Opponents of the public plan want to scare Americans, so maybe it doesn’t matter that the arguments are fundamentally contradictory–they just need to be really scary.
Back in March, the National Journal invited opponents and supporters of the public plan option to briefly lay out the arguments for and against here. While the rhetoric has gotten louder, the positions mostly haven’t changed.
On the one hand, opponents say a public plan option will be so popular that it will “engulf” the private insurance market–repeatedly citing the Lewin study that we’ve already discussed here.
What does that mean? You will like the public plan so much–because you get better benefits for less money–that you will choose it over the packages offered by private insurance companies.
At the same time, opponents also say a public plan option wouldn’t pay doctors enough, so your doctor wouldn’t be there. Since millions of you wouldn’t buy a plan that your doctor refused to join, it hardly sounds like something that would destroy the competing insurance market.
According to yesterday’s Chicago Sun Times about President Obama’s appearance before the American Medical Association (AMA), the AMA is leery of the public plan on exactly those grounds.
While in concept the AMA supports all Americans having health care coverage, the organization wants to avoid an outcome where payments to physicians treating patients in a government-run plan are capped at rates lower than private insurance companies pay.
We support a public plan option that is competitive with private insurance AND pays your doctor enough to get him or her into the system.
Assuming it pays doctors what they would get from private insurance companies, a public plan is still likely to be very competitive in price and benefits to private insurance, and so push insurance companies to give you more for less as well. If insurance companies want to keep playing games with rates and benefits, you will always have a reliable public alternative to turn to. But if they play straight with you, you will have no reason to leave.
The public plan will need to pay doctors competitively with private insurance to ensure that your doctor will be in the plan. No one is advocating a two tier system in which private insurance gets the best doctors and the wealthiest patients while the public plan struggles to find a few doctors to serve the poorest people. We already have that system, it’s called Medicaid, and we know it doesn’t work very well in most states.
Since the public plan will pay doctors enough to work for it, and will still give insurance companies a run for their (your) money, we really don’t have to worry about the final scare tactic—that this is a sneaky way to open the door to government run health care. President Obama yesterday responded to this directly in his comments to the AMA:
What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system. I’ll be honest. There are countries where a single-payer system may be working. But I believe – and I’ve even taken some flak from members of my own party for this belief – that it is important for us to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this – they are not telling the truth.
President Obama spoke to the second most important group who must accept and support the passage of strong health reform–the doctors. But the very most important group is you, the person who needs what’s in that health insurance plan, maybe not today, but some day. We’ve talked to you, and you are clear about what the problems are. But already the discussion in Washington is drifting far from the realities you face and the priorities you’ve described to us–choice, security, freedom. We look forward to the coming months when the President brings his plain talk about cutting cost and improving care directly to you.