The public option sounds like a step toward universal health care, but it’s really a delay tactic. The latest versions would force public plans to mimic private insurers, while the fight over the arcane details buys the industry another decade or two.
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The difference between a vampire and a bad health care policy idea is that vampires jump out of their coffins and drink blood at sunset. Undead health care proposals emerge from think tank closets and suck the life out of useful ideas when the sun rises on a national health care debate. As public fury at exploding costs and deadly corporate claims denials boils over into historic Democratic election gains, can someone please find a wooden stake for the public option?
Improved and expanded Medicare for All would give everyone full coverage at much lower cost than the combined private premiums, taxes, and out-of-pocket payments that are eating up family income today. But it violates a cardinal rule of federal politics: never do anything that causes corporations or the ultrawealthy any pain.
Instead, corporate Democrats wanting to be seen “doing something” about the imploding US health care system have long peddled a vague public option notion because it sounds like the marriage of a big noncorporate vision (it’s public!) with competition and freedom of choice (it’s an option!). Liberal nongovernmental organizations (NGOs) and pundits revived its rotting corpse in response to pro–Medicare for All candidates’ primary victories and Tuesday night’s stunning results.
It’s a perfect nonsolution to our three-headed crisis of health care cost, access, and quality. Nobody knows what a “public option” is because there’s no common definition and nothing like it has ever been seen in the wild, so it can be anything weaselly politicians want it to be. It needs to be put out of our misery.
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The worst thing about public optionism is enduring smug lectures that Medicare for All is a political fantasy that could never happen from people promoting a vague, unworkable idea now enjoying its twenty-third year of politically viable nonexistence. Yet The American Prospect casually assumes that a series of essential Medicare for All elements against which the industry will fight like rabid dogs can easily be grafted onto a public option.
Health care is a public good. Pretending that having government act like a health insurance corporation will do anything useful is absurd. Let’s kill this putrefying political monster right now.