On health reform, don’t think small

Pity the poor insurance companies.

To hear state Republicans say it, they just can’t catch a break. Were a Democratic plan for a health insurance public option to be enacted, it would “operate on an uneven playing field in which taxpayer dollars can be tapped at any time to backfill the government program losses,” the Senate minority leader says.

The idea of a public option has been tossed around for at least a decade, when a version of it was included as part of the Affordable Care Act. It was stripped out late in the process to ensure passage, but the idea was a sound one. It’s a government- run alternative to private plans that aims to force, through competition, better plans for everyone, with lower costs and more favorable outcomes.

When Democrats lost Congress in 2010, the public option died, too. But it was revived in Connecticut by Comptroller Kevin Lembo, and now looks to be a top priority for expanded Democratic majorities in Hartford. The opinion of the governor — who, despite being a Democrat, emerged as a major obstacle to the proposal before the COVID shutdown — remains to be seen.

But it’s worth trying for the simple reason that the health care system remains a nightmare 10 years after reform passed. Much more is needed, and a public option is a good first step. It would open up a quality insurance plan to people who can’t afford it, and give people more peace of mind who are otherwise tied to employer plans. No one should have to stay in a job they hate because they can’t afford to give up their benefits.

The main opposing argument is that insurance companies don’t like it, and since the state economy is so dependent on the insurance industry — less so than we used to be, though we’re still talking tens of thousands of jobs — then we have to listen when they complain. We don’t want all those jobs moving to Texas. That was enough to earn Ned Lamont’s opposition last time around.

Hence the complaint that a public option would be unfair to those companies. If the government can simply make up deficits with taxpayer dollars, that would put the

Aetnas of the world in an untenable position. They might even have to cut into their profits to compete with the state, and surely no one wants that.

This point of view ignores the untenable position so many people already find themselves in as a result of the current system. Jobs lost in the insurance industry are of course a concern, all the more in a state with such tepid job growth. But while there are other jobs that can be found, there is often no helping someone who has their life turned upside down by a medical emergency that turns into lasting financial trauma.

We already have many systems that rely on taxpayer dollars to cover individual needs, including in health care. But if you don’t clear a certain age or fall below a certain income level, you’re basically out of luck. There’s no reason other than difficult politics why we couldn’t change that equation. We could come up with a system where everyone is covered for the basics and call it, say, “Medicare for the Masses,” or “Medicare for Most Everyone.” Something catchier, maybe.

Health care reforms fail when they don’t go far enough, not when they do too much. Obamacare could have been much better with policies that were proposed but didn’t get enacted over the objection of moderates — for instance, Joe Lieberman singlehandedly torpedoed a plan to lower the Medicare eligibility age to 55, something his critics rightfully have never forgiven him for.

State Democrats are in a position to make real changes that can affect people’s lives for the better. A public option is that kind of change. They need to make it happen.