Open Letter: The Public Option

Dear Senators and Representatives,

I am writing today about the very important issue of health care reform. It appears that something will be passed in Congress this year, but of course the details are critical. Specifically, a bill without a “public option” is unacceptable. Without that provision, the impact of any reform bill would be negligible. You must speak forcefully for the public option.

However, having a public option is just an interim step. The United States must ultimately move to a universal national health insurance system. That is why I am disappointed that you did not co-sponsor S.703 or it's House equivalent, H.676. Though each bill is flawed (S.703 has too many details about health care delivery, while H.676 is essentially a placeholder with not enough details) it is important that you endorse and advocate the ultimate goal of the bills. If you do not understand why you should, please review the following economic issues:

• A free market in health insurance is unworkable because only healthy people are profitable to insure. This fact is completely incompatible with the goal of universal coverage, or even broad coverage. By the time insurers are regulated so that coverage cannot be denied on the basis of race, age, gender, geography, existing conditions, and family history, there would be no purpose in having the insurance companies in the mix. They would merely be providing expensive claims processing.
• The very business model of health insurance creates huge, wasteful bureaucracies in doctors offices' and the insurance companies due to the endless fight over the payment of claims.
• Tying health insurance to employment adds a major overhead cost for employers, while disadvantaging small companies and entrepreneurs relative to large companies which can afford employees dedicated to negotiating lower rates.
• Healthy workers are more productive and take fewer days off (for real illnesses, at least).
• Private insurers have no incentive to invest in preventative care, and preventative care is much cheaper (in the aggregate) than curative care. Up-front investment in good maternity care also yields high returns.
• Emergency room care delivery (where the uninsured cannot be turned away) is substantially more expensive than care provided in a medical office or clinic.
• Government-run health insurance systems in other countries have proven records of costing less while covering more people and producing better results as compared to the U.S arrangement.

Many Senators and Representatives need to be reminded that the benefits of a national health insurance system for their constituents far outweigh any harm their campaign contributors in the insurance industry claim will happen. Please remind them often, and help the nation take the first step towards the ultimate goal by voting for a reform bill with a public option.

Thank you for your time.