Herald News

Public Health Insurance Option A Must

Herald News / NorthJersey.com — Wednesday, August 19, 2009


A health care insurance co-op would work well if you’re on Wall Street.

Carl McDonald, a health industry analyst for Oppenheimer and Co., said in June that the creation of co-ops would be "a big positive" for publicly traded insurance companies that own managed care groups. Remember the HMOs, folks?

Sure enough, a day after Health and Human Services Secretary Kathleen Sebelius showed signs of wavering from the public health care insurance option, the profits began to rain on Wall Street.

Shares in Aetna jumped almost 5 percent on Monday, with United Health Group and Well Point also showing a jolt in share prices on a day when the Dow average fell almost 200 points.

It only took a few words and a day to get a rally going for the few. The reason? Co-ops, McDonald said, are destined to fail. Savvy investors know a field day when they see one.

Meanwhile, the nation’s 46 million uninsured people moved farther away from the help that is needed in a public health insurance option. We taxpayers are expected to continue absorbing the cost of uninsured patients receiving health services received at emergency rooms through charity care.

Why is a national health insurance co-op doomed?

It has to be built from scratch. It’s a new business that has to develop its own health care provider network. To do that, it will have to attract doctors and hospitals with contracts better than those currently sewn up by the insurance corporations.

The co-op simply will not have the size or the business volume to offer providers with a competitive option. That’s exactly what the defenders of the insurance companies want.

They talk about the importance of a "free market system," but what they really want is a controlled market in which only a few will profit.

A co-op can’t compete

In others words, a co-op won’t be able to compete in a market where most states — including New Jersey — have a couple of insurance companies controlling a vast majority of the health care market. That’s not competition. That’s simply an arena in which our premiums will continue to rise at an unsustainable pace.

As a member of the House Ways and Means subcommittee on health, I have heard similar criticisms applied to the proposed government-run public health insurance option included in America’s Affordable Health Choices Act.

The criticism leaves me cold.

Those of us who worked long hours to write the legislation had every intention of sending shockwaves through private health insurance companies with an insurance plan backed by the strength and principles of the federal government.

While we don’t have a special grief against the insurance companies, they are a part of the problem.

For too long, the private sector has been more diligent in interfering with doctors’ care of their patients by finding reasons to deny diagnostic tests, treatments, medications and even preventative care.

For too long, those with chronic conditions have been denied insurance coverage.

For too long, seniors have fallen into Medicare Part D’s "doughnut hole." They have paid into a prescription drug plan that gives them no benefit when their drug costs are greater than $2,700, forcing them to pay out-of-pocket until their costs reach $4,350.

It’s time to bring more conscientiousness to capitalism in the United States, and there’s no better opportunity than by providing a public health insurance option.

The public health insurance option is a wake-up call to private insurance companies to heal themselves.

They must return to their core missions of providing for those in need with the help of those who are vesting their dollars in the company out of the trust that the benefit will be returned to them when they are in need.

While private insurance companies are getting in shape, the public health insurance option will be a direct benefit to the American people.

Coverage for 77,000

In the 21 towns of the 8th Congressional District, 77,000 uninsured people will have access to quality, affordable coverage with the help of the public option.

Through the bill that I helped to write, hospitals in the 8th District – which have been decreasing in number due to escalating costs – would get an annual payment of $100 million in care for the uninsured.

I commend President Obama for his courage to put the challenge of health care reform to us in the first year of his presidency.

Clearly, this is a time that can try a president’s soul. I call upon President Obama to resist the temptation of forsaking the public health insurance option for the sake of winning votes from detractors.

The president must lead the nation to its highest ideals by insisting on a public option. This is not only for the sake of enabling all Americans to access the care they need. It is about restoring the United States to a nation of citizens who care for one another and who believe we should demand the same integrity from our insurance providers as we do from our doctors, nurses, hospitals and everyone who provides health care.

President Obama’s election last November was, for all Americans, a great victory.

Health care reform without the public health insurance option would be a hollow one.

Rep. Bill Pascrell Jr., D-Paterson, represents the 8th Congressional District of New Jersey.

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