Sep. 10th, 2009 09:47
Letter to the Editor
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cosLast night, I submitted this as a letter to the editor to USA Today:
- For decades, private for-profit insurance companies have been spreading fear about "government run health insurance". Despite the fact that people on Medicare - run by the government - are more satisfied with their insurance than people on private insurance, the private insurance companies have been telling us that national health care wouldn't work, because the government can't run a good insurance system, and we're all better off with private insurance. Obama's plan puts their claims to the test, and it's time to put up or shut up.
Obama proposes a compromise between a national single payer system, and the private insurance we have now: he wants to put a public health insurance option in the same market as private companies, to let people choose and see what works better.
Insurance companies' complaints about "unfair competition" are a smokescreen. They want to mislead us into a conversation about how to be fair to insurance companies, while they continue being unfair to the American people.
What the for-profit insurance companies are really saying is that they fear the government can run a better health insurance - that satisfies people more, and leaves us healthier, at a lower cost. They may be right. Congress owes it to us to create a public option so we can try it and find out. Stop worrying about the health of the insurance companies, and care for the health of the American people for a change.
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no subject
The answer is that the complaint is wrong, because a government option wouldn't provide "unfair competition." Like the commercial health insurance companies, the government's health insurance program would be self-funded (as in, funded by premiums). So the question is, what exactly is unfair about the government adding to the competition?
The only thing I can think of that's unfair is "another provider will be charging less than we do, stealing all our business." But that's only a valid argument if the government health insurance wasn't 100% funded by premiums -- ie, if tax money was going to the insurance payouts. Companies self-fund their insurance using premium monies, so it would be unfair if the government funded its insurance using monies that regular companies can't get (like tax revenue).
But I wasn't satisfied with that, so I did some research: http://www.heritage.org/Research/healthcare/bg2311.cfm makes the argument that government-run health insurance is unfair because:
1) The government will have the lion's share of the market . . .
a) . . . due to insuring people who aren't currently insured. (solution for commercial entities: make your non-group (ie, not offered through an employer) insurance more affordable and you, too, can insure people who aren't currently insured)
b) . . . due to being cheaper than current options. (see a) for the solution).
c) . . . and that would lead to the OMG DEMISE of private insurance (they could have made this argument better by saying that the government would have a monopoly -- which *is* unfair (historically, among service providers). Thus, even though the government is "fair competition", it's quite logical to conclude that they're *so* much better that they drive their competition away (again, fairly and legally), that they then become a monopoly (which isn't fair.) )
2) The government isn't a corporation and thus does not need to follow corporate laws. Thus, they get out of things like paying taxes,
The article says 'In reality, the "competition" would be rigged, with the government plan enjoying a number of advantages.' but it doesn't say what those advantages are.
If that's really "unfair competition", how come Wal-Mart is still allowed to provide goods at super-cheap prices?
3) The government may or may not need to follow state licensing guidelines for insurance companies. (My first thought was "duh, just look to see if Medicare and Medicaid need to follow state licensing guidelines." But it's not that easy, as each state handles Medicare and Medicaid differently.) Again, this argument could have been made much better if it was changed from "it's unfair because they might not have to follow state licensing guidelines" to "state licensing guidelines exist for your protection -- otherwise insurance companies would never pay out *any* claims. If the government health insurance program doesn't have to follow those same guidelines, those insured by it are at risk."
And then of course, if the government has a monopoly AND doesn't have to follow licensing, the state of health care in the US would get tons worse.
4) Similar to #3, private insurance can be sued with torts, which the government can't. It's unclear whether the government health care insurance program would be able to be sued with torts or not.
(continued)
no subject
6) The government has resources that insurance companies don't. We could get messages about the federal insurance program sent to us with our census forms, tax information, voter information, etc. In essence, the government has the largest list of possible leads to market health insurance to, including lots of private information (like phone numbers, including those on the "do not call" list, e-mail addresses, and mailing addresses). And they have that information already, even before a plan is formed. (I agree that this is unfair, though I doubt that the government will spam us).
7) Medicare currently is allowed to reimburse less money to the doctors and hospitals than any private insurer has been able to negotiate. This would be extended to the government health insurance plan. It is arguable as to whether that is unfair or not; but it helps catapult the government plan towards being a monopoly. And in any case, if the government decides to "negotiate" even lower, there could be a perception that the doctor/hospital has to accept that, because the government is way more powerful than them. (akin to if your landlord raises your rent, or your mortgage company raises your fees or interest rate -- you accept it until a certain pain point, because they are providing you a service and have power over you. And it's hard to deny that the government is perceived as more powerful than any one insurance company....especially if it does end up being a monopoly).
8) Even though the government health plan is self-funded by premiums, it will lose money in the first few years. That money has to come from *somewhere* -- and it will come from the taxpayer (just like if you started your own business, your private bank account covers more losses once the corporate account gets to 0). The government could charge less than the actual cost of a premium *should* be, undercutting everyone, and having the taxpayer pay the difference anyway....basically the government could lie about how much a premium should be, and cover the loss with taxpayer money.
So...after reading this....while there are *some* valid points that a government-run health insurance option is unfair, I believe those are minor points. However, *if* the government manages, in a fair manner, to drive private insurance companies out of business (which is the argument that most people are making in this post + comments as to *why* the insurance companies are saying it's unfair - because a cheaper option means less profits for them), *then* the government will be a monopoly, and *then* there is definite potential for unfairness.
no subject
I have read the rest of this thread and I didn't see a clear answer to this.
The answer is that the complaint is wrong, because a government option wouldn't provide "unfair competition." Like the commercial health insurance companies, the government's health insurance program would be self-funded (as in, funded by premiums).
I disagree, not because you're wrong (I think you're right), but because this is an illustration of the very wrongness I'm protesting with my letter. You're actually trying to answer their question. I think that even engaging that question is falling for the trap, the smokescreen that misleads us away from the questions we should care about.
If we start arguing that no, it's not actually unfair competition, they can come back niggling at the details and explaining why they think it would be unfair competition, and there's no real way to prove that wrong. The point here isn't who can convince who, the point is that they're trying to bog us down into a debate about whether this would or would not be fair competition between the public option and the insurance companies.
That is fundamentally a wrong debate to engage in. It stems from their arrogant sense of entitlement, that somehow the health of private for-profit insurance companies is important, and that it should be our goal to avoid unfairly competing with them. As long as we continue having that debate, we're on their ground, and thus, we're losing.
It's important to stop trying to answer that question. That's my point. It's the wrong question.
IT FUNDAMENTALLY DOESN'T MATTER. Even if they're "wrong", saying so is part of falling into their trap.
no subject
But I did read the thread -- you explained why you weren't following the "is it fair?" trap. However, I think that the question "is it fair or not?" deserved an answer *after* you'd already explained why it's not a good question at all.
I think it's useful to say "that's not the point! The point is that it's a smokescreen." But it's even more useful, for people who *understand* that it's a smokescreen, to go back and actually answer the question...ie, "not only is it a smokescreen, but the claim that it's unfair is wrong."
Plus, I think that using the facts, those who oppose the gov't health care plan could have made a convincing *logical* argument about why it *would become* unfair, in addition to making their *emotional* argument.
no subject
For example, one of the points you brought up was the government's ability to use its size to negotiate lower prices. In the context of "unfair competition" that seems like a possibly good point, but if you step back and look at the real goals of health care reform, you realize that that's actually a great reason *to* have a public plan - if it can do that, who cares if it's "unfair", it's *better*. That's the sort of thing that worrying about the fake "unfair competition" question can obscure. In some cases, the very things we want to accomplish may turn out go hand in hand with competing "unfairly", and where that turns out to be true, those are things we should pursue.
Plus, I think that using the facts, those who oppose the gov't health care plan could have made a convincing *logical* argument about why it *would become* unfair, in addition to making their *emotional* argument.
Perhaps the could've if they'd wanted to more, or tried harder. I don't know. Probably not - in the general public, this is engaged on a level of broader arguments, not details. What I see permeating the public is the idea that the public option might be unfair competition for private insurance companies. I don't see people convinced that they know a bunch of detailed facts that explain why that is or isn't true, I just see people bringing it up as a general concept. Blowing away that smokescreen is my goal here.