A decade and a half ago when the Clinton health care plan thumped down on this citizen-viewer’s desk in its thousand-page majesty, the c-v pronounced it dead on arrival. Not to brag, but the c-v added that it would kill any future reform efforts for at least ten years, and it did.
Like one of Dr. Moreau’s hideous experiments, the Clinton plan was doomed not only by its irrationality but by its complexity. This complexity was built into its genetic code by the major private insurers that fathered it.
President Obama’s health care plan is strategically vague and thus not subject, yet, to the range of specific attacks that killed the Clinton plan. It is not a Maginot Line but a submarine, lurking in the deep.
At this point its most visible feature, and the one getting the most attention, like a conning tower above the waves, is that a public option be available to compete with private insurance for the loyalty of the customer base (that’s us, citizen-viewers).
The thinking here seems to be that a properly run, publicly financed system can compete well on a level playing field against private insurance.
However, the fact is that on a level playing field, public financing of health care would cream private financing every time, and by a wide margin. That’s been proven by variations on public financing all over the world. It’s proven by economics, by mathematics, by logic and by experience.
The problem is that the private health care financing industry doesn’t want a level playing field any more than it wants a publicly financed universal health care system from the get-go. The industry will fight to the death to cripple any public plan. Its very existence is at stake.
So there’s an inherent contradiction in the concept: For private plans to be viable, the public plan must be cut off at the knees. (And by the way, putting a public plan into a private marketplace is to cut it off at the knees. As long as we are customers for insurance, rather than citizens choosing health care providers, we’re toast.)
The possible outcomes of the Obama approach are basically two:
1. The industry wins the political fight, and we see an unfair but ‘equal’ competition, or
2. The industry’s back is broken and we see a competition in which the public option is so obviously better that the private options wither away and die the deaths they deserve.
Believe it or not, some health care advocates, appear to be fighting for option 1.
We deserve better. For the vast majority of citizen-viewers—those who aren’t health insurance executives or major stockholders, only outcome 2 can be acceptable. Yet the industry will fight to the death to avoid outcome 2.
The central fact of the health care financing issue is that quality, efficient, cost-contained health care for all on the one hand, and private insurance on the other, are mutually exclusive. The private health insurance industry has to die.
There’s only one way to win this fight. We citizen-viewers must break the back of the health care finance industry, and we must break it now.