Last week I proposed there were two answers to the question “What is the purpose of a health care system?”
A. Provide health care
B. Support a profitable health care industry
I’m not opposed to a health care system that does both, but not if Purpose A is compromised.
Apparently Sen. Chuck Schumer is attempting to craft a “middle ground” that compromises Purpose A in order to support Purpose B. A New York Times editorial explains Schumer’s plan:
Any competition between a new public plan and private plans would be waged on a regulated field of battle within a new health insurance exchange. Most reform proposals envisage the exchange as a place where individuals unable to obtain coverage at work and ineligible for existing public programs like Medicaid could buy policies that would be available to everyone without regard to pre-existing medical problems. Low-income people would get subsidies to help buy a private or public plan.
Opponents of a new public plan have raised the specter that it might have unfair advantages that would enable it to draw customers from private insurers and ultimately drive them out of business, leaving virtually all Americans enrolled in a full-fledged single-payer system, like Medicare. That prospect could be mitigated by appropriate ground rules.
Now, get this part:
Senator Schumer, a Democratic member of the crucial Senate Finance Committee who was assigned to study the issue, has come up with some reasonable principles to ensure that any competition between a public plan and private plans would be a fair fight. In general, he suggests that a public plan should have to comply with the same rules and standards as private plans.
Because, you know, we cannot be unfair to the private insurance industry, even if it means compromising the health of citizens.
The public plan could not be supported by tax revenues or government appropriations but by premiums and co-payments. It would have to maintain reserves, like private insurers, and provide the same minimum benefits as all other insurers in the exchange. It could not compel doctors who want to participate in Medicare to also participate in the new public plan. And it would be run by different officials from those who run the insurance exchange to lessen the likelihood that federal officials would give unfair advantages to their program.
Because, you know, we cannot give unfair advantage to a public system, which means the public system will be priced out of reach for many people. Yes, it says “low income” people may qualify for subsidies, but we sort of have that now. It’s called “Medicaid.” The income ceiling for qualifying for Medicaid is so low that vast numbers of people who can’t afford health insurance don’t qualify for Medicaid, either. I am not hopeful that low-income subsidies for public health insurance would be any different. Let’s forget about putting people through the indignity of qualifying for subsidies and make the bleeping insurance less expensive, period.
I just sent Sen. Schumer — one of my senators — a message explaining to him why he can go to hell, btw.
And the New York Times editorialist is no less clueless:
Mr. Schumer is on the right track. It should be possible to design a system in which public and private plans could compete without destroying the private coverage that most Americans have and for the most part want to keep.
I don’t think most Americans give a hoo-haw about private versus public coverage, as long as they can see a doctor when they need to. People who have insurance now and can see a doctor when they need to don’t feel a need for change, but if their insurance was publicly funded and they could still see the same doctors they are seeing now, I very much doubt there would be riots in the streets because the government isn’t being fair to the private insurance industry.