Observations on the Public Option
I would like to mention some observations about the Public Option that is so much opposed by Republicans and conservatives.
I worked in an HMO plan called the Health Insurance Plan (HIP) of New York. The famous mayor La Guardia founded it after the Second World War to give the Unions, the Police, and the Firemen good affordable health insurance. The plan attracted a million members including other citizens who were not union members. It contracted the health care in each of the 5 Boroughs of Manhattan, Brooklyn, Bronx, Nassau, and Suffolk, with doctors who organized into a Group that included family physicians, and all the specialists. The Group received a capitation fee for each patient that joined their plan, and they used part of this capitation to spend on whatever was needed to offer the patient all that he needed in health care: clinical care in all specialties, hospitalization, and drugs. All services were covered by the patient’s monthly premium, which was paid by his union or place of work. There was no fee for service. Patients got all their health services freely, effectively and without undue waiting. It was much cheaper than the private insurances formed for profit. Our Group used to receive capitation for whatever we needed to give service to the member patients. Profit was distributed to the member doctors according to a formula agreed upon between the doctors. As doctors, we did not receive very high income comparable to private physicians, but we got decent pay with paid vacations and without the worry and headache of running our own business. The patients were greatly satisfied; they could choose any doctor in the Group without worrying about how much to pay. This plan is exactly what the Public Option is. It is non-profit, only using funds to offer the patient healthcare. That is why the Public Option comes as a great competition to the private health insurance companies, who will be forced to keep their premiums down in order to compete with the public plan. They will not be able to raise their premium every year at will.
At present, health care in the USA costs $6,700 per person compared to $2,200 in Japan. It is the most expensive and not the most effective. It increases every year and can break any economy. Many members of my family live in Canada. They are all satisfied with their healthcare. They can freely chose their doctor and there is no waiting except for some expensive procedures such as a MRI, but the USA is much richer than Canada and can afford to give those services without waiting. There is no excuse why so many countries, less wealthy than the US, can give their citizens public healthcare and we cannot. The opposition is political. It is fighting for the interest of the big private insurance companies, the drug industry and the private doctors organizations. For this fight they use lies, distortions, and fear tactics. I hope that the people wake up to those facts in time so that a health bill that includes a Public Option is finally passed.
Another interesting note: Bob Dole, who was the speaker of the Senate in the nineties and the Republican presidential candidate against Clinton, wrote in the NY Times that his opposition to Clinton’s Health Plan was really personal and political. Now he criticizes the Republican opposition and tries to convince them not to oppose the plan, but he is now 86, retired from politics and he has little influence.