Posted by on Sep 13, 2009 in Politics | Comments Off

The public option in the US healthcare debate appears to be in critical care right now and unlike grandma, everyone seems ready to pull the plug.

This is unforetunate. A public option – god forbid a Canadian style single payer – makes a great deal of sense both financially and healthwise.

Financially, private insurance companies would rather have nothing to do with sick people. They cost a great deal more money than they are worth. Asking insurance companies to ignore previous illness history also makes no sense so getting insurance to someone that is already sick cannot be done after the fact. The only option appears to be a mandatory insurance requirement. Or to let them die. Which doesn’t appear to be working in practice: sick uninsured people just go to the hospital.

Forcing people to get health insurance will also be difficult and enforcement even more so. When would you ask for proof? At tax time I suppose. But enforcing and double checking wlll be costly.

Financially, the insurance companies have little reason to provide coverage for the sick. They recieve little more benefit if the individual gets well again except for the continued premiums which are not guaranteed since individuals would likely want to change providers after a premium increase. Besides, how can you make health insurance mandatory if it’s not affordable.

The government on the other hand has a significant interest financially in the well being of the taxpayer. Dead people don’t pay taxes. They unsettle family finances and destabalize families in general. Families that cannot afford their houses cause a drop in housing prices in the immediate area which has a side cost to their neighbours. Schools with hungry children that just lost the main breadwinners are difficult to educate and less likely to reach their potential financially.

All of this is to say that the state has a strong interest in the health of their citizens while insurance companies have only a short term perspective by their nature. A public option aligns the parties better financially speaking.

From a health perspective, the best way to keep people healthy is to help them avoid financial ruin and all the associated stresses that go with it. Getting people the most advanced doctors is fine once they’re sick but it does little to help them avoid the need for a doctor in the first place.

Any healthcare reform must involve universal coverage and affordability. Neither of these concepts align with private interests. Pretending that they do is foolish and likely to fail.