The "public option" is a lie

Noam Chomsky on health care, as of July 9 (with paragraph breaks added to aid readability):

It is hardly controversial that the disastrous US health system is a high priority for the public, which, for a long time, has favored national health care, an option that has been kept off the agenda by private power.

In a limited shift towards the public will, Congress is now debating whether to allow a public option to compete with insurers, a proposal with overwhelming popular support. The opposition, who regard themselves as free market advocates, charge that the proposal would be unfair to the private sector, which will be unable to compete with a more efficient public system.

Though a bit odd, the argument is plausible. As economist Dean Baker points out, "We know that private insurers can't compete because we already had this experiment with the Medicare program. When private insurers had to compete on a level playing field with the traditional government-run plan they were almost driven from the market."

Savings from a government program would be even greater if, as in other countries, the government were permitted to negotiate prices with pharmaceutical corporations, an option supported by 85% of the population but also not on the agenda. "Unless Congress creates a serious public plan," Baker writes, Americans "can expect to be hit with the largest tax increase in the history of the world -- all of it going into the pockets of the health care industry." That is a likely outcome, once again, in the American form of "guided democracy." And it is hardly the only example.

We now know that private insurers will not compete with a "public option." That option will affect only about ten million Americans.

The odd thing is, most people engaged in this debate pretend that the public option as originally envisioned will play a major role in the new plan, even though it won't. The conservatives are crying "Socialism!" In his televised address, Obama described a plan that has nothing to do with what is now coming out of the Senate and the House. The overall effect is surreal, hallucinatory: Everyone is debating the merits of a scheme that has already been shunted aside.

Drs. Steffie Woolhandler and David Himmelstein wrote the following in The Progressive:

Illness and medical bills contribute to 62 percent of personal bankruptcies — a 50 percent increase since 2001. And three-quarters of the medically bankrupt had insurance, at least when they first got sick.

Coverage that families bought in good faith failed to protect them. Some were bankrupted by co-payments, deductibles, and loopholes. Others got too sick to work, leaving them unemployed and uninsured.

Now Congress plans to make it a federal offence not to purchase such faulty insurance.

On top of that, it’s threatening to tax workers’ health benefits to meet the costs of simultaneously covering the poor and keeping private insurers in business.

President Obama’s plan would finance reform by draining funds from hospitals that serve the neediest patients. His other funding plans aren’t harmful, just illusory. He’s gotten unenforceable pledges from hospitals, insurers and the American Medical Association to rein in costs, a replay of promises they made (and broke) to Presidents Nixon and Carter. And Obama trumpets savings from computerized medical records and better care management, savings the Congressional Budget Office has dismissed as wishful thinking.

The president’s health plan can’t make universal, comprehensive coverage affordable.

Only single-payer health reform — Medicare for All — can achieve that goal.