Ever since the idea of a public/private health insurance combination came about, I’ve been reading articles like this one. Personally, I see things a little differently, but the idea that a public health insurance plan would mean the death of private health insurance is a fairly common view.
The thing that gets me is that I have yet to see an article that is critical of the public health insurance idea and also proposes alternative solutions. Here in Colorado, we have 800,000 people who are uninsured. Nationwide, that number is 47 million, and that was last year, before the recession hit and unemployment numbers started to climb. I have no doubt that the number of uninsureds has increased in the last year, and is continuing to do so.
I do see some validity in the points that people are making about the unfair advantages that a public, government-funded health insurance program would have in terms of competing with private health insurance. Obviously the government has a bigger budget and no requirements to turn a profit. But they would face an uphill challenge in terms of winning over public opinion from all of the people who have no interest what so ever in having the government anywhere near their healthcare. They would also have to start from scratch in terms of setting up a system (just “expanding Medicare” isn’t likely to be as simple as it sounds) that private health insurance companies are already adept at managing.
Employers use health insurance benefits as a tool to attract and retain good employees. Employers are not likely to want to abandon one of the tools that they use to set themselves apart from other employers in terms of recruiting. So the argument that employers would drop health insurance benefits en masse seems overly dramatic. Employers have dropped health insurance benefits over the last decade as premiums increased, and especially as the recession hit last year (and here in Colorado, HB 1355 meant that more employers found themselves facing higher premiums). But typically employers who drop health insurance coverage do so because they are unable to afford the premiums – even though they would rather continue to offer coverage to their employees. I think that employers who could afford to keep offering coverage would do so, regardless of other options that might be available.
But regardless of the implications of a private health insurance option, I’d really like to hear about viable (or even pie in the sky) solutions from people who are opposed to the idea of a combination public/private health insurance system. But we have to start with an agreement that it’s not acceptable to have so many people who are unable to pay for and/or qualify for health insurance. The health insurance industry has proposed a solution that would eliminate medical underwriting (thus taking away the problem of people not being able to qualify for coverage) in trade for a mandate that everyone purchase health insurance. This is a possible solution that would operate within the same mostly private health insurance system that we have now, but I imagine it would likely require some sort of government subsidies to keep premiums affordable for everyone. I’m sure that there are other ideas out there, but it seems that the people who love to hate the idea of a public health insurance program are full of doom and gloom but not many alternative suggestions.