THE BIG QUESTION, June 9: The Government Healthcare Option

The Big Question is a feature where influential lawmakers, pundits and interest group leaders give their answers to a question that’s driving discussion in news circles around the country.

Some responses are gathered via e-mail, while others are gathered in person via tape recorder.

Today’s Big Question is:

Can healthcare reform pass Congress with a government-run option included. Should it?

See responses below from: Sen. Bob Casey (R-Pa.), Sen. Lindsey Graham (R-S.C.), Sen. George Voinovich (R-Ohio), Sen. John Kerry (D-Mass.), Sen. Tom Harkin (D-Iowa), Sen. Mark Begich (D-Alaska), Sen. Mary Landrieu (D-La.), Rep. Steven LaTourette (R-Ohio), Celinda Lake, Michael Tanner, John Sweeney, Chuck Donovan, Marian Wright Edelman, Deepak Bhargava, James Gelfand, and Anna Burger

Read the last Big Question here.

Sen. Bob Casey (D-Pa.) said:

“Yes and yes. I sure hope we can have a public option, and I believe we can get there.”

Sen. Lindsey Graham (R-S.C.), said:

“No, it shouldn’t. And I don’t know.” [laughs]

Sen. George Voinovich (R-Ohio), said:

“From what I can understand from most people, I don’t think it will happen. To have a government program I think you’re gonna have to bring a lot of people to the point of killing it. You know we’re in a life you gotta crawl, then you walk, and then you walk, and then you run. So I think that there’s going to have to be some major compromises if this is going to pass. You know if it ends up with everybody’s mad, that’s a good program.”

Sen. Tom Harkin (D-Iowa), said:

“I’m In favor of a public option. Forecasting Congress is a sport itself. Clearly, I would like to see it pass.”

Sen. John Kerry (D-Mass.) said:

“It’s not a government-run option. Nobody has a government-run option, other than Medicare and Medicaid and veterans.”

Sen. Mary Landrieu (D-La.), said:

“I’m not open to a public option. However, I will remain open to a compromise. A public option is not something that I support. I do not think that is the way to go. But in the spirit of trying to find a way to get a healthcare system in America to cover all Americans that is less expensive, more available and can’t be taken away, I am willing compromise. I think a public option undermines the essence of our efforts to create a market-based system with safe guards for consumers. I don’t think that a healthcare bill with a public option can pass the Congress.”

Sen. Mark Begich (D-Alaska), said:

“I think it’s hard to say whether a healthcare bill with a public option can pass Congress. It depends how the bill is crafted. Issues such as a trigger are going to be important. I’m not sure where I fully stand at this point. I think there needs to be strong competition in the system, and I think that is what President Obama is trying to do with the public option. I would be cautious of any public option until it is all laid out.”

Rep. Steven LaTourette (R-Ohio), said:

“Anything can pass through that the majority wants to pass through because they have the votes. But the government-run model doesn’t excite me very much. But you know what? I mean, they haven’t released all of what they’re looking at. I’ll be fair, and we’ll look at it and decide.”

John Sweeney, President of the AFL-CIO, said:

This is an exciting moment for the millions of Americans without health care. Finally, we have a president and Congress committed to fixing the healthcare crisis in this country. We will create a uniquely American solution that fosters choice, competition, and opportunity for all Americans to choose the health care that works for them.

Health care costs are crushing families, business and government at all levels. We cannot cover everyone without bringing down costs and we cannot control costs without getting everyone in the system.

A public health insurance plan option makes reform work. It will bring down costs and guarantee quality affordable health care for all. Giving everyone the choice of a strong public health insurance plan option will inject needed competition into the market, drive down costs and improve quality across all plans. A public health insurance plan option will also have lower administrative costs than private health insurance plans and it does not have to earn a profit. It also means that health care will be there for all of us, no matter what. READ THE FULL RESPONSE HERE.

John Castellani, President of the Business Roundtable, said:

There’s no doubt that we need health care reform and we need it now. Just look at the results of Business Roundtable’s recent Health Care Value Comparability Study: for every dollar the United States spends on health care, our G-5 competitors (Canada, Japan, Germany, the United Kingdom and France) spend approximately 63 cents – yet the health of our workforce trails theirs by 10 percent in a composite measure. True reform of the health care system must emerge from the uniquely American principles that drive our economy: competition, innovation, choice and a market that serves everyone. Rather than creating a new public plan, Congress should focus on enacting robust insurance market reforms. They should build on the strength of the current employer-based system, making it more efficient and transparent. This will enable them to deliver greater value to consumers and provide more options for both employers and individuals to obtain coverage.

Michael Tanner, a senior fellow at the Cato Institute, said:

The so-called “public option,” more accurately defined as the “government-run plan,” would be the first step toward wiping out the private insurance market as we know it. Regardless of how it is structured or administered, such a plan would have an inherent advantage in the marketplace because it would ultimately be subsidized by taxpayers. It could, for instance, keep its premiums artificially low or offer extra benefits, then turn to the U.S. Treasury to cover any shortfalls. Consumers would naturally be attracted to the lower-cost, higher-benefit government program.

Whatever rules the public plan started with, they would soon be changed to ensure its advantage over private insurance. How long could a Congress that is busy bailing out banks and automobile companies because they are ‘too big to fail” resist subsidizing the government’s insurance plan if it began to lose money? Could a Congress that has been unable to control the unsustainable cost of Medicare set and keep premiums at market levels? It seems unlikely. READ THE FULL RESPONSE HERE.

Marian Wright Edelman, President of the Children’s Defense Fund, said:

Both the American people and the President have made it clear that they stand behind giving the public the choice between keeping their current insurance plan or choosing a new public health insurance plan. Our lopsided health insurance system enables a few to get rich from insurance profits while millions of uninsured families cannot afford to take their children for regular visits to the doctor or dentist. Giving families the option of a public health insurance plan is a uniquely American solution will put the power back into the hands of working families and ensure that doctors and patients are making health care decisions, not insurance companies. And it will provide much-needed competition to big insurance companies, helping to drive down costs for everyone. READ THE FULL RESPONSE HERE.

Celinda Lake, President of Lake Research Partners, said:

Absolutely. 73 percent of americans pick the choice of a public or private insurance plan over just private plans or just a public health insurance plans. That includes 63 percent of Republicans. It will provide competition to keep costs down and help ensure that everyone has access to quality, affordable health care. You do have to wonder if insurance companies are so good and competitive what they are afraid of.

Chuck Donovan, Senior Vice President for Policy and Government Affairs at the Family Research Council, said:

Policy makers on Capitol Hill should resist the temptation to use this summer’s health reform debate to create yet another government-run health care option. The reasons are numerous. While a government option would initially create a new choice for Americans having difficulty obtaining insurance, experience in other countries, as well as here in the United States in places as disparate as Massachusetts, Tennessee and Washington state, has shown that government-managed care will tend to over-attract subscribers, overrun costs, and eventually underfund needed care, leading to rationing of services and even forced removal of people from the program. In the early phases of such an option, people will abandon private health insurance, leading to the demise of at least some private carriers and moving us in the direction
of a public monopoly. READ THE FULL RESPONSE HERE.

Anna Burger, Secretary-Treasurer of the Service Employees International Union, said:

For too long, working Americans have strained their family budgets coping with rising healthcare prices. Today our struggling economy is at risk of being pulled under by the threat of the healthcare system’s collapse. Healthcare reform is not just a moral imperative, but also an economic necessity. In 2007, the U.S. economy lost as much as $207 billion as a result of the poor health and shorter lifespan of the uninsured .Even traditional opponents of healthcare reform have seen the light: Private insurers, business groups and industry heads have sat down with consumer groups, faith leaders, and yes, SEIU, to discuss each of our roles and responsibilities in bringing quality, affordable care to man, woman and child in America.

And yes, President Obama and Congress should and will pass a healthcare bill with a quality affordable public health insurance option. It will be included because as we work together as one nation to restore our economy and rebuild the middle class, hardworking families and our struggling economy need the benefits of a public option. READ THE FULL RESPONSE HERE.

Dr. Jacob Hacker of Campaign For America’s Future, said:

Can Congress pass a health reform bill with a public health insurance option? Absolutely — if our leaders listen to the overwhelming majority of Americans who want to have the choice of a true national public plan available on similar terms throughout the country. Such a plan, offered on a level playing field with private insurance, is vital to providing affordable quality care to all Americans on sustainable terms. By competing with private plans to provide affordable coverage, slow the growth in costs, and upgrade the quality of care, a new public plan for Americans younger than 65 can serve as a backup and a benchmark, creating security and accountability in a troubled economic sector where both are now lacking.

Grover Norquist, President of Americans for Tax Reform, said:

Yes. No.

Herbert London, President of the Hudson Institute, said:

Healthcare reform could pass in the Congress because the President and his party are committed to it. However, government insurance policies will incrementally drive private insurers out of business creating what is ostensibly a single payer system. This kind of overreaching by the president will have one effect: it will democratize medical care and degrade medical quality. The finest medical system the world has known will become marginalized by government bureaucrats who will, in all likelihood, dictate the kind of care a patient will receive.

Jeremy Funk, Communications Director of Americans United for Change, said:

Choice is the key to reforming the health care system and ensuring meaningful choice for consumers means giving people the choice to keep the health insurance they have or join a public health insurance plan. This public health insurance plan will create much-needed competition with private insurers, who currently hold virtual monopolies in many of the markets they serve. This competition will bring down the price of private insurance and make it a real option for consumers who cannot now afford it.

Deepak Bhargava, Executive Director of the Center for Community Change, said:

As lobbyists fight to remove the public plan option from the health care reform debate – every member of Congress should take notice that private insurers are once again fighting against the will and interests of most Americans. They are doing what Wall Street has done for so long and what got us into our present economic mess: putting greed before the public interest.

If Americans wake up after a health care reform bill passes and have no new choices – no public option for their families – they will know that after all the promises of change – it’s still business as usual in Washington.

Larry Sabato, Director of the Center for Politics, said:

As a general rule, everyone prefers good food to bad food. But we can’t agree on what is ‘good’ or ‘bad’. Personal tastes dictate that. Everyone wants a better health care system. The one we have is inefficient, wasteful, and sometimes downright cruel. But everyone has different priorities and preferences. Democrats (and some willing Republicans) will never have a better chance to reform health care, since potentially the votes are there for a big bill, and an eager President has his pen at the ready. As always, though, the further we get from acknowledging the manifestly obvious health care problems and the closer we get to defining the devilishly difficult details of the solutions, the more complex the task becomes. The negotiators must be more flexible and compromise-oriented than they have ever been on a government-run option—and all the alternatives—or the chances for reform will dim once again.

James Gelfand, Senior Manager for Health Policy at the U.S. Chamber, said:

Can a bill pass with a government-run health insurance company included? Maybe. Can a bipartisan bill pass with this “public option”? Definitely not. Democrats would have a hard time holding their own caucus in line on such a policy, much less winning any support across the aisle. It might necessitate going to reconciliation, where health reform would only need 51 votes to pass, but even then, a public option might be stripped out under the Byrd Rule. I would say the crystal ball for possibility of passing a public plan is definitely hazy.

As for whether or not a government-run plan SHOULD be enacted, here we can be more definite: the answer is no. If we want to keep insurers honest, we should pass aggressive insurance regulation. If we want to hold down costs, we should implement robust delivery-system and payment reforms. If we want to increase choice and competition, we should build exchanges that work. But if we want to alienate moderates, nationalize 17% of the economy, make government a referee and a team owner at the same time, elevate government control over free markets, and eventually cause people to lose the coverage they have and get stuck with government-run health care, then yes, pass a public option.