Why we need a public option

Taken from “Let’s Talk About Healthcare Around the Advanced World” http://jcurtin.wordpress.com/, quoted from a column by Paul Krueger:

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

My correction: “rising costs WILL all too easily undermine the whole effort.”  With the pending rejection of a public option for health insurance, this whole healthcare reform thing is about to turn into the new COBRA. 

As I have frequently mentioned, COBRA is a remnant of a past healthcare reform effort.  Before anyone tries to rewrite history, it was enacted during the administration of Bush Sr. —  not Clinton, who never managed to enact any healthcare-reform legislation whatsoever as far as I know, unless it was some small amendment to COBRA. 

I mention this because the wingnuts’ history rewriting efforts started in earnest during the Clinton administration.  I remember overhearing two conservative-coiffed, business-suited old ladies whispering loudly together in a store during that period, that “Clinton’s healthcare had “ruined (their grown children’s) lives.”    As they stage-whispered they eyed me suspiciously, certain that I was some foul liberal determined to undermine their Constitutional right to be idiots. 

While I didn’t say anything, I remember thinking, “what the hell was that all about?”  Because, you see, Hillary Clinton had just tried and utterly failed to get Congress to do anything at all about healthcare.  And after she did, the same wretched system dragged on and on through Bill Clinton’s administration and then the lesser Bush administration with no change in sight.  Lives were lost as insurance was lost when jobs went overseas in search of cheaper labor.  Meantime, healthcare prices spiraled completely out of control.  Apparently these are now referred to as the “good old days.”

Anyway, as I said, COBRA never worked very well and was finally forced, with only a few vital signs still apparent, into a shallow grave by private insurers’ combined efforts.  As I remember, first they tried to gut it by trimming post-employment insurance policies down to the bare bones and charging higher rates to the ex-employed that they charged the still-employed. 

Then, when the act was modified to stop this, the insurers simply doubled or quadrupled the already inflated premiums.  Nowadays, while I can’t find any actual figures on who can afford COBRA, my guess is that it may be less than half of those who find themselves between jobs.  Too often the expense of COBRA eliminates the possibility of eating and/or paying the mortgage or the rent, and when it comes down to it, eating and keeping a roof over one’s head sort of tends to take priority over things like physicals, care for chronic ailments, and/or the 7 warning signs of cancer.

Oh, and there’s another thing — COBRA only helps those who are between jobs for a relatively brief time.  I think it’s now up to 18 months; it used to be less than a year if I recall correctly.  And private insurers use it as an excuse to reject those who have not yet found another job, taking away the option of purchasing private insurance during that period.  Not that that is much of an option for the vast majority of us, anyway.

So overall, COBRA bites.  The concept was great, since at the time it was enacted, people between jobs frequently went without insurance for a long time, often extending for up to six months after they had finally landed new positions.  There were countless horror stories about uninsured people becoming ill from the stress of being jobless, or finding new jobs only to become ill before they were eligible for insurance from their new employers, losing both the new jobs and any chance of having insurance at the same time.  COBRA has alleviated that somewhat, but not nearly enough.  The insurance companies have placed too high a price on it for it to be the help it was supposed to be.

So indeed, before the private health insurers strangled it, COBRA was a good idea for those who are not self-employed (it has never addressed the chronic insurance problems of enterpreneurs).  You can have no doubt that these same nice insurers will do the same to any healthcare reform that is enacted unless there is a public option so people can opt out of dealing with their shenanagans.

Some other thoughts: the lack of a public option renders U.S. workers uncompetitive with workers in countries where there is a public option or at least a lot of governmental regulation of the private healthcare industry.  It makes us too expensive  Moreover, (and somewhat ironically) it also makes us all into wage slaves by discouraging many people from starting their own businesses. 

Kinda runs counter to the American Dream, doesn’t it?  Ironically, that’s what we’re actually talking about here.  So if you’re a wingnut and have been convinced that a public option will be the end of the U.S. as we know it, just consider this: the U.S. as it is isn’t the U.S. as it is supposed to be.  Our founding fathers were more than a bit anti-corporation and abhorred the idea of wage slavery (for upper-crust white men, that is). 

If looking at it through the eye of history doesn’t change your view, then you are hopelessly in the control of the Fat Man and Fox News, and there is nothing anyone can do to save you.  Enjoy your private health insurance, (if you can pay for it), until you lose your job.  Cheers.

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