Public Option

Some people in this country have expressed concern that a “public option” in health care would drive out private insurance companies. The warning is repeated over and over again as though this prediction were fact. We have a history of a public option competing with private insurance companies – Workmen’s Compensation Insurance. Has it driven private companies out of the market? No.

In an 8/16/09 San Diego Union Tribune article, Dean Calbreath relates the early history of Workmen’s Comp insurance and the criticism that Pres. Woodrow Wilson endured from conservatives for initiating a public medical plan for workers. Dean recounts the century long struggle between private insurance companies and the California State Fund in this insurance market. The result? Private insurance companies in California dominate the Workmen’s Comp insurance market. Yet there are those clamoring that such a thing is impossible.

Were we to have a public option in health care insurance, a plan covering basic insurance needs, we might expect that private insurance companies would design insurance plans that filled the gaps left by such a public plan. Just as workmen’s comp insurers did in California, health insurance providers will offer competitive pricing to larger companies and command the majority of the market. Like the workmen’s comp example, the public health insurance option will appeal to small businesses and those individuals who have difficulty getting affordable insurance.

Had they been born a hundred years ago, those arguing against a public option today probably would have argued against Workmen’s Comp then. This debate is less about public insurance options and more about the role of government, a long and fierce argument that began before the founding of this country and continues to this day.

A hundred years ago, Andrew Carnegie was criticized by conservatives for his support for the use of public taxes for libraries. Public libraries did sometimes swallow up the collections of social libraries that charged a subscription fee to members. However, libraries whetted a desire for books, and private booksellers fluorished in larger cities to meet the demand for popular newly published books, a need that libraries were not designed to satisfy.

In smaller towns like Kankakee, Illinois, citizen-initiated drives for a public library were met with resounding support from their neighbors; private donations of books and land helped launch the library in 1896. Does President Obama hope that this kind of community spirit is still smoldering in the hearts of Americans?

How can any company possibly compete with a public entity as large as the Post Office? UPS, FedEx and other private mail and package delivery companies have met the challenges of this competition and fluorished. The once stodgy Post Office, in turn, has offered new services and products to compete with these private companies.

In the 1850s, conservatives protested loudly at the use of public dollars to fund free education for children. Has public education led to the demise of private schools? No.

The competition between a public option and private companies in insurance, libraries, mail delivery and education have promoted a vigorous environment which offers better choices to the public. To those who predict that a public option will kill the private insurance market, history replies, “You’re wrong.”

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