The Obama administration took a single-payer solution to America's health care crisis "off the table" at the outset of the debate. Since then it has cut dubious "deals" with Big Pharma and the private hospital industry. And finally, this weekend, officials signaled that the Obama team might be willing to jettison the central progressive plank of reform: the creation of a publicly run insurance program that could compete with private insurers.
On CNN, Health and Human Services Secretary Kathleen Sebelius said the public option wasn't "the essential element" of reform, and at a town hall in Colorado on Saturday, President Barack Obama himself said of the public option: "whether we have it or we don't have it, [it] is not the entirety of health care reform. This is just one sliver of it, one aspect of it."
It may be just one "aspect" of health reform, but without it, the legislation promises to be a massive rip-off; a taxpayer give-away of hundreds of billions of dollars to an unreformed 'disease care' industry.
The industry would get millions of new customers thanks to generous government subsidies and a law requiring that (almost) everyone carry insurance. And that windfall would come without the structural changes needed to bend the medical "cost curve" in years to come -- without any provisions that might endanger the industry's bottom line.
The number of uninsured would plummet -- obviously a good thing -- but with little potential to control costs or come up with innovations in terms of delivering care or controlling overhead, it would achieve only incremental improvements in Americans' health -- and economic -- security overall.
As such, it's a small improvement with a huge price tag. And the drop in the number of uninsured Americans would make more substantial reforms much tougher to bring about down the road.
While some argue that even without a public option, the rest of the reform package is good enough -- with subsidies to help workers buy coverage and new insurance regulations -- the reality is that while it might be an incremental improvement over the current system, it wouldn't be worthy of any significant investment of public money.
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