Public Option Will Complement, Not Compete By: Mark W Adams

Do we want insurance or medical treatment for what ails us?  Insurance is only a means to an end.  Health care is what we want.

As the debacle of AIG, the world's largest insurance company (until last fall), so graphically illustrated -- insurance companies are big evil blood-sucking vampires.

No, really. I'm sure I saw that somewhere. 

They place bets on the likelihood of us encountering misfortune and like any bookie takes it's cut whether we win or lose.  They've made so much money on our suffering, and often denying us the coverage we thought we paid for, they can afford to buy themselves a Congress.

Enough. 

The original idea of insurance was to spread the cost of tragedy over as many people as possible so whatever harm befalls one of us can be mitigated by spreading the hurt so far and wide that it's barely noticeable to society at large -- and society benefits by bringing an otherwise productive member who no longer can contribute back to wellness and helping us all move forward.

Our entire tort system is based in large part on this idea, spreading the cost associated with calamity, reducing the risk of doing business far and wide because we are more than the sum of our parts.  We're better together than apart.  Respondeat Superior, agency, vicarious liability, product liability, and the very concept of a corporation are all legal doctrines ingrained in our law that express this idea -- that we cannot as a society rely on the law of the jungle and be considered civilized.  Risk must be spread so no one person alone bears the full weight of failure and injury lest nothing be done for fear of unbearable consequences.

Specifically, when it comes to health care, it's bad enough that the cost of medicine and medical procedures have gone through the roof, but to tolerate the vampires who feed off the system and give nothing of value back is unacceptable.  Having a public option will do more to keep them honest than any regulation.  Those that can't compete were cheating anyway.  They were running a care denial company and not acting as a health care provider should.

Doctors should be paid, and paid well.  Nurses and technical staff too.  When looking at the system with an eye towards what benefits society, we all are better off if the best and the brightest find it financially and emotionally attractive to enter the medical field if so inclined.  I want the best people there and you get what you pay for.  I want state of the art advanced facilities and equipment which ought to cost a lot too.  And I want everyone to have access to all that.

So you spread the cost.  All of us spend some so that we can all enjoy the benefits of a wellness system of the highest caliber.  If your Congressional Representative balks at the very idea that a publicly funded health care provider is unacceptable for some sort of ideological reason, you have the right to wonder what is wrong with the government run health plan they use.

I have to admit, the long debate over what form our health system revolution should take over the last couple of years has dented my resolve that single payer is the only way to go and/or a public plan is at least a good start towards running the private insurance companies out of business if not a complete dismantling the for-profit model.

The best argument, to me, for resisting socialized medicine is in the area of research and developments.  Private enterprise simply is the fastest and often most effective route to innovation.  Pharmaceuticals especially illustrate the greed-is-good effect, Viagra being one of the most stunning examples.  Simultaneously it shows how market forces can advance discovery and success, and at the same time proves the market has whacked out priorities and is devoid of social conscience.  If there were a market for an AIDS cure as lucrative as that for male-pattern baldness, HIV would be a memory.

So there's good and bad in the market-based approach to medical R&D. The market indeed works, and works well.  Yet it doesn't necessarily work for the greatest good.  There is no "invisible hand" when it comes to our well being.

So, which way to go?  Should we scrap the whole for-profit system or at least pour our energies into creating a competing public system designed to eventually destroy private health insurance -- or accept at face value that a public system really is a benign competitor filling a societal need and not something more sinister.

We already have an example of a system that uses public institutions and private enterprises that both compete and complement each other in a uniquely American way.  Bumbling and stumbling but always chugging forward -- Education.  America higher education exploits both a  market-driven environment and public finance in the form of assistance to students in private and public institutions, as well as universities that are wholly manufactured creatures of government. 

Which would you get rid of?  Would you rather have only Harvards and Yales or do away with those hoity-toity schools in favor of funding Ohio State or Michigan University?  Of course we do neither and accept that the Ivy League Schools are the envy of the world -- but cannot boast anywhere near the volume of citizens who recieve excellent educations at State run universities throughout the land -- most of whom rooted for way better football teams than the Ivy League had in over a century. 

The Big Ten pretty much doomed decent football in the Ivy League (apologies to Doug Flutie and Fran Tarkenton), but these public universities, big as they are, in no way threatened to undermine the existence of the private colleges who still keep going despite costing double, triple or more than their public counterparts.

Don't knock the football factories, which not only pay for all the other athletic programs but earn a lot of their graduates millions as pros -- the only measure so many conservatives who deplore public anything recognize as the meaning of success.  Next time a Republican insists that anything the government runs turns to crap, ask him or her which NBA team drafted the starting point guard from Princeton. 

It is relevant if making cash is what counts.  If it's about educating as many people as possible to make the country more productive, where would we be if we relied solely on private colleges?  Not the leader of the free world, that's for certain, since the vast majority of our population would be embarrassingly undereducated.

We spread the benefits of a world class American education far and wide through both public and private systems which both fill complementary instead of competing market and social needs.  They work side by side and I wouldn't eliminate either.  Having both a public and private educational system spreads knowledge and wealth.  Now it's time to spread the health.