Pub­lic op­tion query …

Modern Healthcare - - Opinions Letters -

Three ques­tions for those who may find this at­trac­tive (“Key House lead­ers restart push for pub­lic op­tion,” Mod­ern Health­, July 22):

1. How is this in­creased com­pe­ti­tion? This scheme is clearly set up to drive pri­vate com­pe­ti­tion out of the mar­ket, the re­sult be­ing only the govern­ment op­tion left stand­ing. There are al­ready re­ports of in­sur­ers po­ten­tially go­ing out of busi­ness be­cause of the med­i­cal-loss-ra­tio re­quire­ments. How does fewer plans to choose from in­crease com­pe­ti­tion?

2. Will con­sumers be able to ap­peal rescis­sions and claims de­nials in the pub­lic op­tion? Even if con­sumers can do this with the pub­lic op­tion, who is go­ing to check HHS’ power? And if there are fewer pri­vate choices in the mar­ket, and if HHS de­nies the con­sumer’s request in the name of the “pub­lic good,” where do con­sumers go? Back to what’s left of the pri­vate mar­ket? Back to my first ques­tion about com­pe­ti­tion.

3. Politi­cians, as well as many Amer­i­cans, fail to un­der­stand the dif­fer­ence be­tween “hav­ing in­surance,” i.e., a card in one’s wal­let, and hav­ing “ac­cess to health­care” i.e., abil­ity to see a doc­tor.

There has never been any in­stance in the his­tory of eco­nom­ics where price con­trols have not re­sulted in re­duced sup­ply. In the case of health­care, sup­ply refers to the doc­tors. This pro­posed pub­lic op­tion, as well as the cur­rent Medi­care and Med­i­caid pro­grams, are ef­fec­tively im­ple­ment­ing price con­trols.

Here are a cou­ple of ob­vi­ous re­sults. First, doc­tors will—and do—refuse pub­lic op­tion/Medi­care/Med­i­caid pa­tients for the sim­ple rea­son that they lose money on these pa­tients. This re­duces ac­cess to health­care.

This is not rocket sci­ence nor is there any cred­i­ble dis­pute to this eco­nomic re­al­ity. Eco­nomic his­tory has shown time and time again that the best way to al­lo­cate re­sources—in this case health­care—and to in­crease the re­sources to be al­lo­cated (doc­tors and hos­pi­tals) is to en­able in­di­vid­u­als to make de­ci­sions that best suit their needs, not a dis­tant bu­reau­crat. This is the fun­da­men­tal dif­fer­ence be­tween a man­aged so­cial­ist econ­omy and a free-mar­ket econ­omy. Ryan Hovey Minneapolis

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