May 23, 2018
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Public health plan the cure for sick private system

By Jesse Graham, Special to the BDN

Delaying medical treatment for a serious illness is generally a bad idea. At best, it can lead to unnecessarily severe symptoms and lengthy and expensive hospital stays. At worst, the outcome can be fatal. Our health care system as a whole is in a similar state of serious illness, and it makes no sense to delay needed treatment.

Some members of the Senate Finance Committee, including Sen. Olympia Snowe, are floating the idea of delaying the establishment of the new public health insurance plan intended to reduce costs and ensure universal coverage. They have suggested relegating the public option to a “fallback” that would be triggered several years down the road and only if for-profit insurance companies fail to meet certain benchmarks.

Sen. Snowe’s support for the idea of a public plan is encouraging, but her support for this so-called “trigger” mechanism is disappointing. According to publised reports, the trigger would deny the public plan to consumers unless one or two carriers monopolized the private market in their state. While it is clear that the Maine insurance market would qualify as “monopolized,” it is also clear that the problem is national. According to the American Medical Association, 94 percent of the local health insurance markets in the United States are no longer competitive.

There is a reason that health insurance markets across the nation have failed. A recent report released by Maine People’s Alliance, the Maine Small Business Coalition and the national Health Care for America Now coalition details a host of examples of private insurers “rigging the system” and colluding to drive up prices and restrict competition through controversial financial schemes. Left to their own devices, private insurance companies will continue to create monopolies, drive up prices and make profits by denying coverage to those who need it most. The idea that we would delay the establishment of a public insurance plan in the hopes that the private sector will miraculously change a decades-long pattern of profit-hungry behavior is ludicrous.

Insurers are aware of the demand and are looking for a way to derail reform. By accepting a public plan in principle but delaying its implementation, they hope to buy a little time. Once health care reform is “done” and the country moves on to other issues, they will quietly use their lobbying and market power to make sure that the public insurance trigger is never pulled.

If that sounds a bit cynical, keep in mind that the Medicare Part D prescription drug program enacted by Congress in 2003 also included a public plan with a similar “trigger” provision. The insurance companies that participate in the Part D program have failed to create effective cost controls, and they continue to provide higher prices and lower-quality coverage on prescription drugs than government programs like the VA and Medicaid. Despite this, the trigger has not been pulled, and taxpayers are spending billions of dollars each year to subsidize these inefficient private plans.

In a 2006 Harris Interactive survey, only 7 percent of Americans said they found insurance companies “generally honest and trustworthy.” Recent polls show that 73 percent of Americans currently support the idea of a public plan. Mainers have struggled to keep up with insurance premiums that have grown 5.4 times faster than wages in Maine between 2000 and 2007.

Teams of door-to-door canvassers from our organization have been knocking on doors across Maine every night, and in addition to hearing heartbreaking stories about what a lack of coverage can mean for families in our state, they’re also hearing a very consistent message: We can’t wait any longer. We should not trust private insurance companies to get us out of this mess. We need a public plan now.

Now is the time for action. Our health care system is sick, and consumers shouldn’t have to wait any longer for the right treatment.

Jesse Graham is the executive director of the Maine People’s Alliance.

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