Saturday, August 29, 2009

What's the Public Option, Anyway?

Fivethirtyeight.com has an essay up about people's misperceptions and misconceptions about the public option, and how it's not even accurately defined in poll questions, much less in the answers of regular voters. So here's my best crack at a short definition of the public option as it appears in the House bill that passed earlier this August:

The public option is a set of government-run health insurance options available to those who make less than 400% of the poverty line and who have no employer-provided health insurance.

Estimates of the number of people who would actually choose this option vary widely, but the range of estimates I see is somewhere less than twenty million, and somewhere more than seven million. No seniors would be affected (although they might be affected by other parts of health care reform). No person would be 'forced' into public option insurance -- there will also be standardized private options made available to the same people.

So when I see people up in arms about socialized medicine, or a government takeover, I feel like there's a certain amount of disinformation at work -- this is a policy that bends over backwards to make sure that everybody gets to choose the insurance they want. It simply creates opportunities for working families, small business employees, and others who make too much to be eligible for Medicaid, but not enough to be able to afford terrifically overpriced private insurance. The argument that the public option will put private insurers out of business assumes 1) that the government-run insurance option will be so successful that private insurers can't compete, and 2) that our system of private insurance is somehow financially dependent on the working poor and the lower middle class -- that they'll collapse if 10-15% of the population, many of whom are uninsured or underinsured, choose a government option. That doesn't, to me, make sense -- how can you price a group of customers out of the market, deny them the opportunity to be covered, and then turn around and argue that you can't survive without them?

For more, here's a description of the bill at OpenCongress and a journalist from the Nation describing the public option.

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