Today was an encouraging day.
It may have been their plan all along, or it may be their response to last week's preview of what passing a health care bill that leaves no insurance executive behind would do, but Senate Democrats and the White House appear to be heading in the right direction on health care reform. And the President himself is taking a more direct role in the process, or at least leaking that role to the press.
These are all welcome developments. But the fight to include a public option in the final health care reform bill is on-going. Senator Olympia Snow (R-ME) wants the Senate to adopt a public option which will only go into effect if the insurance industry fails to provide adequate competition for American consumer.
There are two problems with Senator Snowe's public option. First, we already know that the American insurance industry doesn't provide adequate competition. Why should Americans have to deal with five more years of dealing with insurance companies that stop them from going to the doctor in order to make a quick buck on Wall Street? It is true that the bills currently being considered would outlaw the insurers worst behavior, but the refusal of multi-millionaire insurance executives to commit to banning the practice of rescission doesn't inspire confidence.
Second, we've already tried a public option trigger. A triggered public option was contained within the Medicare Prescription Drug benefit that President George W. Bush signed. As the New England Journal of Medicine points out, everybody agrees that the Prescription Drug benefit isn't working, and is a boondoggle to the drug industry, but the trigger still hasn't been pulled.
I believe a public option trigger would never be pulled. The system that would exist if a triggered plan is signed into law is a system which would force Americans to buy into the Wall Street-first, customer-last ways of the insurance industry. The system would increase insurers profits while providing dubious increased access to health care.
The insurance industry--which has been a worthy opponent of health care reform--would then redouble its efforts to ensure that there is never real competition from a public option. They'd do this because they know that the people that they currently put last--their customers--would happily leave for a non-profit option that is dedicated to the proposition that customers, not bankers with $53 million parachutes, should come first.
It's encouraging to hear that there are still United States Senators who put the needs of their constituents before the needs of their campaign donors. Senators Maria Cantwell (D-WA), Ron Wyden (D-OR), and Jay Rockefeller (D-WV) should all be commended for demanding assurances that the Finance Bill be dramatically altered in order to hold insurance executives accountable before it hits the Senate floor.
This isn't to say that a middle ground doesn't exist. I've previously advocated for a middle ground that empowers the Secretary of Health and Human Services to negotiate reimbursement rates for all plans on the exchange, and then leaves the administration of these plans up to the states. This would provide a needed check on insurance executives while still allowing conservative Democrats to claim victory for "stopping a government takeover of health care reform." This also wouldn't foreclose state governments trying the public option approach, which could enable the progressives to claim victory as well. Most importantly, this compromise wouldn't have Americans receiving unequal benefits because of their place of residence.
What the final compromise will look like is an open question. But with signs pointing towards the inclusion of some public option, I'm optimistic that health care reform will increase competition, expand access, and reduce costs.