There's nothing un-American about a public option

This is the second part of a two-part column.

The U.S. federal highway system has proven to be more efficient and cost-effective than any network of privately owned, toll-taking turnpikes, nationwide. Our U.S. military, State Department and USAID are all examples of potentially sound, government-run operations engaged in national security and foreign affairs. They are American public options.

Unfortunately, the conservative Bush administration privatized and outsourced many of these functions to for-profit corporations, such as Dick Cheney’s “no-bid� Halliburton, Brown & Roote, Blackwater, alias Xe, Titan Corporation and CACI International. These corporations and their top executives have creamed billions of taxpayer dollars in profits, while engaging in fraud, deception, tax evasion, incompetence, false imprisonment and torture — thus producing the best possible recruitment poster for global terrorism and anti-Americanism worldwide.

If we want competence and integrity in peaceful nation building, democracy, development, control of nuclear weapons, environmental protection, and international health work, let’s use USAID, NGOs, the UN, UNDP, UNEP, IAEA, UNICEF and WHO, for the “global citizen� work they are specifically designed to do. They are American-designed, American-funded, not-for-profit public options. We are free to use them or not. All we have to do is rejoin the community of nations, and make better use of our not-for-profit governmental, non-governmental and intergovernmental agencies and organizations — our public options — to strengthen America’s standing in the free world.

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So, what’s the problem with adopting public options in health? Most Americans do not realize that close to 60 percent of all American spending on health care is already mediated through government-run programs: Medicare, Medicaid and the VA. President Obama simply wants to streamline these programs, and clean up the rest of the 40 percent, where the private health insurance industry has let us down, putting the United States in 37th place in terms of health outcomes versus costs, according to the 2009 report of the World Health Organization (WHO). How shall we go about  this task? The answer is obvious: focus firmly on the public option.

“If I ran the zoo, I’d make a few changes, that’s what I’d do,� said Dr. Seuss. I would “mandate� (meaning require) Obama’s principal reforms for the public option only — not necessarily for the private sector.

These reforms include: (1) No discrimination for pre-existing conditions; (2) No exorbitant charges; (3) No cost-sharing for preventive care (e.g., immunizations); (4) No dropping of coverage for the severely ill; (5) No gender discrimination; (6) No annual or lifetime caps on coverage; and, yes, (7) Extended coverage for young adults; and, yes, (8) Guaranteed insurance renewal.

That’s the WHO way, operating in the black in some 200 countries. So why not make it the American way?

I would not “mandate� the above reforms for, or impose additional excise taxes on, private insurance policies or corporations. However, private insurace providers will doubtless be “incentivized� to adopt the above public option reforms voluntarily, as a result of head-to-head competition in the free marketplace. That, too, is the American way.

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Would the public option drive private insurers out of the health-insurance market? Possibly, yes, if they failed to compete, or refused to reform. Nevertheless, President Obama is right: Even under a public option or single-payer system, there will still be room for private insurance, especially for secondary or back-up insurance. What’s the evidence?

Take France, ranked number one in health outcomes versus cost by WHO. Most Americans do not realize that while nearly 100 percent of Frenchmen have national health insurance, fully 92 percent of Frenchmen have private secondary coverage as well. Public and private options can and do co-exist. As a result, no Frenchman has ever been bankrupted by medical costs. Compare that with tens of thousands of bankruptcies in America.

The German national health-insurance system, around since 1880, is so highly regulated by the government that it looks to us like a single-payer system. In fact, the German national health-insurance system is delivered by 240 independent, private insurance companies. Yet no German has ever been bankrupted by medical costs.

Germany has done it their own way. That’s an option we could pick: tight government regulation. Thus, there’s more than one way to skin a cat. Let’s cherry pick what’s best for America. If we don’t like apple pie, let’s try cherry.

It is high time we Americans get our collective heads out of the false ideological sand dunes, and realize that what our democratic “socialist friends� are doing in public health care (and beating us at it) is worth imitating. Public health, like public education, is perfectly American, humanitarian and right. Let’s do the right thing and do it now.

Sharon resident Anthony Piel is a former director and legal counsel of the World Health Organization.