Op Ed
June 12, 2009

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Real health care reform must include a choice of a public health insurance option

by Julie Burkhart

Health care reform is coming in 2009. Business owners small and large demand it. Cash-strapped consumers are clamoring for it. Even the insurance and pharmaceutical industries expect it.

Just months into President Obama's presidency, the nation has already taken significant steps toward achieving what has been but a dream — quality, affordable health care for everyone. First, we've expanded the State Children's Health Insurance Program to cover four million kids who previously had no access to health care unless they ended up in the emergency room (unfortunately, the expansion money was turned away in Missouri). Second, through the jobs and economic recovery package, we've made it easier for uninsured or laid-off workers to obtain coverage. And third, President Obama's budget outline leaves room for real, significant health care reform.

The question, then, is what kind of real, significant reform?

No reform proposal can be significant without including the choice of a public health insurance plan. Under this scenario, we would be able to choose between the private insurance plan many of us have now or participating in a public plan.

Congressman Roy Blunt (R-Springfield) would leave Missourians at the mercy of the private insurance industries, arguing that having another opportunity to find coverage in the choice of a public health insurance option would do away with "real" competition. Rep. Blunt has joined with the insurance industry in fearing the competition a public health insurance plan would offer — but there are four reasons why creating such a plan makes sense.

First, a public health insurance plan would always be there for us, just like Medicare is always there for the elderly and for people with disabilities. Private insurance companies can close, merge or leave the state.

Second, a public health insurance plan would be accountable to us and would help keep private insurance companies accountable through real competition. Competition in the marketplace is a good thing — if private companies have to compete with a public plan, they will face incentives to keep costs down or lose customers.

Third, a public health insurance plan would offer us a safety net in case we lose our jobs. Half of all bankruptcies in the U.S. are caused by medical bills. Such a plan not only would cover people who are unemployed, but would help address the skyrocketing foreclosure rate in this country.

Fourth, a public health insurance plan would be operated more efficiently than current private sector plans. For example: Medicare is a public plan that uses only about three percent of its budget for administrative costs. Private plans, in contrast, spend between 15 percent and 20 percent on administration, advertising and profits.

A recent poll found that nearly three out of every four voters want the choice of a public health insurance option. Voters want the choice between keeping their private insurance or opting for the public plan.

In a letter to Congress last week, President Obama said, "I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest."

Regardless of what other reforms are debated and passed or rejected, this real reform is a no-brainer. Americans want a choice. Any legislation lacking the choice of a public option is merely insurance reform and not the real, comprehensive health care reform we need.


Julie Burkhart is the executive director of Missouri ProVote. More information can be found at www.MissouriProVote.org.



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