October 3, 2019 | Updates

Reminder: The Public Option Is Not About Choice

WASHINGTON – As some presidential candidates and Members of Congress continue to push for a new government-controlled health insurance system known as the public option, they often present it as a way of providing an additional choice for consumers.  However, the facts show otherwise.

As Dr. Scott Atlas of Stanford University explained recently in The Wall Street Journalthe public option would “mainly erode, or ‘crowd out,’ private insurance, rather than provide coverage to the uninsured.”  Not only that, “[t]he public option would cause premiums for private insurance to skyrocket because of underpayment by government insurance compared with costs for services … A single-payer option is not a moderate, compromise proposal.  Its inevitable consequence is the death of affordable private insurance.  Even Democratic presidential candidates calling for ‘a public option’ openly admitted in the recent debate that it would inevitably lead to a single-payer-dominated system.”

Meanwhile, in a story headlined “How a Medicare Buy-In or Public Option Could Threaten Obamacare,” The New York Times reports that the public option “could also rock the employer-based system that now covers some 160 million Americans,” plus it could “raise premiums” and “prove costly” for taxpayers:

A government plan, even a Medicare buy-in, could shrink the number of customers buying policies on the Obamacare markets, making them less appealing for leading insurers, according to many health insurers, policy analysts and even some Democrats … [A] buy-in shift in insurance coverage could profoundly unsettle the nation’s private health sector, which makes up almost a fifth of the United States economy.  Depending on who is allowed to sign up for the plan, it could also rock the employer-based system that now covers some 160 million Americans … Siphoning off such a large group of customers could also lead to a 10 percent increase in premiums for the remaining pool of insured people, according to the Blue Cross analysis.  More younger people with expensive medical conditions have enrolled than insurers expected, and insurers would have to increase premiums to cover their costs, Mr. Haltmeyer said.  Tricia Neuman, a senior vice president at the Kaiser Family Foundation, which studies insurance markets, said a government buy-in that attracted older Americans could indeed raise premiums for those who remained in the A.C.A. markets, especially if those consumers had high medical costs … Dr. David Blumenthal, the president of the Commonwealth Fund, a foundation that funds health care research, said a government plan that attracted people with expensive conditions could prove costly.  “You might, as a taxpayer, become concerned that they would be more like high-risk pools,” he said.

These sobering facts point to a government-controlled health insurance system that reduces Americans’ choice and control over their care rather than expanding it, all while forcing patients to pay more and wait longer for worse care.  Remember that the next time a politician says the public option is about providing Americans with greater choice.



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