The proposed “public option” has become a major flashpoint in the health care reform debate. President Obama initially insisted that he would not sign a reform bill without a public option. Later he signaled some flexibility, but he still wants it. Arguments for and against the proposal have become emotional, shedding more heat than light on what such a plan means. So let’s consider the issue from a new perspective.
Personally, I found the term “public option” rather curious the first time I heard it. After all, who doesn’t like options, and why not one more? But as George Washington said, “Government is force”, and bureaucrats aren’t known for giving people choices. And some proponents of the public option, like Congressman Barney Frank, are quite open about their preference for a single payer system. Yet President Obama assures us that “if you like your current health insurance, you can keep it”. (Based on language in the various bills, he should have added “but not for long”, but let’s leave that aside for now.)
Much of the debate centers on a government “takeover” of health care, comparing the reforms to socialized medicine in other countries, like Canada and the United Kingdom. Based on current proposals, such comparisons are not very enlightening. Proponents are technically correct that the proposals are not true socialized medicine, but opponents can argue, with equal legitimacy, that that sure looks like where they’re headed.
But one aspect of British health care that could be particularly relevant to the “public option” proposal has been conspicuously absent from the debate thus far. That is the fact that in the U.K. the National Health Service (“NHS”) and private health care coexist. Since the proposal under discussion here is a public “option”, doesn’t that imply the continued existence of private options?
My family and I lived in London for a couple of years, and experienced British health care. We even used the same hospital where Princess Diana gave birth to Princes William and Harry. I don’t know how it looked to a princess, but to us ordinary American, it looked old, dark and dingy.
The NHS appeared to be as abysmal as claimed. “Free” medical care was supposedly available to all, but waiting times were long, and care was often denied. NHS doctors earned only slightly more than coal miners, so there were never enough doctors, nurses or hospitals to meet the demand. At one point, I understand that kidney dialysis was automatically denied to anyone over age 55. If you need dialysis, that’s not a “death panel”, that’s a death sentence!
But being employed by an American company, my U.S. health insurance allowed my family to have private health care. Most of our doctors had Harvard Medical degrees. Waiting rooms were often empty, and appointments were kept on time. The services were excellent, and the prices were actually lower than they would have been at home. Yet in all of the debate over a “public option”, I haven’t seen a single mention of the private health care alternative in the U.K.
Back when Hillary Clinton was spearheading her health care initiative, Bill Clinton signed a major crime bill into law (assault weapon bans, more police on the streets, and so on). Somebody did a count, and found more felonies in the health care bill than in the crime bill. Among others, simply paying a doctor for medical services would have been a felony for both doctor and patient! President Obama is trying to avoid the mistakes of Hillarycare, but can he avoid the temptation to use mandates to force the American people to do what he wants?
The proposed “public option” is obviously another welfare program, and as such its merits can be debated ad infinitum. But the real concern should be whether it is truly an “option”, or whether it will turn into a mandate. The president says we can keep our existing coverage, so let’s demand that he put it in writing. Rather than a “public option”, let’s demand a private option.
Any health care reform package should guarantee that outside of the “public option” plan, the government will not interfere with doctors practicing medicine, with hospitals treating patients, or with insurance companies offering competing insurance policies. As citizens of a free country, we should demand nothing less. Like the British, we should be free to choose any doctors, any treatments, and any insurance coverage that we deem appropriate.
Absent that freedom, the so-called “public option” will soon become a mandate, and we will suffer runaway cost inflation, lower quality and rationing of health care.