The "Public Option" Is Just Single-Payer on the Installment Plan
By Sally Pipes
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, 11.1 million instead of 21 million.
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. Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina, and Wyoming will have just one insurer per rating region statewide.
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 is to have a government-run insurance plan available in every market to compete with private insurers.
"The public option is one of those policy ideas that hits the trifecta: simultaneously simple, popular, and effective," said Yale professor Jacob Hacker.
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.
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.
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 HealthCare.gov, 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.
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. 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.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The Way Out of Obamacare (Encounter 2016).
