As the health care reform debate shifts into high gear, we need to make sure that the reformers have the right priorities. The fundamental issue before us is what is the purpose of our health care system – the health of the American people or the health of the private insurance companies? Frankly, these two priorities are increasingly at odds with each other. As Atul Gawande’s celebrated New Yorker piece reminds us, patients are best served, at the lowest cost, in locations where the medical culture is focused on the health of the patient instead of making a profit. Because private insurance companies are for profit entities, they are institutionally poorly suited to best serve the needs of the patients. This does not mean that all private health insurance companies are bad, of course, but it does explain why they are fighting the “public option” tooth and nail in this health care reform debate. Their argument against the public option is that it is unfair to make private insurance companies compete with government provided health care. Why? Because the government can provide services at a lower cost so the competition would be unfair. Are you kidding me? All this argument proves is that the public option might hurt the private health insurance industry.
Currently the profits of private insurance companies account for 30% of the cost of our health care. It’s time to face the fundamental question – how much does preserving the outrageous profits of the private health insurance companies matter? Is it worth sacrificing access to health care at an affordable cost? That’s really what’s at stake in the “public option” debate, and the answer to the question is obvious. Interestingly, polls show that almost 80% of the American public supports a public option. While Americans may distrust the government, they apparently distrust health insurance companies even more. For the health of the nation, we need the public option.