The ‘Public Option’ Is Just Single-Payer on the Installment Plan

Obamacare’s government-run insurance markets are collapsing. Insurers are losing millions of dollars — and proposing double-digit premium hikes combined with high deductibles to try to stanch the bleeding. It’s no wonder that exchange enrollment is roughly half what the Congressional Budget Office predicted.

So what’s the left’s answer to this government-caused debacle? More government, naturally. This time, Obamacare’s partisans are calling for a new government-run insurer to compete against private insurers in the exchanges. This “public option” is only a precursor to a full-blown, government-run, single-payer healthcare system.

Thanks to Aetna’s decision to pull out of all but four states — and defections by UnitedHealth, Humana, Blue Cross, and others — one-third of the country will have only one insurance carrier to choose from next year. According to Avalere, a consultancy, Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina, and Wyoming will have just one insurer per rating region statewide. As of right now, there will be no insurers on the exchange in Pinal County, Arizona.

The people who engineered this mess should be hanging their heads in shame. Instead, many of them are celebrating — not because Obamacare is failing but because they see its failure as an opportunity to push for still more government control over Americans’ health care.

The best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans,” said Robert Reich, a former Labor Secretary under President Bill Clinton.

But progressives face the same problem pushing single-payer they always have — the public won’t stand for it. So they’re dusting off an old idea that will get them to single-payer without using those words.

It’s called the public option. The idea, which was included in some of the initial drafts of what became Obamacare, is to have a government-run insurance plan available in every market to compete with private insurers.

Despite a massive campaign by left-wing advocacy groups and the backing of President Obama, the public option died when centrist Democrats in the Senate refused their support.

But today, those centrist Democrats are gone. Hillary Clinton has endorsed it. Bernie Sanders says he will make it a priority next year. The Progressive Change Campaign Committee is boasting that “the stars are aligned” to make it a reality this time.

“ The public option is one of those policy ideas that hits the trifecta: simultaneously simple, popular, and effective,” said Yale professor Jacob Hacker.

Hacker is considered by some to be the “inventor” of the public option, so his enthusiasm is understandable. He’s also all but admitted that the public option will invariably lead to single payer.

“We’re going to do it in a way that we’re not going to frighten people into thinking that they’re going to lose their private insurance,” he said in 2008.

Hacker is hardly alone in his assessment.

An early version of Obamacare-style reforms developed for California — but never enacted — was called CHOICE. Like Obamacare, it would have created an exchange with private managed care plans as well as a public option. A paper describing it was titled: “Getting To A Single-Payer System Using Market Forces: The CHOICE Program.”

Writing in Health Affairs, Helen Halpin and Peter Harbage noted that “progressives supported (the public option) as a voluntary transition toward single-payer insurance.”

Mark Schmitt, in an article published by the left-wing American Prospect, called it “a kind of stealth single-payer.”

The government can price a public option however it wants and absorb any losses with deficit spending. Private plans can’t do the same; they’ll eventually go out of business. In fact, that’s exactly what happened to 16 of the 23 state-sponsored CO-OP plans created by Obamacare.

Consequently, a public option could easily end up being the only option available on the exchanges.

The idea that a public option would be “simple, popular, and effective” is laughable. After all, that’s precisely what Obamacare’s cheerleaders promised that the law would be. Remember? “Just visit, and there you can compare insurance plans, side by side, the same way you’d shop for a plane ticket on Kayak,” said none other than President Obama in 2013.

It’s hard to comparison-shop when there’s just one plan on offer, as many consumers will discover this fall.

Now the folks who brought the American public Obamacare are claiming after almost six and a half years that just a little more government meddling will do the trick.

If that doesn’t work, they’ll no doubt argue for more.

The end game is clear. And single-payer health care has been an unmitigated disaster everywhere it’s been tried. The government-run Veterans Health Administration is a monument to waste and inefficiency, where veterans can die on a wait list to see a doctor — even as the agency spends ever-greater amounts of taxpayer money. In Canada and the United Kingdom, patients suffer from a chronic lack of access to advanced equipment and therapies — and months-long waits for care.

The very last thing our nation needs is to move closer to single-payer by implementing a public option. Americans need health reform that empowers doctors and patients — not the federal government.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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