Montgomery County GOP

After this past week it certainly should be crystal clear that the primary objective of advocates for a government-run health care option is the transition of the US healthcare system into a single payer government health system.
 
Consider the rage on the left at the Obama Administration's suggestion that it might compromise on the point.  According to Howard Dean: "The worst thing that could happen is to pass a bill without a public option." Apparently every other aspect of health care reform, from cost control to covering the uninsured, is secondary to Dean.
 
Although liberals are now facing polling data from NBC/WSJ that 47% of Americans oppose the public plan, versus 43% who support it, the left continues to dig in.  Washington Post columnist Eugene Robinson writes: "Giving up on the public option might be expedient. But we didn't elect Obama to be an expedient president."
 
According to House Speaker Pelosi: "There's no way I can pass a bill in the House of Representatives without a public option." On his MSNBC show Ed Schultz told one Obama official this week that the left is seriously considering dumping support for the President for dropping the government option.
 
Wow!  Evidently this government-run plan is a very, very big deal to the left.  It is not just one part of their plan - this is the heart of their plan.
 
Both government-run option supporters and detractors appreciate the connection between it and a transition to a single payer system.  If the government-run option is passed, employers will be able to tell employees that health care is no longer a company-provided benefit and direct employees to the post office where they can pick up the necessary forms to enroll in the government-run plan. 
 
Responsible estimates suggest that in the early stages half of employees could see their private coverage dropped.  Over time, as private coverage costs increase, the government-run option would evolve into become a single payer system by pushing other alternatives out of the market.
 
"Government Option" advocates like to say their plan that can compete on a "level playing field" with existing health care payers. For this, Freddie Mac and Fannie Mae come to mind, not to mention AMTRAK and the Postal Service.  Many of these government enterprises have crowded out their competitors, all the while having to be bailed out financially.  
 
"Government Option" advocates also argue that they "only want another choice to compete with profit making alternatives."  Yet there are already many non-profit alternatives to choose from.  For example here in Maryland, not-for profit CareFirst is the largest health care insurer in the region.  CareFirst is not alone, not-for profit and for-profit payers compete side by side across the country.
 
Creating a government-run plan is also not really about creating a new choice.  Free market health reform advocates have long proposed that choice be expanded to allow consumers to buy any health plan being offered anywhere in the country, not just plans approved by their local insurance regulators. Liberals have fought to preserve local insurance mandates, even though the largest employers can avoid these local requirements through self-insurance.  Similarly liberals have opposed allowing small businesses pooling their buying power through "association" health plans.
 
So when finally pressed with the likelihood of an emergence of a single payer system, government-run plan supporters usually profess that they are not the least bit troubled by that prospect and neither should be anyone else.
 
Consider then the "Chaoulli v. Quebec" court case.[1]This is a 2005 Canadian court decision ruling that the Quebec Health Insurance Act and the Hospital Insurance Act prohibiting private medical insurance in the face of long wait times violated the Quebec Charter of Human Rights and Freedoms and the Canadian Charter of Rights and Freedoms. The court said: "The prohibition on obtaining private health insurance... is not constitutional where the public system fails to deliver reasonable services."
 
The Court's reasons are worth considering:
 
"Governments have promised on numerous occasions to find a solution to the problem of waiting lists. Given the tendency to focus the debate on a socio-political philosophy, it seems that governments have lost sight of the urgency of taking concrete action. The courts are therefore the last line of defense for citizens."
 
"This brings us to the evidence ... on the experience of other developed countries with public health care systems which permit access to private health care [the evidence shows these countries have] delivered to their citizens medical services that are superior to and more affordable than the services that are presently available in Canada."
 
Back in 1993 Hillary Care supporters said we should look to Canada's health care experience, and they seem to be right in 2009.
 
Mark Uncapher, Chairman
mark@uncapher.net