Health Care Reform and the Public Option: Without Trust Americans Are Screwed

By FireDogLake's milesz FDL

It is a wonder of incredulous proportions that Speaker Pelosi declared the other day that the House reconciliation bill will not contain a public option, because the Senate did not include it in their bill and it does not have the votes for one. This was after Senate Majority Whip Dick Durbin (D.-Ill.) said he will “whip” anything the House sends over to the Senate, after 41 Senators have now committed to a public option, and Adam Green, head of a progressive group, did its own whip count this past week and came up with over 50 senators who would support a public option. Add to this that the House has already included the public option in its version of health care reform and a voter would surely ask, what the hell is going on? The answer to this query is an easy one: Pelosi speaking for her caucus simply does not trust the Senate. She has pointed to the over 290 bills the House has passed yet they are gathering dust on someone’s desk over in the Senate. From some corners, it seems that even though 41 senators are publicly supporting the public option, when the “rubber hits the road” in terms of these senators having to cast a vote, maybe they are bluffing and really don’t mean what they say or do not really back a document (Senator Bennett’s letter) to which they affixed their signatures. But then again this would call into question whether the word of any elected official can be trusted. We surely know that answer. The icing on this cake is, of course, that Obama and his minions are remaining silent, preferring to let two chambers who don’t trust one another duke it out, and whatever mess is decided upon they call health care reform will be with what Americans will have to live. All the while, the American voter does not trust Washington regardless of whether it is health care reform or not. Even the reason the White House Press Secretary has given for Obama delaying his upcoming trip to Indonesia and Australia for a few days is to build trust among the rank and file.

During the Blair House summit on reform couple of weeks ago now, Pelosi said that a public option was not on the agenda because the insurance industry feared competition. Since then, reports by Goldman Sachs and the progressive group, Health Care for America Now, have both come out with scathing reports detailing how the insurance industry has vastly overstated the reasons why it has to charge the premiums that it does, and that this trend will not stop any time soon. We are also seeing double digit increases throughout the country now so there is no conjecture into this equation.

Competition is an ever-necessary ingredient for any final reform bill. Competition prevents monopolization and that is what the insurance industry has in spades around the country. Health care reform does not include competition, and without it the insurance industry will not only receive $billions more from the mandate that everyone have insurance over what it rakes in today, but will continue to gouge on premiums as they see fit. Moreover, has anyone asked, what mechanism will be in place from the very first day any legislation is signed into law that will effectively control premium increases? Or, what about these new reforms like no pre-existing condition will bar coverage. Has anyone asked who will be paying for these new goodies? The answer is, we will—unless there is strong and effective competition. And we must not forget about lifting the antitrust exemption for insurers. The antitrust laws ensure competition over monopolization. The bill that the House passed lifting this exemption did so with over 400 votes, but is one of those couple hundred sitting somewhere in the Senate that has yet to see the light of day.

In the end, trust begets competition, competition begets a public option, and a public option begets the necessary ingredient that enables every single American to afford health care. Without trust, Americans will remain screwed.