Separate Bill Needed for Public Option

by Tyler Murphy

Last week, President Obama convened a “Health Care Summit,” bringing Democrats and Republicans in Congress together in an attempt to salvage the administration’s flagship legislative priority: health care reform. The summit made for splendid politic theater but was lacking in substance. While efforts at drafting a bipartisan reform package are laudable, the comments from leading Republicans during the summit suggest that such cooperation is not only impossible but would be detrimental to achieving the reform we so desperately need in America. There are areas of the bill on which opponents of health care will not cede any ground and two of these elements are necessary to reform the system most effectively.

First is the public option. Not a single Republican at the summit supported the public option and it’s a phrase that makes moderate Democrats in Congress uncomfortable. It’s included in the House bill but excluded from the president’s proposal and the Senate bill. A public option would establish a government-run health insurance program as one of many options from which Americans can choose. Any American satisfied with their current health insurance coverage would be under no obligation to change providers or switch to the government plan. The public option is vital because it introduces competition in the insurance market. Without excessive administrative overhead and a profit-focused accounting department, a government-run health insurance option would encourage the private insurance companies to improve their standards of business in order to retain current customers and attract new ones.

Second is the individual mandate. Republicans – and some moderate Democrats – are generally united in their opposition to this requirement. But just as every driver in Kentucky is required to purchase car insurance, so too should every American be required to have health insurance. If affordability is a problem, then government subsidies can be used to help lower-income citizens purchase coverage. When you expand coverage for those Americans who need health insurance, you will attract those most in need of insurance – and those most likely to file claims. This places an enormous cost strain on the system. What an individual mandate would do is create a counter to this surge of claims by bringing healthy people into the system – people who would not otherwise need insurance and are less likely to file an insurance claim. More people would be paying their share of the bill and lower costs for everyone.

While dispute is widespread on these two key issues, there is some agreement in other areas. Both Democrats and Republicans generally agree, that insurance companies should not deny coverage based upon a pre-existing condition or drop an individual’s coverage if he or she becomes sick. Both support proposals to increase the maximum age for dependent care – increasing the length of time students like us can stay on our parent’s insurance. And both oppose limits on the amount of health care claims one can file over a year or the life of their plan. So these relatively important areas of agreement can provide a foundation for a much broader reform that includes the integral elements mentioned above.

But how, without a filibuster-proof majority in the Senate, can Democrats accomplish this goal? First, the noncontroversial elements on which most members of Congress agree should be passed as part of a comprehensive health care bill. But it cannot end there. Given the importance of the public option and the individual mandate to any health care reform, Democrats should pass these as a separate bill through the budget reconciliation process. Stated simply, this would make the most divisive health care legislation (i.e., the public option and individual mandate) immune from the obstruction of the Republican minority since reconciliation items require a mere majority vote in the Senate.

Our health care system is in desperate need of reform. And piecemeal reform will not solve our crisis – if anything it will only exacerbate it. And “bipartisanship” is futile when it dilutes a piece of reform of this magnitude to the point of making it meaningless. When it comes to this type of reform, you cannot “make a pie a piece at a time” as Sen. Ben Nelson, D-Neb., has advocated. It’s time that the Senate’s Democratic leaders channel President Lyndon B. Johnson and stand up for the American people, against the obstruction of the Republican minority, and pass a reform measure for which this country has waited for six decades.

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