I have recently argued that the public option is now so weak and diluted that it really doesn’t amount to much. Trudy Lieberman of the Columbia Journalism Review, among the few writers to find her way through the blizzard of misleading press accounts on the subject, has done an interview with Oregon’s Senator Ron Wyden that includes his own takedown of the current public option. Here is what Wyden says:
The House public option would cover six million people and the Senate three to four million—roughly one out of eight people. United Healthcare has seventy million policyholders. Why haven’t the American people been told that under ten million would be eligible? How can six million people hold United Healthcare accountable? You never see the press writing how virtually nobody would be eligible…. I think people will be flabbergasted by the idea that the typical person is going to be virtually defenseless against the insurance companies.
The battle over the public option Wyden says, has become a meaningless political exercise, promoted by the media’s inadequate coverage of health care reform. “It’s all about the horserace and a lot of the rest is about personalities….[The press’s] idea is liberals for and conservatives against. It’s the clash on Capitol Hill over the public option. The public hasn’t been informed.”
Wyden thinks this pitched battle has distracted attention from the real issue, which is that for the “typical consumer,” health reform will change things “very little.” He believes that even if a reform bill is passed, millions of people will still not be able to afford decent insurance–with or without a public option, and with or without the proposed federal subsidies. This is because lawmakers are unwilling to seriously regulate the costs incurred by insurance companies and the rest of the profit-driven health care industry. So the entire “reform’ is ending up as a subsidy to the insurance industry. Wyden says this:
RW: If you don’t have cost containment, you can’t get affordability. Lack of cost containment flows from an unwillingness to make the special interests hold the costs down. If you don’t have real cost containment and just tell the special interests we’re going to guarantee markets and subsidies, you’re in a vise. The [comprehensive] benefits are not there.
TL: Will people still be underinsured when illness strikes?
RW: Nobody has guaranteed all Americans good quality, affordable health care. There’s no question that, under the bill, underinsurance will remain a very substantial problem. Bankruptcies will still continue. People will be paying nineteen percent of their income out-of-pocket on health care—even people with subsidies. This is going to take a toll when you’re falling farther and farther behind every year. I’m very, very concerned with the issue of underinsurance.