More on the Public Option

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June 8, 2009 9:47 a.m.

Along with many others, last night I flagged the New York Times article in which opponents of a ‘public option’ in the health care reform bill are saying that the ‘public option’ (which is essentially the federal government entering the field with its own health insurance plan) would be so efficient and inexpensive that it might drive for-profit health insurance companies out of business.

Why this is a problem for anyone else beside the for-profit health insurance companies, whose lobbying muscle in Washington kept them out of Dante’s third cirlce of hell, is not clear.

But a few readers written in to say, Look, Medicare (which is probably the closest analogue to what a public option might look like) isn’t perfect. Many doctors won’t accept Medicare, it doesn’t cover enough, etc. etc. etc.

I don’t think anyone who seriously follows health care policy debates honestly disputes that Medicare insures a ton of people with very low overhead. But you only need relatives in their sixties to know that people have problems finding doctors who will accept Medicare or who feel that Medicare doesn’t cover enough and so forth.

But this seems to me to be the heart of the case — and the real tell about the opposition to the public options within the insurance industry. If it’s really true that lots of the best doctors aren’t going to accept the ‘public option’ subscribers, then I have to imagine that’s going to put a big brake on migration out of for-profit health insurance and into the public option. In other words, the problem — to the extent there are ones — should be self-correcting. Assuming the ‘public option’ has to exist on something like the same basis as the private carriers, the private carriers only have something to worry about if the ‘public option’ is just demonstrably better insurance.

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