Santa Cruz science writer Jennie Dusheck, who has been through the mill with our health care system, circulated a letter about the "public option" debate via email, to friends, and I believe it deserves a much wider readership.
Her letter was in response to Harvard economist Greg Mankiw, who had posted a blog entry titled "What's the point of a public option?"
http://gregmankiw.blogspot.com/...
Jennie asks: What is the point of a private option?
Nothing I've read clarifies the madness of the status quo as well as this.
Date: Sat, 25 Jul 2009 23:58:49 -0700
To: ngmankiw@harvard.edu
From: Jennie Dusheck
Subject: Re: "What's the point of a public option?"
On June 5th, you blogged:
It seems to me that this passage, like most discussion of the issue, leaves out the answer to the key question: Would the public plan have access to taxpayer funds unavailable to private plans?
If the answer is yes, then the public plan would not offer honest competition to private plans.
Dear Professor Mankiw,
Given your assumptions, your logic is unassailable. But not everyone considers honest competition among health insurers the key question, or even a key question. Some people consider universal coverage, reasonable cost, and genuine pooling of risk (as opposed to excluding those most likely to need care) to be the key health insurance issues facing us. How much longer must millions of Americans go without health care?
We don't cringe at the idea of pooling risk for things like public education, fire protection or national defense. Nobody says these systems are perfect, but they help more people than Honest Competition. Honest Competition is great for selling vacuum cleaners and other things we don't really have to have. It's not great for the welfare of the people. What if national defense only protected the states and industries least likely to be attacked in a war? What if we only educated kids who already knew how to read and write? What if fire departments only put out fires that were cheap to put out and announced that rescuing people from burning houses was too dangerous and expensive?
But I'm biased. My own health insurance went up 37% this month, 400% in the last 5 years. The premium alone took up half my income last year. AND I don't have any real choice of doctors. I literally cannot pay this new bill in any sustainable way. Maybe another month or two. But then what? So this week, I am contemplating joining the ranks of the millions of uninsured Americans. This is the bitter harvest of Honest Competition.
I didn't bring this on myself; I don't abuse alcohol and don't smoke. I eat properly, exercise regularly. I've had low blood pressure and low cholesterol all my life. I don't have diabetes, cancer or heart disease. I don't need an organ transplant. I go to the doctor only when I absolutely must and I do what they recommend and don't beg for needless procedures. But in 2004, I broke my back when an airport shuttle bus driver shut his doors on me, as I was on my way to a stem cell conference. In a mere moment, I became uninsurable if I ever leave my current HMO--and they clearly would like for me to leave.
I've paid back my HMO for the surgery I had in 2004. I have paid easily half a million dollars in federal taxes in my life (nothing like what you've paid, I'm sure). Surely basic medical coverage for every American, including even me, is more important than ensuring a fair game for a collection of corporations that are not even living entities (even if they like to play at being persons). Honest Competition is for basketball games, not health care. A decade ago, HMOs had so much surplus cash that Wall Street was betting on where the HMOs would put it. An amusing and potentially lucrative game if you had a chance of winning. I hope you'll consider taking this problem more seriously than you seemed to in your blog. It's not a game for a lot of us.
All the best,
Jennie Dusheck
Science Writing & Editing
(and college textbook author)
Santa Cruz, CA