I have never written to my elected representatives before. I can only make that claim once, and the fact that I am doing so now should give you an indication of how important I consider this to be. I am writing about the current discussion on how to improve health care in this country. My position can be stated in one sentence: it is vital that any legislation passed include provisions for a public health option, and I am willing to accept increased taxes to achieve that goal.
As an elected official at the national level, you, more than anyone (and on this day, more than any other) should be aware of a major reason that the US Constitution was written the way it was. To put it in modern language, the founders wanted to make it difficult to game the system. For decades now, private insurance companies, whose goal is profit maximization, have demonstrated an ability to game the system to maintain those profits, and a willingness to do so at the expense of their customers. Far from being a competitive market, health care today is characterized by few buyers colluding with few sellers, none of who represent the population, either sick or well. The most important thing a public option would do is create a countervailing power, with a different objective, that will help keep the insurance companies and hospital chains honest.
I come from a military family, and a military career. I lived in Europe and Asia for six years, and I got to see how other systems worked. Recently I have been assisting an aged mother-in-law with her medical bills. She has a decent health care package as a result of her late husband’s years of work. Her own decades of work, by the way, proved fruitless – the victim of corporate mergers and destruction of retirement medical plans, well before the current meltdown. Her bills are a labyrinth of bureaucracy, apparently designed to discourage the elderly and infirm, and those who need it most. I have seen and been the beneficiary of a ‘public’ health care system since birth, and I can say without reservation that, despite it’s many flaws, it is far better than what most Americans have now.
I recognize that all systems have to ration medical treatment. Today, in the US, we do it by employment status, by socioeconomic standing, by luck, and by bureaucratic frustration. A private health industry is an important way to offer higher end treatments to those who can pay. A public option has to establish a rational method of rationing, but will have the example of the many different methods used around the world as a starting point. For example, it has been pointed out that in the Canadian system, everyone gets prompt, efficient emergency care, with moderate waits for elective surgery. High end treatment is constrained by limited numbers of specialists, not by government bureaucracy. The current US system provides an overabundance of specialists, with a shortage of General Practitioners. A private insurance system with a strong public option is the best way to go.
I also recognize that providing even minimal coverage for everyone will cost money (although not as much as the public plan critics have claimed, and there is a reasonable chance it will save money, overall). Even if it does cost more, it will be worth it, for two reasons. First, a public option will remove the uncertainty and frustration associated with today’s non-transferable employer-funded (if you have a job) system, a system that is designed to deliver profits, not health care. Second, it will be worth it because it is the right thing to do. I am offended by the fact that I live in a country that allows the poor and the unlucky to die in order to maintain insurance company profits. I am appalled that so much of my contribution to health care is wasted in a corporate bureaucracy designed to limit support for my needs. Under the current system, health care costs continue to rise, and more of every patient’s valuable time is spent digging through paperwork. These costs are at least as burdensome as higher taxes. If taxes go up, and the system becomes more reliable and available, then the extra tax is worth it.
Recently, conservative columnist George F. Will admitted that a public option would be cheaper because of the negotiating power of the government, and because it is not driven by a profit motive. He then complained that this was unfair to the insurance industry. I am not opposed to the insurance industry, and I certainly am not opposed to businesses making a profit. I am opposed to businesses profiting from the suffering of their customers. The whole point of a public option is to use the power of the government, and its mandate to provide for the common good, to…provide for the common good.
In conclusion, I urge you, our Senators and Representatives, to support a public option in the upcoming health care legislation. I know there are compelling political reasons and pressures against such support. But, the point of health legislation is to protect the health of Americans, all Americans, rich or poor, employed or (increasingly) unemployed. It is too important to be held hostage to special interest groups and politics as usual. This is your chance to rise above politics, to rise above being a politician, to become a statesman.