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Healthcare and a Public Option

Posted by tigerhawkvok on September 15, 2009 23:16 in politics

A brief comment on healthcare:

A healthcare bill makes no sense without a public option. Whether or not you think there should be a bill is irrelevant to this point. The message that should be out there, on both sides, is that there's no point in debating a bill that does not have a public option, nor is there a point in sponsoring a bill without a public option.

The public option in the US would be fairly different from the way it is in other countries. It would not be mandatory, and indeed, its principle point to exist is to provide a low-level baseline for people of low means (and is thus affordable). If that were the only point of it, yes, it would be a bankrupting bill that would be a colossal tax burden. However, arguably the primary point of a public option, which is often overlooked, is that a public option will serve to compete with private firms, driving down costs via competition. The healthcare system is in a very similar state to our broadband infrastructure — an undercompetitive, and monopolistic mess. This helps everyone — and the individual savings would offset your own tax contribution to a public option to help those who cannot afford a more comprehensive private option. The end result is everyone saves money, and the system is very, very cheap. No options are being removed, only one option being added.

Now, it is perfectly logical and consistent to be against public options in general, but then to be consistent you must be against medicare and medicaid, which is essentially the same system. Ditto for welfare, foodstamps, and unemployment checks. Once you accept that any of these are permissible or even required, then you acknowledge there is some baseline support that a government should provide people in bad times or with low means. Then, to paraphrase a famous quote, we are just haggling over price. While it is possible to support food stamps, unemployment, or welfare without supporting a public healthcare, public healthcare is just a superset of medicare, which is public healthcare for seniors. Thus, if you support medicare, you cannot, consistently and logically, protest against public healthcare. And, for reasons given above, since public healthcare is ill-posed without a public option, you essentially must support a public option if you support medicare.

While there is an argument that the government should provide none of these support programs, and it is internally consistent, it is vital that one recognizes that acknowledging any of these aspects as valid means that you agree in principle, and that you must then define your boundaries, and the logic for those boundaries. Furthermore, that same ideology is almost invariably coupled with a strong capitalism, and thus it almost makes no sense to try to convince people to vote against their own immediate interest (not quite, but as a sweeping, immediate generality it works). Weakening either strong position to any degree accepts either the premise of government intervention on behalf of its people, or on behalf of stimulating competition, both of which the public healthcare option accomplishes.

In 1.5 hours I will lose my health insurance, and will be unable to afford a replacement. I suppose I just hope I don't get sick.

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Re: Healthcare and a Public Option

the count of los angeles | 09/16/2009, 08:28

I mostly agree with you BUT

there is something about the government competing with private industry that doesn't seem fair: they get to set the rules, they don't have investors to punish them when they go massively in debt and the government never risks having to declare bankruptcy. competing with the government is always unfair.

look at the post office. it's alright though far from perfect. it's losing money. and it gets to stay in business. no one uses fedex to send a letter so it has a monopoly on that market. so much for competition.

i'm not against the public option. i'm not for it either. because although there are very serious problems with the proposals, the biggest being that there isn't a direct and honest discussion about it's costs (since when have politicians ever been direct and honest about the costs of anything they do?) but to say that government run industries encourages competition isn't right in the long run, and we have examples to have shown that.

maybe there's something different about medical insurance or about this bill's government run program that'll make it different? who knows, there are so many variables that to make any absolute predictions about the future of the economy or a particular business is an exercise in foolishness. hence i'm willing to wait and see what the final proposal looks like and see how it operates before i judge it.

hopefully there's enough money to keep the courts open, the police on the streets and the firefighters paid by that point.