs; Clinging to Bad Marriages 

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Joshua Holland is an editor and senior writer at AlterNet.

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