A Case for the Public Plan Option
May 28, 2009 -- We appear to be closing in on the next generation of health care reform with expectations of action by Congress as early as this summer. One of the most contentious questions is whether the introduction of a new government run, public plan should be included. Would this be the mother of all unfunded entitlements?
Is it just a coy strategy to diminish the private sector over time as has occurred in higher education? Can government and politics be relied upon to control health care inflation? If Medicare is widely considered the untouchable “third rail of politics,” what would this new public plan be?
A few years ago, the reform work of the Oregon Health Assessment Project concluded that choice should include a public option (referred to as the "civic segment"). The same compelling reasons remain: 1) significant numbers of people want a single payer system which a public plan could satisfy; 2) Robust individual choice increases the prospects of member support for the innovative practices of any given health plan, public or private; 3) Arguably, the performance of the private system would be enhanced by this disruption; 4) Perhaps the introduction of a public option would shatter existing cost shifting practices and force all choices to float on their own bottom; 5) There would be a residual need for an organized safety net for those unable to exercise other options; and 6) In the context of alternatives and personal choice, regulation could be far more tolerant and even nurturing of outside the box innovation within all health plans.
Stephen Gregg is a retired hospital administrator and health plan chief of staff. He can be reached at [email protected].
For related coverage on the public health plan option click here.