Monday, October 26, 2009

Can A Public Option Be Optional?

Senator Majority Leader Harry Reid has indicated that he will add a Public Option to the Senate Healthcare Bill, with the added element that states can opt out. It is not clear yet whether this decision is the purview of the governor or the entire state legislature. In either case, the caveat is that states most in need of a public option will indubitably opt out claiming they can’t afford it. Of course they cannot afford to be without it. Leaving it to the states to decide who shall have healthcare and who shall not have healthcare is reminiscent of the roulette played back in Reid’s home state. We know the house always wins in the end. It's all about money and not healthcare.

The fact is that we cannot afford not to have a public option since that is the only way to begin to bring down healthcare costs. In a strong public option, there is no profit-making middleman. Only such an option can make insurance companies behave. True, not everyone will even be able to select the public option, particularly if they get insurance through their employers. But those costs should come down as well when it is demonstrated that things can be done more economically. And with better outcomes. Insurance companies cannot continue to make healthcare a commodity to be sold much as a company would sell diamonds rather than a basic necessity. A strong public option that is not an optional option would also force fairer rules.

No man, woman, or child should be refused insurance or dropped for any reason, including pre-existing conditions or catastrophic illness. These are the people who most need insurance and we cannot continue to allow insurance companies to morph into the death panels of our country. For that is precisely what they do when they cut off insurance for those with catastrophic illness. Unless that patient is extremely wealthy—and if that were the case they would have a far superior plan to begin with—the company is for the most handing out a death sentence. It is unconscionable in a democratic society claiming to be sophisticated and caring.

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