Opinion » Editorial

The Public Option



With Congress in temporary summer recess, more attention than usual is being paid to unfinished business — namely, health-care legislation, and, in particular, the clearly imperiled prospect of what is now being called, somewhat euphemistically, a "public option" for health insurance.

What that term denotes, quite simply, is a modest venture — a pilot program — whereby the federal government would offer basic health insurance as one of the many alternatives now available in the marketplace. Neither it nor anything offered by the traditional name-brand health-insurance carriers would be subject to government mandate.

To be sure, some of the more zealous advocates of "single-payer" (i.e., government-run) health insurance see the public option as a necessary precursor to what would eventually be a major, even an all-encompassing, federal role in providing affordable health care. Call that "socialized medicine," if you must, but another alternative term, "Medicare for everybody," expresses the concept better. By now, most of the elected federal officials from this area have participated in town hall meetings on the subject of health-care legislation. Some of these meetings have been disorderly, some not, but a feature of almost all of them is that at some point the question gets asked of attendees: How many of you get a significant measure of your health care from Medicare?

The show of hands is always substantial. In the case of the town meeting held some weeks back by 9th District congressman Steve Cohen, where attendees were asked to stand up if they thought Medicare had functioned overall in a positive, necessary way, a large percentage of those who got on their feet had been standing up earlier, bellowing anti-government slogans at every mention of the modest bill that was then, and still is, slowly making its way through the House of Representatives. That's the irony that is summed up in a perhaps apocryphal slogan — "Keep the government's hands off my Medicare!" — that has turned up in some reports.

A public option would offer yet one more insurance solution among many — to enhance, not abolish, the system of marketplace competition. To be sure, a public plan's overhead expenses would be much more limited than those of the private carriers, who notoriously bleed an enormous portion of their proceeds into advertising, public relations, and — these days, especially — active lobbying efforts in Congress. In that sense, a public plan would have an advantage but only in the sense that the U.S. Postal Service, a bona fide "public option" for mail and package deliveries, has a theoretical advantage over FedEx and UPS.

Yet, the last time we looked, those two monolithic enterprises were holding their own in the marketplace just fine, thank you. In fact, both giant companies came into being with the postal public option already in place and have prospered in competition with it and with each other.

There is no reason to believe that a public option in health insurance would operate to any different end.

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