Nov 10 2009
Keep this in mind when you hear opponents of the House healthcare reform bill protest that it would constitute a government take-over of our healthcare system: the Congressional Budget Office and the Kaiser Foundation estimate that a public plan would enroll only 2% of Americans. To put this in perspective, about 15% of the US population is currently uninsured or underinsured. By reason of its mandate for individuals to purchase coverage, the House bill would result in new enrollment in private insurance of a far larger portion of the population – roughly 10%. The House bill arguably does much more to grow the private insurance market than a public one.
The public plan population, moreover, would likely include the high-risk and the unhealthy in disproportionate numbers, making it if anything more difficult for the public plan to compete with private insurance on the basis of cost. Indeed, the public plan would tend to draw those persons that the insurance industry currently finds unattractive. It would not be depriving private insurance of the objects of its desire.
For further assurance that the public plan will not swallow up the private insurance market, note that the public plan is available only to those who are not enrolled in qualified or grandfathered employer or individual coverage, Medicare, Medicaid (with some exceptions), TRICARE or VA coverage (with some exceptions), plus some small businesses. The public plan, moreover, is required to sustain itself on its premiums, must meet the same requirements as private plans regarding issue and renewal guarantees, benefit levels, provider networks, consumer protections, cost-sharing – in short, must bear all the burdens to be imposed on private insurance.
Perhaps one more observation is due: these provisions of the proposed public plan relate to coverage, not to the practice of medicine. As of today, the AMA continues to endorse the House bill. We are, after all, talking about the way healthcare providers are paid, not the way they practice, except to the extent that the way they practice is informed by the way they are paid. But on that score, providers are of course already affected by the payment directives of Medicare and Medicaid, and those of private insurers, which operate with a profit motive.
Postings on this blog do not necessarily reflect the opinions of Widener University or Widener University School of Law.