Friday, 9 October 2009

Dr Stangelove 2009, or, How I Learnt to Stop Fearing Socialism and Love the Public Option

I have always been sceptical of people who support increased government power explaining why this or that further incursion is “for my own good,” or prop up the action by offering that opposition to it must necessarily be due to lack of clarity, or worse, because of propaganda that has obscured. Now that the Democrats appear to be on the verge of passing some sort of health care bill (really, calling a piece of legislation that is physically larger than the Manhattan yellow pages is a stretch), and Speaker Pelosi has said that it *will* include some sort of ‘public option,’ I’ve decided to set aside my worries about Big Government and embrace the creeping socialism.

Before I get into any further detail, I’d like to start with a few clarifications ahead of time.

I think the Republican Party has contributed in a large way to the mess we are in. I voted for President Obama. I do not believe he is a crypto-Moslem plant, nor was he born in Kenya or an illegitimate president. I don’t watch Glenn Beck or listen to Rush Limbaugh. I think Fox News is tabloid rubbish. I do not own a gun, do not think that the Democrats are trying to disarm us and install a Soviet or Nazi regime. I have never seen black helicopters flying over, and am not particularly concerned about the Masons or that a black man is president.

But I do believe that the “public option,” as is being discussed by the Democrat House leadership, is a kind of soft socialism. Using monies taken by taxation from one group of people to redistribute in the form of services to others who have not paid for those services is almost the definition of socialism.

Accept it, and move on.

So, in that spirit, here is what I propose as a sort of sugar (Splenda, perhaps?) to help the socialism go down.

Let’s have a public option. But let’s make it a real option, not something delivered at the point of a tax policeman’s gun.

Let the federal government set up a true insurance scheme, run and administered by government experts. Put whatever rules into the plan that they think will make it ‘work’ (i.e., it must cover this that or the other procedures, cannot charge higher premiums according to actuarial data, cannot refuse care for pre-existing conditions, etc.). Allow it to negotiate fees, prices, and co-pay rates. Give people the option of buying into this system or opting out. The profit motive presumably would be removed, and the only goal of such a scheme would be the health of its participants.

That is what proponents such as Dennis Kucinich and Bernard Sanders argue is the fundamental problem with private insurance, and hence the motive of pushing a public option.

But this public option must be subject to the same rules as other choices. Doctors and other health care providers can freely look at re-imbursement and other factors, and choose not to take patients who use the public option.

And, most important of all, require that this public option be self-sustaining. Put simply, it cannot use tax money for funding, and must be sustained by the premiums paid in by its participants. The bottom line here is, the word “option” implies that one has choices, and that participation is voluntary, not compulsory. I like the current health insurance I have, and I do not want to see my quality of care go down (which it would with the sort of single payer scheme seen in Canada or the UK) and my costs go up (which I suspect they would given what Speaker Pelosi is pushing – expanding “coverage” to 45 million additional people).

The maths simply do not work – you cannot provide the same level of care to a larger group of people without an increase in total cost. And presumably, since these additional 45 million (or whatever number you choose) currently do not participate in the current system because they cannot afford to, they would use resources without contributing a proportional amount of money.

Put simply, health care reform, with a public option, must not be yet another means by which federal kommisars rob Peter to pay Paul.

I propose we go forward with this reform, inclusive of such a public option, and after a period of years, see how it has worked out.

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