Elena and I were talking last night what the public option would mean and we were surprised that we did not know the answer to some basic questions. Yes, we can go to the website and find out what is in any of the 5 or so bills that are being debated in congress behind more or less closed doors. Instead, I decided to see if I could reason my way through it.
Can we individually join the poublic option and leave the insurance plan that we now are now part of through our employers? I don't think that is what we are talking about here, but maybe it is. President Obama says that if I like my insurance I can keep it. That sounds like choice to me. That if I don't like my insurance, I can get other insurance, including the public option. If that is the case we are all going to have to make some decisions pretty soon. Of course, we can postpone making a decision. By this I do not mean that we can procrastinate like what we have been doing with health care reform over the last 60 years and what we continue to do with so many social problems, need I mention social security, immigration reform, global warming, and the deficit? No, what I meant is that Elena and I can decide not to make a change for ourselves and keep things the way they are, Elena insured through her employer and I through mine.
I believe that the above described scenario is not what will happen. This is what I think will happen, assuming that the public option becomes part of the health care overhaul.
At the start, only those who currently do not have insurance, let's call them the have-nots, will be able to choose between the traditional insurance companies, and the public option. All insurance companies, private and public, will compete for the have-nots. After a while, 5 maybe 10 years down the line, the haves will get choice as well. But to make that happen you have to make insurance a choice.
Most of our citizens are currently insured through their employer, although a substantial group buys insurance privately, most notably the self employed. To many of the haves it does not look like we have much of a choice and it feels that way because we cannot get anywhere close as good a financial deal on individual insurance as we get on insurance through our employer. The choice that the haves 'have' is between our company's plan and no insurance at all. Although that may not seem much of a choice, let's be clear, none of us have to buy into our company's plans. Some of us may have a little bit more choice as we can instead take insurance from the plan offered by our partner's employer. But even if Elena were not employed, I don't think there is anyone looking over my shoulder saying "let's make sure that this Eksteen fellow doesn't forget to sign up for health insurance at his company". If I don't get insurance, that's just fine, or at least, it is possible.
That being the case, why not give the haves access to the public option right away and not after 5 or more years. Which brings me to an important part of what we should be talking about from now on: what insurance will the public plan offer? Once that plan is known, I can compare the public plan with what my current insurance covers. At that point I will have to make a decision similar to the one I make now every year, do I take the HMO option with lower out of pocket expenses, but less choice of doctors and the need for a referral when I want to see a specialist or get another opinion, or do I select a higher deductible with more freedom in choosing a doctor or specialist.
Last night I thought that the title of this blog would be "We are a nation of cowards". The premise of the article was that we, as a nation, are postponing making important decisions, that we have recurring nightmares about things that we discuss forever without making any headway. I am more hopeful this morning. This starts feeling like we are part of something that is more important and that will define us as a people. That we can have a discussion that will end with the president making the final pitch and the people doing what many of us have been longing for all those years: make a decision to accept the challenges of change and move forward with faith in the future.
On a final note, I am a supporter of president Obama. I know, he tries a lot, who knows, maybe he tries too much, but he cannot be blamed, or at least he is not by me, for trying to talk with citizens over a subject that is not simple, a subject that touches us all in a most intimate way. In the end, after 4 or 8 years, we will judge him how he 'did', how he will be remembered for generations to come. In my book, he is doing something that I value, being a president who does not shy away from leading the debate. We can talk long about how to reform health care, and we should take our time, but at some point we have to move on and tackle other important problems that we face as a country and as a global citizen. I am not asking anyone to rally behind the president, but I do ask your help in answering the questions of how to make healthcare work for us all. This is part of who we are.
1 comment:
I agree. BUT the distortion points that keep rising up are the only response that incompetent republicans keep making. Death panels, more scared people and fear is a primary republican tactic. What Obama isn't doing is making this picture clear to the undecided. He is so desperate for bipartisanship that he lets them muddy the waters for the middle-of-the-road and not-so-bright folk who are out there and still think he wasn't born in the USA.
The real enemy here is the thought that republicans are capable of bringing anything to the table. What Obama should do is give up on the republicans and destroy them as a party, much the same way we destroy bacteria with drugs.
When one sees how much money the republican vermin are spending on these disruptive tactics it gets really sad to realize that the money value is large and could be used in more constructive ways. Yet this is all they have. Obama would be wise to put them out of their misery while he has the chance and not allow them to gain traction with the morons of America.
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