Why The Public Health Insurance Option Is Worth Fighting For

From Think Progress-

Gov. Howard Dean, former chairman of the DNC and the author of Howard Dean's Prescription For Real Health Care Reform.

In today's Washington Post, Steven Pearlstein argues that Democrats should just give up on the public option. "Enough already with the public option!," he writes. Steven thinks we should drop one of the most popular and effective aspects of health care reform simply because the fight is too politically difficult in Congress. I think such an approach would ruin health care reform and devastate the Democratic party.

Steven is confusing health insurance reform with health care reform. If we only get reform that requires insurance companies to provide coverage to everyone who applies, charge everyone the same premiums, and end their discriminatory practices, that would be great insurance reform, but it's not, as Steven writes, health care reform.

Real health care reform that includes a new public health insurance option would give Americans a real choice and not reward for-profit health insurers with 47 milllion new customers. Real health care reform that includes a new public health insurance option would cut out the administrative waste of private insurers and begin changing the way health care is delivered. Real health care reform that includes a new public health insurance option could adopt the kind of payment reforms that would start to "hold down long-term growth in health spending" and encourage providers to deliver care more efficiently. We know that premiums in the public option would be about 10 percent lower and that a real robust plan that piggy backs off of Medicare's infrastructure could save us somewhere between $75 billion and $150 billion over 10 years.

Just because the public health insurance option is "new," moreover, does not mean it's not worth fighting for. Steven points out that I did not propose a robust public option in 2004 election. The measure of good politics and policy is the ability to accept and identify new ideas. My 2004 plan may not have included a new stand-alone program, but it did allow Americans over 55 to enroll in Medicare and everyone under 25 would have been eligible for Medicaid.

I believed that government could help expand coverage and control costs then, and the overwhelming majority of Americans believe it today. If the August recess has taught us one thing, it's that Republicans have ended all serious conversations about reform and will oppose reform whether it includes a public option or not. They want to make the choice for the American people instead of letting Americans have their own choice of coverage. And if Democrats follow their lead, they will have to face the voters' choice come November.